title: A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important.
abstract: BACKGROUND
  Tailored treatments are topical in pain rehabilitation. One key issue for correlational studies is the identification of factors having a potential causal impact on essential treatment outcomes.
  
  
  OBJECTIVE
  To study associations between pain beliefs and disability with regard to the amount and time-frame of available data.
  
  
  METHODS
  A prospective, correlational design.
  
  
  METHODS
  Ninety-two patients consulting physical therapists in primary care for persistent musculoskeletal pain.
  
  
  METHODS
  The Pain Disability Index, the Self-Efficacy Scale and the Tampa Scale of Kinesiophobia.
  
  
  RESULTS
  Functional self-efficacy and fear of movement/(re)injury explained variance in pain-related disability pretreatment (adj R(2) = 0.41). Self-efficacy was the most salient predictor. Adding data from immediately post treatment decreased explained variance (adj R(2) = 0.25). Functional self-efficacy and fear of movement/ (re)injury lost their significant contribution in favour of pain-related disability at baseline. Change scores in functional self-efficacy and fear of movement/(re)injury accounted for a modest share of explained variance in change scores of disability (adj R(2) = 0.11). Fear of movement/(re)injury but not functional self-efficacy was related to a reliable change in pain-related disability.
  
  
  CONCLUSIONS
  Longitudinal data suggest that pretreatment levels of pain-related disability and changes in fear of movement/(re)injury are most important to immediate treatment outcomes and individual reliable change. Disability and elevated fear of movement/(re)injury should therefore be addressed in tailored pain treatments.
authors.affiliation: Department of Neurosciences, Section of Physiotherapy, Uppsala University. pernilla.asenlof@neuro.uu.se
authors.forename: Pernilla
authors.initials: P
authors.lastname: Asenlöf
authors.forename: Anne
authors.initials: A
authors.lastname: Söderlund
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D001519:Behavior; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000534:rehabilitation*; D010146:Pain / Q000523:psychology / Q000534:rehabilitation*; D010147:Pain Measurement; D011446:Prospective Studies; D020377:Self Efficacy; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome