title: Kinesiophobia and physical therapy-related pain in musculoskeletal pain: A national multicenter cohort study on patients and their general physicians.
abstract: Physical therapy (PT) represents a major approach in musculoskeletal (MSK) pain. This study aimed to assess kinesiophobia, its impact and management, in patients with MSK pain treated by PT.
  
  
  
  A national multicenter, prospective study was conducted in France in patients with MSK pain referred to PT. Kinesiophobia was scored with the Tampa Scale of Kinesiophobia (TSK). Pain, satisfaction, analgesic intake and acceptability were assessed at the initial visit, at the 5th PT session, and at the end of PT.
  
  
  
  A total of 700 consecutive outpatients with MSK pain, 54.5% female, referred to PT were recruited by 186 GPs: 501 had significant levels of kinesiophobia (TSK score>40). Patients with kinesiophobia were significantly older, with less physical activity, more pain and less acceptability. Patients from GPs presenting with kinesiophobia had both higher pain and kinesiophobia levels. After 5 PT sessions, global satisfaction was significantly higher in patients without kinesiophobia. A significant increase of PT satisfaction was observed in patients who had been given preventive analgesics before PT sessions, in 25.6% of patients. Independent predictors for specific management of PT-induced pain were: patient's kinesiophobia (OR=2.02 [1.07-3.82]), current analgesics treatment (OR=2.05 [1.16-3.63]), GP with postgraduate course on pain (OR=2.65 [1.29-5.43]), GP's independent practice (OR=1.88 [1.01-3.48]).
  
  
  
  Kinesiophobia is frequent in patients with MSK pain, is associated to GPs' kinesiophobia and decreases satisfaction of physical therapy. Preventive analgesic treatment before PT sessions improves patients' satisfaction and should be proposed to improve MSK pain management.
authors.affiliation: Pain center, Hôtel-Dieu and Cochin hospital, Inserm U 987, 75014 Paris, France. Electronic address: serge.perrot@aphp.fr.
authors.forename: Serge
authors.initials: S
authors.lastname: Perrot
authors.affiliation: Pain center, Hôtel-Dieu and Cochin hospital, Inserm U 987, 75014 Paris, France.
authors.forename: Anne-Priscille
authors.initials: AP
authors.lastname: Trouvin
authors.affiliation: Inserm U897, 33000 Bordeaux, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Rondeau
authors.affiliation: Aixial-Pharma, 92300 Levallois-Perret, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chartier
authors.affiliation: Bristol-Myers Squibb, 92500 Rueil-Malmaison, France.
authors.forename: Rosine
authors.initials: R
authors.lastname: Arnaud
authors.affiliation: Bristol-Myers Squibb, 92500 Rueil-Malmaison, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Milon
authors.affiliation: Department of general practice, François-Rabelais university, 37000 Tours, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Pouchain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D058005:General Practitioners; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D059352:Musculoskeletal Pain / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D017060:Patient Satisfaction; D010698:Phobic Disorders / Q000453:epidemiology / Q000209:etiology*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Kinesiophobia; Musculoskeletal pain; Pain; Physical therapy