Influence of Fear-Avoidance Beliefs on Disability in Patients With Subacromial Shoulder Pain in Primary Care: A Secondary Analysis

Abstract

Fear-avoidance beliefs contribute significantly to baseline disability but not to disability change scores after 3-month follow-up. Duration of complaints and baseline disability were the main factors influencing disability change scores. Although the results help to improve understanding of the role of fear-avoidance beliefs, further studies are needed to fully understand the influence of psychological and clinical factors on the development of disability in patients with subacromial shoulder pain.

Association of psychological variables and outcome in tendinopathy: a systematic review

“…The most frequently used study design was cross-sectional (n=5) 29 32 35 36 38. Other study designs were case–control (n=1),34 case series (n=1),37 RCT (n=1)31 and cohort (n=2) 30 33…”

“…The mean age of the participants was 48.8 years, ranging from 1836 to 82 years 33. Six studies included participants with LE,29–31 33–35 two studies included participants with RT,32 36 one study included participants with AT37 and one study included participants with PT 38…”

“…One high-quality study investigating RT supported a statistically significant positive association of the presence of catastrophisation and tendinopathy at baseline 32. The other study investigating LE was also of high quality and showed a statistically significant positive relationship between a reduction in catastrophisation and a reduction in the need for additional treatment 33…”

“…Three studies investigated the association of fear-avoidance and tendinopathy 29 32 37. One high-quality study investigating LE demonstrated no statistically significant association between kinesiophobia and tendinopathy 29.…”

Patellar and Achilles tendinopathies are predominantly peripheral pain states: a blinded case control study of somatosensory and psychological profiles

“…In LE, some studies have reported higher levels of anxiety and depression,20 21 whereas others have not 9 10. Pain and disability of shoulder impingement are associated with pain catastrophisation and kinesiophobia 22. Investigating lower limb tendinopathies, no association between anxiety, depression and PT was found, whereas there is a negative effect of kinesiophobia on the recovery from physical work of heel rise  in AT 12 23…”