Objectives: To investigate how socio-demographic and clinical factors were associated with psychosocial functioning and disability at admission and at a 1-year follow-up.
Design:A cohort pre-post study.Setting: A University hospital specialized pain rehabilitation unit.Participants: Five hundred and nine participants with musculoskeletal pain (neck disorders 29%, fibromyalgia 24%, low back pain 24%, myalgia 14% and other pain diagnoses 8%).Intervention: A 5-week outpatient, group-based, and goal-oriented comprehensive musculoskeletal interdisciplinary pain rehabilitation program based on cognitive behavioral principles.
Main outcome measures:The Multidimensional Pain Inventory (MPI), the Disability Rating Index (DRI), and forms including socio-demographic (sex, age, ethnicity, marital status, educational level and vocational situation) and clinical factors (pain duration and pain diagnoses). Data were analyzed with multivariate logistic regression.Results: At admission, factors associated with more positive scores on the MPI were being older than 40 years, being at work, being Nordic born, attainment of a higher educational level and a diagnosis of fibromyalgia (compared with a neck disorder) (P < .05). Being at work and a diagnosis of fibromyalgia (compared with low back pain) were associated with more positive scores on the DRI (P < .05). On the basis of cut points for clinically important change on the MPI, participants rated themselves as most improved on the Affective Distress (52%), Life Control (49%) and Pain Severity (43%) subscales, and on the DRI index improvement rate was 22%. At the 1-year follow-up, neither socio-demographic nor clinical factors were associated with clinically important improvements of the MPI and the DRI, but lower age was related to deteriorations on pain severity.3
Conclusions:The lack of an association between socio-demographic and clinical factors and psychosocial functioning and disability at a 1-year follow-up after a musculoskeletal pain rehabilitation program suggests that the program was effective regardless of the participants' initial characteristics, except for age. The changes at the 1-year follow-up indicate that the program influenced the participants' psychosocial functioning more than their perception of disability.