REVIEW  PSYCHOLOGY 

The Journal of Sports Medicine and Physical Fitness 2023 April;63(4):598-607

DOI: 10.23736/S0022-4707.22.14319-7

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Depression, fear of re-injury and kinesiophobia resulted in worse pain, quality of life, function and level of return to sport in patients with shoulder instability: a systematic review

Fabrizio BRINDISINO ¹, Fabiola GARZONIO ¹ ✉, Giovanni DI GIACOMO ², Raffaello PELLEGRINO ³, Margie OLDS ⁴, Diego RISTORI ⁵

¹ Department of Medicine and Health Science, University of Molise, Campobasso, Italy; ² Department of Orthopedic and Trauma Surgery, Concordia Hospital for Special Surgery, Rome, Italy; ³ Antalgic Mini-invasive and Rehab-Outpatients Unit, Department of Medicine and Science of Aging, G. D’Annunzio University, Chieti-Pescara, Chieti, Italy; ⁴ Flawless Motion, Auckland, New Zealand; ⁵ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy

INTRODUCTION: Maladaptive psychological responses may hinder participation and return to pre-injury level in sport.
The aim of this study was to investigate the psychological factors influence on pain, function, quality of life and time to return to sport in subjects with shoulder instability.
EVIDENCE ACQUISITION: The research was conducted until the 15^th of May 2022 in MEDLINE, CENTRAL, PEDro, and PubPSYCH regardless language, publication status or date. We included adults (≥16 years old) with shoulder instability. Quality assessment was performed using Joanna Briggs Institute Critical Appraisal tools.
EVIDENCE SYNTHESIS: Three papers, 270 participants, met the inclusion criteria. Subjects with preoperative depression demonstrated worse 1-year postoperative shoulder-related quality of life score than the cohort without depression. Shoulder function had a weak negative correlation with depression. Pain intensity and depression showed a positive correlation of moderate strength. Fear of re-injury correlated with SPADI total, pain and function; moreover, it increased the likelihood of recurrent dislocation in multivariate analysis. Kinesiophobia at baseline correlated with WOSI.
CONCLUSIONS: Depression, fear of re-injury and kinesiophobia correlate with pain, function, quality of life and return to sport in people with shoulder instability. We recommend a multi-professional approach to integrate the psychological standpoint in rehabilitation treatment to maximize quality of life and function in subjects with instability.

KEY WORDS: Shoulder; Joint instability; Psychology; Depression