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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):936-43

DOI: 10.23736/S1973-9087.17.04608-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

The influence of expectations on improvements in pain and function in patients with neck/back/shoulder complaints: a cohort study

Sigrid SKATTEBOE 1, 2 , Cecilie RØE 1, 2, Morten W. FAGERLAND 3, Lars-Petter GRANAN 4

1 Deparment of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; 2 Faculty of Medicine, University of Oslo, Oslo, Norway; 3 Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway; 4 Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway


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BACKGROUND: In musculoskeletal research, patients’ expectations have recently received increased attention. However, few prospective studies have investigated these expectations or their prognostic significance and possible clinical value.
AIM: To investigate the influence of patients’ expectations on improvements in pain and functional status six months after an outpatient physical medicine assessment.
DESIGN: Prospective cohort study.
SETTING: Physical Medicine and Rehabilitation (PMR) outpatient clinic.
POPULATION: Patients with neck, back, or shoulder complaints.
METHODS: Pain, during rest and activity, and functional status (PainFunction) were assessed using numerical rating scales (NRSs; 0 to 11) prior to a PMR consultation and after six months. At baseline, the patients were asked to define their expectations (Exp) regarding pain and functional status at six months using equivalent NRSs. The influence of Exp on PainFunction at six months was assessed through multiple regression analysis, controlling for demographic factors.
RESULTS: A total of 256 patients were included between January and June 2013, and 181 were followed up at six months. PainFunction improved statistically significant between baseline and six months (P<0.001). Approximately 40% of the patients expected (Exp) an improvement, while 29% reported an improvement at six months, reflected by a minimum of two points improvement in PainFunction. The regression analysis revealed that sick leave and the number of pain sites, but not expectations (Exp), influenced improvement in PainFunction at six months.
CONCLUSIONS: The present study does not support the suggested influence of expectations on pain and functional improvement in patients with neck, back or shoulder complaints.
CLINICAL REHABILITATION IMPACT: The patients’ expectations were more positive than their actual pain and functional improvements. However, their expectations did not significantly influence the study outcomes.


KEY WORDS: Back pain - Neck pain - Shoulder pain - Musculoskeletal pain - Treatment outcome - Physical and rehabilitation medicine

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Publication History

Issue published online: December 12, 2017
Article first published online: May 23, 2017
Manuscript accepted: May 23, 2017
Manuscript revised: May 2, 2017
Manuscript received: December 12, 2016

Per citare questo articolo

Skatteboe S, Røe C, Fagerland MW, Granan LP. The influence of expectations on improvements in pain and function in patients with neck/back/shoulder complaints: a cohort study. Eur J Phys Rehabil Med 2017;53:936-43. DOI: 10.23736/S1973-9087.17.04608-1

Corresponding author e-mail

sjskatte@medisin.uio.no