Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis

Lynn Leemans; Jo Nijs; Luna Antonis; Timothy H Wideman; Hester den Bandt; Zoe Franklin; Patrick Mullie; Maarten Moens; Erika Joos; David Beckwée

doi:10.1016/j.bjpt.2022.100453

Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis

Braz J Phys Ther. 2022 Nov-Dec;26(6):100453. doi: 10.1016/j.bjpt.2022.100453. Epub 2022 Oct 17.

Authors

Lynn Leemans¹, Jo Nijs², Luna Antonis³, Timothy H Wideman⁴, Hester den Bandt⁵, Zoe Franklin⁶, Patrick Mullie⁷, Maarten Moens⁸, Erika Joos⁹, David Beckwée¹⁰

Affiliations

¹ Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: Lynn.Leemans@vub.be.
² Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Belgium; Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
³ Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium.
⁴ School of Physical and Occupational Therapy, McGill University, Canada.
⁵ Pain in Motion International Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Therapy, University of Applied Sciences Rotterdam, Rotterdam, the Netherlands.
⁶ Department of Sport and Exercise Sciences, Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom.
⁷ Department of Movement and Sport Sciences, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Belgian Defense, COS Well-Being, Queen Elisabeth Barracks, Evere, Belgium.
⁸ Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium.
⁹ Physical Medicine & Rehabilitation Department, UZ Brussel, Brussels, Belgium.
¹⁰ Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Department Rehabilitation Sciences and Physical Therapy | Research Group MOVANT, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.

Abstract

Background: A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychological factors being suggested. Whether or not to include these factors in the assessment of movement-evoked pain has not yet been determined.

Objectives: The aim of this systematic review is to explore the association between psychological factors and movement-evoked pain scores in people with musculoskeletal pain.

Methods: For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transformations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Results: Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain.

Conclusions: Movement-evoked pain is weakly to moderately associated to depressive symptoms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.

Keywords: Meta-analysis; Movement-evoked pain; Musculoskeletal pain; Psychological factors; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Adult
Cross-Sectional Studies
Humans
Longitudinal Studies
Musculoskeletal Pain*
Phobic Disorders*
United States

Supplementary concepts

Phobia, Specific