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Background/Objectives: There is emerging evidence that task-specific pain-related psychological measures may better predict movement behaviour in chronic low back pain (CLBP) than general pain-related psychological measures. Currently, little is known regarding the prediction of movement duration and movement velocity. Methods: Baseline data from a previously published randomized controlled trial were used (clinicaltrials.gov NCT02773160). Fifty-five patients with CLBP and 54 pain-free persons performed a lifting task while kinematic measurements were obtained to calculate movement velocity of the L1 vertebra, S1 vertebra, and the lumbar spine, as well as the time to complete the lifting task. Scores on the Photograph Daily Activities Series-Short Electronic Version (PHODA-SeV), Tampa Scale for Kinesiophobia (TSK), and its Activity Avoidance and Somatic Focus subscales were used as general pain-related psychological measures. The score on a picture of the PHODA-SeV, showing a person lifting an object with a bent back (PHODA-Lift), was used as task-specific measure of perceived harmfulness. Results: The task-specific measure best predicted movement duration and movement velocity of L1 and the lumbar spine, and explained 35%, 19%, and 25% of the respective movement parameters. Although general perceived harmfulness predicted S1 velocity and movement duration, it only explained 6% and 8% of the respective movement parameters. General measures of pain-related fear were not predictive for any of the movement parameters. It took patients with CLBP significantly longer to complete the lifting task when compared to the pain-free participants (ES = 1.01, p < 0.0001), and patients with CLBP also moved significantly slower at L1 (ES = 0.85, p < 0.0001) and the lumbar spine (ES = 1.01, p < 0.0001). These between-groups differences were larger for CLBP subgroups with higher scores on the PHODA-Lift, and to some extent for subgroups with higher total scores on the PHODA-SeV. Conclusions: Task-specific perceived harmfulness best predicts movement velocity. General pain-related fear measures (i.e., TSK and its subscales) do not predict these movement parameters. [ABSTRACT FROM AUTHOR]

The Fear-Avoidance Components Scale (FACS) is a recently developed patient-reported instrument assessing different constructs related to the fear-avoidance model of pain. The aim was to translate the original English FACS into Dutch (FACS-D) and assess its measurement properties in persons with chronic musculoskeletal pain. The original English FACS (20 item-scale, range: 0–100) was translated in Dutch through standard forward-backward translation methodology. The FACS-D's measurement properties were evaluated in 224 persons with chronic musculoskeletal pain. Internal consistency, test-retest reliability and measurement error were assessed with the Cronbach's alpha coefficient (α), intraclass correlation coefficient (ICC), and standard error of measurement (SEM). Construct validity was assessed through inter-item correlation analyses, exploratory factor analysis, association with other fear-avoidance-related constructs, and hypothesis testing. Internal consistency, test-retest reliability and hypotheses testing were good (α=0.92; ICC=0.92, CI 0.80–0.96; 7/8 hypotheses confirmed). Similar to the original FACS and other translated versions, a two-factor model best fit the data. However, the item distribution differed from other versions. One factor represented "pain-related cognitions and emotions" and a second factor represented "avoidance behaviour." In contrast to the original FACS, low inter-item correlations for item 12 were found. The FACS-D was more strongly associated with fear-avoidance-related constructs of pain severity, perceived disability, feelings of injustice, and depressive/anxiety symptoms than the other fear-avoidance-related scales studied here. The FACS-D demonstrated good reliability and construct validity, suggesting that it may be a useful measure for Dutch-speaking healthcare providers. Two clinically relevant factors, with a different item distribution than the original FACS, were identified: one covering items on pain-related cognitions and emotions, and one covering items on avoidance behaviour. The stronger association between FACS-D and fear-avoidance related constructs suggests that the FACS-D may be more effective in evaluating the cognitive, emotional and behavioural constructs of pain-related fear-avoidance than other similar measures. [ABSTRACT FROM AUTHOR]

Upper limb (UL) function is one of the health outcomes that matters the most for women with breast cancer. However, a better understanding of the factors contributing to UL dysfunctions in the late stage after breast cancer surgery is needed. This study explores associations between impairment-related and cognition-related factors and UL function in women with pain and myofascial dysfunctions at the affected UL region in this late stage after breast cancer surgery. In forty-one women, UL function (dependent variable) was evaluated by the Disabilities of Arm, Shoulder and Hand questionnaire. As independent impairment-related factors, relative excessive arm volume (perimetry), pain intensity (maximum score on the visual analogue scale past week) and humerothoracic elevation and scapular lateral rotation (kinematic analysis) were assessed. As independent cognition-related factors, pain catastrophizing (Pain Catastrophizing Scale) and pain hypervigilance (Pain Vigilance and Awareness Questionnaire) were evaluated. Bi-variable analyses and a stepwise regression analysis were used to explore associations. A higher pain intensity (r = 0.52; p < 0.001), more pain catastrophizing (r = 0.49; p < 0.001) and more pain hypervigilance (r = 0.40; p = 0.01) were related to more UL dysfunction. Pain intensity (p = 0.029) and pain catastrophizing (p = 0.027) explained furthermore 29.9% of variance in UL function. Pain intensity and cognition-related factors are significantly associated with UL function in women with pain and myofascial dysfunctions, indicating the need of assessing pain beliefs in women in the late stage after breast cancer surgery. Pain intensity and pain-related beliefs, including pain attention and catastrophizing, are related to the severity of upper limb dysfunctions in the late stage after breast cancer surgery. Impairments such as lymphedema and movement restrictions seem not related to upper limb function in the assessed sample. To understand upper limb dysfunctions in the late stage after breast cancer, assessing pain beliefs is needed. [ABSTRACT FROM AUTHOR]

To investigate the variables per International Classification of Functioning, Disability and Health (ICF)-domain that are associated with upper limb (UL) function in women after breast cancer surgery. PubMed and Web of Science were searched until 7 January 2020. Eligibility criteria were: prospective investigation of an association between one or more variables of the ICF model and UL function in women after breast cancer surgery. PRISMA guidelines were used to conduct and report the systematic review. The Quality In Prognosis Studies tool (QUIPS) was used to evaluate risk of bias. Twelve studies were included (2244 participants). Risk of bias of the included studies was low to moderate. Variables at the ICF-function level that were systematically associated with decreased UL function across multiple included papers were: increased UL pain, decreased shoulder range of motion, decreased handgrip strength and a higher number of comorbidities. Results on the association between UL function and variables at other ICF-domains were conflicting. UL function was associated with certain variables at the ICF-function level. Variability in disease stages, treatment and measurement methods might explain inconsistent associations with other variables. Only limited studies investigated associations between UL function and psychosocial factors. This paper gives an overview of associations between different variables of the ICF model and UL dysfunctions in women after breast cancer surgery. Identified associated factors are situated at the ICF function level, i.e., UL pain, decreased handgrip strength and shoulder (abduction) ROM. These factors are modifiable and should be monitored, prevented and treated in physical therapy practice. UL dysfunction is not consistently associated with treatment-related variables. The role of psychosocial personal factors in UL dysfunctions should be considered and further explored. [ABSTRACT FROM AUTHOR]