Psychological Factors Predicting Outcomes of Conservative Treatment in Frozen Shoulder Patients (Psy-Fs)

Abstract

Frozen shoulder contracture syndrome (FSCS) is characterized by underhand onset, severe shoulder daily and night pain, active and passive range of motion (ROM) limitation, disturbing sleep, and shoulder-related disability. FSCS has a cryptogenetics etiology and is more prevalent in people with diabetes, autoimmune and thyroid disease, with higher prevalence in the age range between 50 and 60. Notably no deal is about higher incidence in people with physically low activity and female sex. Moreover, although some patients report complete symptom recovery, others report residual motion impairments and pain. Research on prognostic factors was applied on FSCS, and Eljabu et colleagues (2016) stated that diabetes, comorbidities, bilateral presentation and onset higher pain and disability are negative prognostic factors that could direct patient to early surgery; however, little is known about the prognostic influence of psychological factors in FSCS patients. On the other hand, in other shoulder pathologies, the presence of psychological factors is well documented, and evidence confirms that some of these features could represent prognostic factors that impact the prognosis. A recent systematic review reported that psychological factors were associated with increased pain perception and decreased function and quality of life at baseline in patients with FSCS, and pain-beliefs seem to be associated with a worst perception of arm function; however, little is known about the prognostic value of such factors in FSCS recovery. Knowing about the presence and the role of all types of prognostic factors is important because they can aid treatment and lifestyle decisions, improving individual risk prediction, providing novel targets for new treatments, and enhancing collaboration between different professionals. This study aims to determine if pain, function, disability, quality of life, ROM and time for recovery were influenced by psychological factors in FSCS patients AIMS primary aim: To determine if decreasing SPADI total > 40 points at 3 months is influenced by psychological factors such as Pain Catastrophizing, Pain Self Efficacy, Depression and Anxiety, Pain Beliefs, Fear Avoidance Beliefs, psychological well-being, Sleep Quality, self-perception of Optimism, Pessimism, motivation in receiving conservative treatment, expectation regarding the success of conservative treatment in patients with FSCS. Secondary aims: To determine if pain, function, disability, quality of life, ROM and time for recovery were influenced by psychological factors as Kinesiophobia, Pain Catastrophization, Pain Self Efficacy, Depression and Anxiety, Pain Beliefs, Fear Avoidance Beliefs, subjective psychological well-being, Sleep Quality, self-perception of Optimism, Pessimism, motivation in conservative treatment, expectation regarding the success of conservative treatment in patients with FSCS at 3 and 6 months follow up. To determine if the scores reported on psychological factors outcome measures will change in the period of interest.