Psychological, Pain, and Disability Factors Influencing the Perception of Improvement/Recovery from Physiotherapy in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional Study

Abstract

Objectives: The aim of this study was to identify the possible relationships between psychological, pain, and disability variables with respect to the perception of change/recovery from physiotherapy in patients with chronic musculoskeletal pain (CMP). Methods: A cross-sectional observational study was performed with 150 patients. All patients completed a series of self-administered questionnaires and a series of self-reports to quantify the perception of change with respect to the physiotherapy they underwent, the level of disability and pain intensity, the level of fear of movement, the level of catastrophism, the degree of self-efficacy, the level of therapeutic alliance and their adherence to the physiotherapy. Results: The strongest correlations were between the subjective perception of change and the number of sessions, treatment beliefs, self-efficacy, pain intensity, collaboration, and bonding. The linear regression model showed that the number of sessions, treatment beliefs, self-efficacy, compliance, pain intensity, and bonding were predictors of subjective perception of improvement, with 50% of the variance. Conclusions: Treatment beliefs, therapeutic alliance, degree of self-efficacy, and pain intensity have been shown to be predictors of a subjective perception of improvement in patients with CMP. In turn, multimodal treatments had the greatest positive impact on the subjective perception of improvement.

Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy

“…Such an integrative perspective considers not only the practitioner’s expertise and techniques but also patient expectations, verbal suggestions, narratives about body representations and interpretations of symptoms, the strength of the therapeutic alliance, and treatment settings that can evoke biological and psychological responses [ 54 ]. These factors influence clinical outcomes via placebo and nocebo effects [ 54 ] and, in turn, contribute to improved outcomes across various areas including pain management, disability, and patient satisfaction [ 56 , 57 , 58 ]. Such a contemporary, humanistic, and holistic perspective within the field of health sciences emphasizes the importance of practitioners simultaneously addressing the biological, psychological, and social dimensions of illness, aiming to enhance their understanding and responsiveness to patients’ suffering.…”