Psychological profiles of patients reporting with musculoskeletal shoulder or elbow pain

Abstract

Background: The Optimal Screening for Prediction of Referral and Outcome-Yellow Flag (OSPRO-YF) is a questionnaire that helps assess multiple psychological domains. The primary purpose of this study was to evaluate the effect of body region (shoulder and elbow) and sex on baseline OSPRO-YF scores. The secondary purpose was to evaluate the association of age on baseline OSPRO-YF scores for both shoulder and elbow patients.

Methods: 242 subjects completed 1) a demographic survey and 2) the 17-item OSPRO-YF. The OSPRO-YF estimates the individual scores of 11 psychological patient-reported outcome measures. To assess the effects of body region and sex on the OSPRO-YF, 1 multivariate generalized linear model was conducted. To assess the association of age on the OSPRO-YF, 11 simple linear regressions were conducted for each subscale of the OSPRO-YF.

Results: Patients with elbow pain exhibit higher fear avoidance behavior than those reporting with shoulder pain. Patients with elbow pain also presented with lower self-efficacy with respect to pain and rehabilitation. There was no significant main effect for sex nor was there a significant interaction for body region and sex. When controlling for both sex and BMI within the elbow cohort, age was significantly associated with the Tampa Scale of Kinesiophobia and the State-Trait Anger Expression Inventory.

Conclusion: Patients reporting with elbow pain seem to experience psychological barriers. By establishing psychological awareness in clinical settings, providers will be able to provide a patient-specific plan of care that accounts for these barriers.

Keywords: Fear avoidance; Musculoskeletal elbow; Musculoskeletal shoulder; Negative mood; OSPRO-YF; Positive affect; Psychological distress; Upper extremity.

Figure 1

Flowchart of screened, excluded, and included subjects. OSPRO-YF, Optimal Screening for Prediction of Referral and Outcome-Yellow Flag.