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Determinants of disability after proximal interphalangeal joint sprain or dislocation
Arjan G J Bot1, Stijn Bekkers1, James H Herndon1
1Massachusetts General Hospital, Boston, MA.
Psychosomatics
|July 19, 2014
Summary
Pain self-efficacy, or confidence in managing pain, is crucial for recovery after proximal interphalangeal joint injuries. Higher pain self-efficacy correlates with less disability, pain, and stiffness, aiding rehabilitation.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Psychology
Background:
- Proximal interphalangeal joint (PIPJ) sprains/dislocations have excellent prognoses but recovery can be hindered by pain-induced protectiveness.
- This protectiveness often impedes essential stretching exercises, complicating the rehabilitation process.
Purpose of the Study:
- To investigate the relationship between upper limb disability and pain self-efficacy in patients with PIPJ injuries.
- To identify factors influencing recovery outcomes following PIPJ sprains and dislocations.
Main Methods:
- A prospective study enrolled 82 patients (54 male, 28 female) post-PIPJ injury.
- Data collected included finger motion, upper limb disability (DASH questionnaire), depression (PHQ-9), pain self-efficacy (Pain Self-Efficacy Questionnaire), and pain intensity.
- Patients were enrolled an average of 48 days after injury.
Main Results:
- Lower pain self-efficacy, increased depressive symptoms, and female gender were associated with greater disability.
- Pain self-efficacy was the strongest predictor of increased pain intensity and finger stiffness.
- Depression and gender also significantly impacted disability levels.
Conclusions:
- Effective coping strategies, particularly high pain self-efficacy, are vital for improving recovery outcomes.
- Enhancing self-efficacy can lead to reduced disability, pain, and stiffness after PIPJ injuries.
- Interventions targeting psychological factors like self-efficacy may optimize rehabilitation for PIPJ injuries.
