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Early Self-Efficacy Predicts Short- and Long-Term Pain and Functional Outcomes Following Surgically Treated Lower
Joshua J Van Wyngaarden1, Brian Noehren2, Curtis Auterson1
1Army-Baylor University, Doctoral Program of Physical Therapy, Baylor University, San Antonio, TX.
Archives of Physical Medicine and Rehabilitation
|June 20, 2026
Summary
Early pain catastrophizing and self-efficacy predict recovery from lower extremity fractures (LEF). Pain self-efficacy showed the strongest, most consistent association with pain and physical function outcomes over 24 months.
Area of Science:
- Orthopedics
- Psychology
- Rehabilitation Medicine
Background:
- Lower extremity fractures (LEF) significantly impact patient recovery and quality of life.
- Psychosocial factors are increasingly recognized as crucial determinants of long-term outcomes following traumatic injuries.
Purpose of the Study:
- To identify early psychosocial predictors of pain severity, pain interference, physical function, and chronic pain development after LEF.
- To determine the most influential psychosocial measures for predicting recovery trajectories in LEF patients.
Main Methods:
- A prospective cohort study involving 240 adult patients with acute lower extremity fractures.
- Patients completed psychosocial questionnaires six weeks post-surgery, with longitudinal assessments of pain and function up to 24 months.
- Hierarchical regression analyses were used to evaluate the predictive power of early psychosocial factors.
Main Results:
- Pain catastrophizing was linked to pain interference throughout the 24-month recovery period.
- Self-efficacy was associated with pain interference, physical function, and chronic pain at multiple time points.
- Self-efficacy demonstrated the most consistent association with physical function and chronic pain outcomes.
Conclusions:
- Early psychosocial factors, particularly pain catastrophizing and self-efficacy, are associated with pain and disability outcomes post-LEF.
- Pain self-efficacy emerged as the most consistent predictor of pain and functional recovery.
- Assessing early self-efficacy may offer valuable prognostic insights for patients recovering from lower extremity fractures.
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