Changes in Pain-Related Fear Predict Shoulder Disability in Rotator Cuff Tendinopathy With Resistance Exercise

Area of Science:

• Orthopedics
• Physical Therapy
• Rehabilitation Science

Background:

• Rotator cuff tendinopathy often involves psychological factors like pain-related fear and catastrophizing.
• Understanding the trajectory of these factors during treatment is crucial for effective rehabilitation.

Purpose of the Study:

• To examine changes in pain-related fear and catastrophizing during an 8-week resistance exercise program for rotator cuff tendinopathy.
• To compare these changes between treatment satisfaction groups.
• To investigate the relationship between fear/catastrophizing trajectories and shoulder disability.

Main Methods:

• A prospective longitudinal observational study involving 64 participants with rotator cuff tendinopathy.
• Pain-related fear and catastrophizing (OSPRO-YF) and shoulder disability (Penn Shoulder Score) were assessed at baseline and weeks 2, 4, and 8.
• Treatment satisfaction was defined by Patient Acceptable Symptom State (PASS) at 8 weeks.

Main Results:

• Pain-related fear and catastrophizing measures significantly changed over time (P < .01).
• Non-responders (dissatisfied) showed increased or less decreased fear/catastrophizing scores (e.g., FABQ-W: +0.63 pts, TSK-11: -0.1 pts) compared to responders (P = .02, P = .03).
• Reduced shoulder disability correlated with lower pain-related fear and catastrophizing, particularly in responders (P < .04).

Conclusions:

• Pain-related fear and catastrophizing evolve during resistance exercise for rotator cuff tendinopathy.
• Treatment satisfaction is linked to greater reductions in fear and catastrophizing.
• Lower pain-related fear and catastrophizing are associated with decreased shoulder disability, highlighting the importance of addressing psychological factors in rehabilitation.