Severity of Persistent Pain and Disability Can Accurately Screen for Presence of Pain Catastrophizing and Fear of Performing Wrist Movements in Individuals With Distal Radius Fracture Publisher Pubmed



Mahdavi M¹ ; Farzad M^{2, 3} ; Mehta SP^{4, 5} ; Macdermid JC^{6, 7, 8} ; Vahedi M⁹ ; Hosseini SA¹ ; Shafiee E² ; Farhoud AR¹⁰
Source: Musculoskeletal Science and Practice Published:2022

Abstract

Background: The evidence indicating presence of psychological factors concerns in individuals who report persistent residual pain and disability over a longer term after distal radius fractures (DRF) is emerging but requires further inquiry. Objectives: To examine the associations of persistent wrist pain and disability at 6-months after DRF with the presence of psychological factors. Methods: Eighty-five patients with DRF were evaluated for wrist pain and disability with subscales of Patient-rated wrist evaluation (PRWE), 6-months after the fracture. The associations of wrist pain and disability with these psychological factors at 6-months after DRF were examined using multivariable logistic regression models. The ability of PRWE scores at 6-months after DRF to accurately classify individuals with and without these psychological factors was examined using the area under the receiver operating characteristic curve (AUC). Results: Higher PRWE-P scores were significantly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. In addition, higher PRWE-F scores were also highly associated with worse pain catastrophizing, having emotional distress, and fear of performing wrist movements. The PRWE-P or PRWE-F Scores of ≥18/50 showed the best combination of sensitivity and specificity in identifying individuals with pain catastrophizing, emotional distress, and fear of performing wrist movements at 6-months after DRF (AUC values of ≥0.88). Conclusion: The novel finding of this study is that scores of ≥18/50 PRWE-P or PRWEF can be used to screen for the presence of these psychological factors. © 2021 Elsevier Ltd