Kinesiophobia, catastrophizing, and the duration of immobilization: a prospective study on factors associated with shoulder disability following wrist-hand injuries

Review written by Dr Ian Gatt info

Key Points

  1. Immobilization time is a strong predictor for shoulder dysfunction after wrist-hand injury.
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BACKGROUND & OBJECTIVE

Shoulder pain and disability are highly prevalent musculoskeletal problems influenced by a host of biological, psychological, and social factors (1,2). However, shoulder pain is not always a primary shoulder pathology and may be due to the immobilization after a distal upper extremity injury (1-5). Increased immobilization after distal radius fracture (DRF) has been associated with increased shoulder pain and a need for further shoulder rehabilitation (6).

Pain catastrophizing can also play a role in the perception and grading of pain. The term catastrophizing refers to a negative and exaggerated mental perception regarding the experience of real and anticipated pain (7). Although the causes of pain catastrophizing are unclear, main consequences associated with catastrophizing are more intense pain, greater consumption of analgesics, decreased daily activities, work incapacity, and more extended rehabilitation periods after surgery (8).

Therefore, the aim of this prospective observational study was to identify possible interrelationships between pain catastrophizing and kinesiophobia at baseline and their potential influence on persistent shoulder pain and disability after wrist-hand immobilization.

Shoulder pain is not always a primary shoulder pathology and may be due to the immobilization after a distal upper extremity injury.
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This study highlights the importance of considering the length of immobilization and kinesiophobia in understanding shoulder disability after wrist-hand injury.

METHODS

All participants completed an initial screening to confirm their treatment of wrist and thumb immobilization of up to two-third proximal to the forearm after DRF or scaphoid fracture. All participants were right-hand dominant. Inclusion criteria for this study were patients

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