RESEARCH ARTICLE


Psychophysical and Patient Factors as Determinants of Pain, Function and Health Status in Shoulder Disorders



Zakir Uddin*, 1, 3, Joy C. MacDermid1, 2, 4, Jaydeep Moro5, Victoria Galea1, 1, Anita R. Gross1
1 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
2 Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario, Canada
3 Department of Physiotherapy, College of Health Sciences, University of Sharjah, UAE
4 Department of Physical Therapy, Western University, London, Ontario, Canada
5 Division of Orthopaedic Surgery, Departments of Surgery, McMaster University, Hamilton, Ontario, Canada


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© Uddin et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Physiotherapy, College of Health Sciences, University of Sharjah, UAE; Tel: +971-6-505-7503; Fax: +971-56-505-7502; E-mails: zuddin@sharjah.ac.ae, uddinz2@mcmaster.ca, zakiru@gmail.com


Abstract

Objective:

To estimate the extent to which psychophysical quantitative sensory test (QST) and patient factors (gender, age and comorbidity) predict pain, function and health status in people with shoulder disorders. To determine if there are gender differences for QST measures in current perception threshold (CPT), vibration threshold (VT) and pressure pain (PP) threshold and tolerance.

Design:

A cross-sectional study design.

Setting:

MacHAND Clinical Research Lab at McMaster University.

Subjects:

34 surgical and 10 nonsurgical participants with shoulder pain were recruited.

Method:

Participants completed the following patient reported outcomes: pain (Numeric Pain Rating, Pain Catastrophizing Scale, Shoulder Pain and Disability Index) and health status (Short Form-12). Participants completed QST at 4 standardized locations and then an upper extremity performance-based endurance test (FIT-HaNSA). Pearson r’s were computed to determine the relationships between QST variables and patient factors with either pain, function or health status. Eight regression models were built to analysis QST’s and patient factors separately as predictors of either pain, function or health status. An independent sample t-test was done to evaluate the gender effect on QST.

Results:

Greater PP threshold and PP tolerance was significantly correlated with higher shoulder functional performance on the FIT-HANSA (r =0.31-0.44) and lower self-reported shoulder disability (r = -0.32 to -0.36). Higher comorbidity was consistently correlated (r =0.31-0.46) with more pain, and less function and health status. Older age was correlated to more pain intensity and less function (r =0.31-0.57). In multivariate models, patient factors contributed significantly to pain, function or health status models (r2 =0.19-0.36); whereas QST did not. QST was significantly different between males and females [in PP threshold (3.9 vs. 6.2, p < .001) and PP tolerance (7.6 vs. 2.6, p < .001) and CPT (1.6 vs. 2.3, p =.02)].

Conclusion:

Psychophysical dimensions and patient factors (gender, age and comorbidity) affect self-reported and performance-based outcome measures in people with shoulder disorders.

Keywords: Abnormal sensory function, Potential risk factors, Sensory evaluation, Shoulder pain,.