AI Article Synopsis
- The study examines how preoperative anxiety and catastrophic pain thoughts affect recovery outcomes like grip strength and wrist motion after distal radius fracture surgery in 121 patients.
- Results show that higher catastrophic pain ideation and pain anxiety correlated with poorer recovery at early stages (4 and 12 weeks), but by 24 weeks, only factors like age and fracture severity mattered for recovery scores.
- The findings suggest that addressing anxiety and catastrophic thoughts before surgery may help improve recovery, highlighting the importance of early psychosocial interventions for patients.
Article Abstract
Purpose: To evaluate the effects of preoperative anxiety and catastrophic pain ideation on perceived disability and objective measures after distal radius fracture surgery.
Methods: A total of 121 patients with distal radius fractures treated with volar plate fixation were enrolled. The wrist range of motion (ROM), grip strength, and perceived disability as measured by the Michigan Hand Questionnaire (MHQ) score were assessed 4, 12, and 24 weeks after surgery. To evaluate psychological factors related to pain, catastrophic pain ideation was measured using the Pain Catastrophizing Scale (PCS) and pain anxiety was measured using the Pain Anxiety Symptom Scale (PASS). Then relative contributions of pain anxiety and catastrophic pain ideation and other clinical parameters to functional recovery in terms of grip strength, ROM, and MHQ score were assessed.
Results: An increase in the PCS score was associated with the wrist ROM and grip strength only at week 4, whereas an increase in the PASS score was associated with the wrist ROM at week 4 and grip strength at weeks 4 and 12. According to a multivariate regression analysis, an increase in the PCS score was associated with a decrease in grip strength, ROM, and MHQ score at week 4; and an increase in the PASS score was associated with a decrease in grip strength, ROM, and MHQ score at week 4 and grip strength and MHQ score at week 12. At week 24, only age and fracture severity were associated with the MHQ score. In addition, age was associated with grip strength and fracture type was associated with ROM.
Conclusions: Preoperative PCS and PASS were significantly associated with delayed recovery as evidenced by scores on both objective and subjective measures of function. Given these relationships, it becomes important to assess preoperative PCS and PASS and address issues for patients at risk with brief psychosocial intervention early in the recovery process.
Type Of Study/level Of Evidence: Prognostic II.
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| http://dx.doi.org/10.1016/j.jhsa.2014.08.007 | DOI Listing |
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