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  • Title: The perception of pain and pain-related cognitions in subacute whiplash-associated disorders: its influence on prolonged disability.
    Author: Bunketorp L, Lindh M, Carlsson J, Stener-Victorin E.
    Journal: Disabil Rehabil; 2006 Mar 15; 28(5):271-9. PubMed ID: 16492621.
    Abstract:
    PURPOSE: To clarify the relations between the sensory, affective and cognitive dimensions of pain and to analyse what influence these components have on persistent disability in patients with subacute whiplash-associated disorders (WAD). METHOD: The data was obtained from an on-going randomised controlled trial (RCT) on 47 patients. The sensory dimension of pain was evaluated with a visual analogue scale (VAS) diary and a Painometer. The affective dimension was assessed using the Painometer. The Tampa Scale for Kinesiophobia (TSK) and the Self-Efficacy Scale (SES) were used as measures of pain-related cognitions. The Pain Disability Index (PDI) was used as the outcome measure. RESULTS: Forty patients (85%) completed the trial. The correlations between the sensory and affective dimensions of pain were non-significant, which indicates that they are two independent constructs that describe various dimensions of whiplash-related pain. High pain intensity and pain affect, more widespread pain, and high fear of movement/(re)injury corresponded to low self-efficacy. Multiple regression analyses showed that self-efficacy was the most important predictor of persistent disability contributing to 42% of the variation in the PDI score. CONCLUSION: The treatment approach for patients with subacute WAD should incorporate the multidimensional nature of pain and to prevent disability special effort should be made to enhance the patient's self-efficacy beliefs.
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