Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis

Background: A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychologi-cal factors being suggested. Whether or not to include these factors in the assessment of move-ment-evoked pain has not yet been determined.Objectives: The aim of this systematic review is to explore the association between psychologi-cal factors and movement-evoked pain scores in people with musculoskeletal pain.Methods: For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transfor-mations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain.Conclusions: Movement-evoked pain is weakly to moderately associated to depressive symp-toms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.(c) 2022 Associa4ao Brasileira de Pesquisa e Pos-Gradua4ao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.