The associations of emotional health with pain, disability, and health-related quality of life in patients with rotator cuff disease

Background: Psychosocial factors have been associated with poor outcomes in patients with rotator cuff disease. Emotional health is one of these factors, and relationships between emotional health and outcome measures evaluated before and after physical therapy have not been reported. Aim: To investigate the associations of baseline emotional health status with pre-treatment, post-treatment, and pre-to-post changes in pain, disability and health-related quality of life in patients with rotator cuff disease. Methods: Forty-one patients with rotator cuff disease were included. Emotional health was measured with the emotions domain of the Western Ontario Rotator Cuff Index (WORC). The outcomes were the WORC-total, the Shoulder Pain and Disability Index, and the numeric pain rating scale. All outcomes were measured at baseline and 6-week follow-up. Results: The baseline emotional health score and the outcomes scores were moderate to strong, and weak to moderate correlated at baseline and at follow-up, respectively. There was no correlation between the baseline emotional health score and the changes in the outcome measures from baseline to follow-up. Conclusions: Lower baseline emotional health status was associated with worse outcomes in pain, disability and health-related quality of life at baseline and follow-up in patients with rotator cuff disease. However, the changes in these outcome measures from baseline to follow-up were not correlated with the baseline emotional health status. In clinical practice, an assessment of patients' emotional health status using standardised measures may help to predict post-treatment outcomes, and a multidisciplinary cooperation (e.g., among physical therapists and psychologists) may enhance outcomes.