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Phys Ther. 2016 Jul;96(7):1049-56. doi: 10.2522/ptj.20150335. Epub 2015 Dec 23.

Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity.

Author information

1
C.B. Simon, DPT, PhD, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida; Pain Research and Intervention Center of Excellence, University of Florida, 2004 Mowry Rd, PO Box 100242, Gainesville, FL 32610 (USA); and Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida. csimon@dental.ufl.edu.
2
T.A. Lentz, PT, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida, and Pain Research and Intervention Center of Excellence, University of Florida.
3
M.D. Bishop, PT, PhD, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida, and Pain Research and Intervention Center of Excellence, University of Florida.
4
J.L. Riley III, PhD, Pain Research and Intervention Center of Excellence, University of Florida, and Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida.
5
R.B. Fillingim, PhD, Pain Research and Intervention Center of Excellence, University of Florida, and Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida.
6
S.Z. George, PT, PhD, Department of Physical Therapy, College of Public Health & Health Professions, University of Florida, and Pain Research and Intervention Center of Excellence, University of Florida.

Abstract

BACKGROUND:

Because of its high global burden, determining biopsychosocial influences of chronic low back pain (CLBP) is a research priority. Psychological factors such as pain catastrophizing are well established. However, cognitive factors such as working memory warrant further investigation to be clinically useful.

OBJECTIVE:

The purpose of this study was to determine how working memory and pain catastrophizing are associated with CLBP measures of daily pain intensity and movement-evoked pain intensity.

DESIGN:

This study was a cross-sectional analysis of individuals with ≥3 months of CLBP (n=60) compared with pain-free controls (n=30).

METHOD:

Participants completed measures of working memory, pain catastrophizing, and daily pain intensity. Movement-evoked pain intensity was assessed using the Back Performance Scale. Outcome measures were compared between individuals with CLBP and those who were pain-free using nonparametric testing. Associations were determined using multivariate regression analyses.

RESULTS:

Participants with CLBP (mean age=47.7 years, 68% female) had lower working memory performance (P=.008) and higher pain catastrophizing (P<.001) compared with pain-free controls (mean age=47.6 years, 63% female). For individuals with CLBP, only working memory remained associated with daily pain intensity (R(2)=.07, standardized beta=-.308, P=.041) and movement-evoked pain intensity (R(2)=.14, standardized beta=-.502, P=.001) after accounting for age, sex, education, and interactions between pain catastrophizing and working memory.

LIMITATIONS:

The cross-sectional design prevented prospective analysis. Findings also are not indicative of overall working memory (eg, spatial) or cognitive performance.

CONCLUSION:

Working memory demonstrated the strongest association with daily pain and movement-evoked pain intensity compared with (and after accounting for) established CLBP factors. Future research will elucidate the prognostic value of working memory on prevention and recovery of CLBP.

PMID:
26700272
PMCID:
PMC4935786
DOI:
10.2522/ptj.20150335
[Indexed for MEDLINE]
Free PMC Article

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