Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 1

The Influence of Pain Self-efficacy on Physiotherapy Outcomes for Patients with Shoulder Pain: A Systematic Review

Aws Obaid*, Ahmad Alhamed and Alaa Khushhal

Rehabilitation Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia

*Corresponding Author: Aws Obaid, Rehabilitation Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia.

Received: October 28, 2021; Published: December 21, 2021


Background: Shoulder pain is a very complex and common condition among population, and the mechanisms involved in its perpetuation remain unclear. Pain self-efficacy appear to play a role in the outcomes of treatment in people with shoulder pain. The purpose of this systematic review is to investigate the impact of pain self-efficacy on physiotherapy outcomes (pain intensity and disability) in patients with shoulder pain.

Objectives: To identify the impact of pain self-efficacy on physiotherapy outcomes in patients with shoulder pain.

Methods: A systematic search performed on the following databases PubMed, the Physiotherapy Evidence Database (PEDro), Scopus (Elsevier), Science of Direct, (CINAHL) and Psychology database (ProQuest). Longitudinal studies with quantitative designs analyzing the role of psychological factors and pain self- efficacy on treatment outcomes included. The quality assessment of the included studies evaluated using National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observation Cohort and Cross‐Sectional Studies.

Results: Two studies were selected for this systematic review. From 1030 patients 71 putative prognostic factors were collected, main findings were higher patient expectation of recovery as a result of physiotherapy (β=-12.43, 95% CI -8.20 to

-16.67), higher pain self-efficacy (β=-0.36, 95% CI -0.50 to -0.22), lower pain severity at rest (β=-1.89, 95% CI -1.26 to -2.51). The results of secondary analysis showed that patient expectancy is related to the patient recovery as the patients who expected to recover with the physiotherapy had better results than those who did not expect to recover with the physiotherapy.


Conclusion: The available evidence suggests that there is a relationship between high levels of pain self-efficacy, and low levels of pain intensity and disability in patients with shoulder pain.


Keywords: Patient Expectations; Psychological Factors; Pain Self-efficacy; Shoulder Pain


  1. Roquelaure YHC., et al. “Epidemiologic surveillance of upper- extremity musculoskeletal disorders in the working population”. Arthritis Care and Research5 (2006): 765-778.
  2. Walker-Bone K., et al. “Prevalence and impact of musculoskeletal disorders of the upper limb in the general population”. Arthritis Care and Research4 (2004): 642-651.
  3. Rechardt M., et al. “Metabolic changes and shoulder pain” (2010).
  4. Klintberg IH., et al. “Consensus for physiotherapy for shoulder pain”. International Orthopaedics4 (2015): 715-720.
  5. Eriksen W. “The prevalence of musculoskeletal pain in Norwegian nurses’ aides”. International Archives of Occupational and Environmental Health8 (2003): 625-630.
  6. House J Mooradian A. “Evaluation and management of shoulder pain in primary care clinics”. Southern Medical Journal11 (2010): 1129-1135.
  7. Luime JJ., et al. “Prevalence and incidence of shoulder pain in the general population; a systematic review”. Scandinavian Journal of Rheumatology2 (2004): 73-81.
  8. Ryall C., et al. “A case-control study of risk factors for arm pain presenting to primary care services”. Occupational Medicine (Chic Ill) 56.2 (2006): 137-143.
  9. Reilingh ML., et al. “Course and prognosis of shoulder symptoms in general practice”. Rheumatology5 (2008): 724-730.
  10. Keefe FJ and Somers TJ. “Psychological approaches to understanding and treating arthritis pain”. Nature Reviews Rheumatology4 (2010): 210-216.
  11. Somers TJ., et al. “The context of pain in arthritis: self-efficacy for managing pain and other symptoms”. Current Pain and Headache Reports6 (2012): 502-508.
  12. Stewart DE and Yuen T. “A Systematic Review of Resilience in the Physically Ill”. Psychosomatics3 (2011): 199-209.
  13. Costa LDCM., et al. “Self- efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain”. European Journal of Pain2 (2011): 213-219.
  14. Chester R., et al. “Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: A multicentre longitudinal cohort study”. British Journal of Sports Medicine4 (2018): 269-275.
  15. Engebretsen K., et al. “Predictors of Shoulder Pain and Disability Index (SPADI) and work status after 1 year in patients with subacromial shoulder pain”. BMC Musculoskeletal Disorders (2010): 11.
  16. Kamioka H. “Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015 statement”. Japanese Pharmacology and Therapeutics8 (2019): 1177-1185.
  17. of Health NI, others. National Heart Lung, and Blood Institute. “Quality assessment tool for observational cohort and cross-sectional studies” (2014).
  18. Chester R., et al. “Self- efficacy and risk of persistent shoulder pain: Results of a Classification and Regression Tree (CART) analysis”. British Journal of Sports Medicine13 (2019): 825-834.
  19. Bandura A. “Self-efficacy: Toward a unifying theory of behavioral change”. Psychological Review2 (1997): 191-215.
  20. Van Der Maas LCC., et al. “Psychometric properties of the Pain Self-Efficacy Questionnaire (PSEQ): Validation, prediction, and discrimination quality of the Dutch version”. European Journal of Psychological Assessment1 (2012): 68-75.
  21. Chester R., et al. “Self- efficacy and risk of persistent shoulder pain: Results of a Classification and Regression Tree (CART) analysis”. British Journal of Sports Medicine13 (2019): 825-834.
  22. Håland Haldorsen EM., et al. “Is there a right treatment for a particular patient group? Comparison of ordinary treatment, light multidisciplinary treatment, and extensive multidisciplinary treatment for long-term sick-listed employees with musculoskeletal pain”. Pain1-2 (2002): 49-63.
  23. Holtermann A., et al. “Prognostic factors for long- term sickness absence among employees with neck-shoulder and low-back pain”. Scandinavian Journal of Work, Environment and Health1 (2010): 34-41.
  24. Martinez-Calderon J., et al. “The Role of Self-Efficacy on the Prognosis of Chronic Musculoskeletal Pain: A Systematic Review”. Journal of Pain1 (2018): 10-34.
  25. Jackson T., et al. “Self-efficacy and chronic pain outcomes: A meta-analytic review”. Journal of Pain8 (2014): 800-814.
  26. Martinez-Calderon J., et al. “The role of psychological factors in the perpetuation of pain intensity and disability in people with chronic shoulder pain: A systematic review”. BMJ Open4 (2018).


Citation: Aws Obaid., et al. “The Influence of Pain Self-efficacy on Physiotherapy Outcomes for Patients with Shoulder Pain: A Systematic Review". Acta Scientific Orthopaedics 5.1 (2022): 18-24.


Copyright: © 2022 Aws Obaid., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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