Predictors of Chronic Dizziness in Acute Unilateral Vestibulopathy: A Longitudinal Prospective Cohort Study.

OBJECTIVE: Chronic dizziness after acute unilateral vestibulopathy (AUVP) causes significant social and economic burdens. This study aims to identify predictors of chronic dizziness. STUDY DESIGN: Prospective, longitudinal cohort study. SETTING: ENT departments from secondary and tertiary hospitals. METHODS: Participants meeting the Barany Society's diagnostic criteria for AUVP were included. Evaluations occurred within 0 to 21 days (T1), and at 4 (T2) and 10 weeks (T3) postonset. The primary outcome measure was the Dizziness Handicap Inventory (DHI) at 6 months, with a score >30 indicating chronic dizziness. Five clusters of predictors were assessed at T1-3: central vestibular compensation, visual dependence, movement exposure, psychological factors, and balance performance. Separate linear regression models for T1, T2, and T3 were constructed to explain the variability in the 6-month DHI score. Receiver operating characteristics analyses were conducted to predict chronic dizziness. RESULTS: From June 2021 to January 2024, 103 participants (55.2 ± 16.6 years old, 49 women) were included. The regression models explained the variability in the 6-month DHI score by 33.0% at T1, 47.6% at T2, and 64.0% at T3 (P < .001), including psychological factors (T1, T2, T3), visual dependence (T2, T3), and static balance performance (T3). Cutoff values for the Vestibular Activities Avoidance Instrument (23/54), Visual Vertigo Analog Scale (33.5/100), and Hospital Anxiety and Depression Scale-Anxiety (7.5/21) at 10 weeks postonset predicted chronic dizziness. CONCLUSION: Higher psychological burden, increased visual dependence, and poorer static balance performance were associated with chronic dizziness. Cutoff values were determined to identify individuals with AUVP at risk for chronic dizziness.

The Genetic Profile of Combat Sport Athletes: A Systematic Review of Physiological, Psychological and Injury Risk Determinants.

This systematic review aims to assess the genetic determinants influencing combat sports performance and address potential gaps in previous reviews. Twenty-four selected studies were analysed, investigating genetic influences on physiological performance, psychological traits, psychophysiological factors like pain perception, and injury susceptibility in combat sport athletes. The systematic literature search, using keywords, encompassed PubMed, Scopus, SportDiscus, Medline, and Google Scholar. The Covidence systematic review management software facilitated the screening process and the creation of the PRISMA flow diagram. The quality assessment complied with the PRISMA guidelines, featuring a custom 10-point scale and the STREGA criteria for more reliable study inclusion. Collectively, the 24 studies incorporated 18,989 participants, of which 3323 were combat athletes of majority European ancestry (71.7%) from various combat sports disciplines. Twenty-five unique genetic variants were significantly associated with combat sports performance across diverse domains. These included physiological performance (nine genetic variants), psychological traits (ten genetic variants), psychophysiological factors (one genetic variant), and injury susceptibility (four genetic variants). In conclusion, this systematic review lays the foundation for a more comprehensive exploration of the association between genetics and athletic performance in the demanding arena of combat sports, offering valuable insights for talent identification, training optimisation, and injury prevention.

Psychological Factors Protecting Against Suicidality in Older Adults: A Systematic Review.

OBJECTIVE: Suicide rates in older adults are often the highest of any age group, particularly among high income countries. However, there is a limited understanding of the factors that could protect against suicidality in older age. This systematic review aimed to identify and evaluate the psychological factors that protect against suicidality in older age. METHOD: An a priori protocol was established and registered on PROSPERO (CRD42022343694). EMBASE, MEDLINE, PsycINFO, Web of Science and Scopus were searched. Papers were quality assessed using the Quality Assessment with Diverse Studies (QuADSs) tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seventeen papers were included and narratively synthesised. RESULTS: The initial searches identified 10,673 records, resulting in the screening of 5441 records after the removal of duplicates. The protective factors identified were (1) meaning/purpose in life, (2) reasons for living, (3) coping styles, (4) psychological wellbeing, (5) life satisfaction, (6) personality factors, (7) cognitive functioning, and (8) sense of belonging. The factors with the most empirical support were meaning in life, followed by psychological wellbeing and coping responses, such as primary control strategies, and personality traits, such as positive affect and agency. There was also evidence to suggest that the influence of some protective factors, for example meaning in life, may depend upon stage in older life and gender. CONCLUSION: This review identified several psychological factors that have been found to protect against suicidal ideation in older adults, representing potential treatment targets for reducing suicide in older adults. Recommendations for future research includes greater use of longitudinal and case-control designs, measuring outcomes across the continuum of suicidality and using samples that allow comparison between younger and older adults and within the spectrum of old age.

English Premier League and English Football League academy managers' experiences of how psychosocial skills and characteristics are identified and developed in youth academy soccer players.

Psychological skills and characteristics (PSCs) are vital for player development, yet there is a lack of agreement on which are important and how they should be identified and developed in academy players, creating barriers to implementation into curricula. The key stakeholder with considerable insight into PSC development is the academy manager (AM). The aims of this study were (a) explore AMs' experiences of PSC identification and development, (b) identify challenges AMs feel affect development of PSCs. Nine AMs (i.e. Category 1; n = 3, Category 2; n = 3 and Category 3; n = 3) comprising an average coaching experience of 20.4 ± 7.4 years and time in the role of 5.2 years ±3.2 years participated in semi-structured interviews. Reflexive thematic analysis generated themes identified ideal PSC outcomes that AMs felt were important. AMs identified current practices within academies alongside challenges: transitions, need to upskill coaches, access to additional support from external partners and National Governing Bodies. There was consensus that PSCs are key drivers of progression and that embedding them into the pathway was critical to facilitating development. Academies should think carefully about design, implementation and evaluation of programmes to support player PSC development for success during and after soccer careers.

Comparative effectiveness of Maitland Spinal Mobilization versus myofascial techniques on pain and symptom severity in women with Fibromyalgia syndrome: A quasi-randomized clinical trial with 3-month follow up.

OBJECTIVE: The aim of this experimental study was to determine which manual therapy approach is more effective in addressing health status by improving symptoms (sensory, cognitive, emotional, and social) in patients with fibromyalgia. MATERIAL AND METHODS: A quasi-randomized clinical trial with 3-month follow-up was conducted in 52 female patients (age 52.5 ± 8.1 years) affected by rheumatologist-diagnosed Fibromyalgia and evaluated at the Asociación de Fibromialgia y Síndrome de Fatiga Crónica (AFINSYFACRO) in Móstoles and AFIBROM, Madrid, Spain. Two manual therapy approaches were applied: the myofascial technique approach (MTA) and Maitland Mobilization Approach (MMA). The study examined the following outcomes: Widespread Pain, Symptom Severity, Impact on Quality of Life, Perceived Pain, Sensitization-Associated Pain, Sleep Quality, Physical Activity, and Psychological, Cognitive, and Emotional Factors. Patient Satisfaction was also assessed. RESULTS: No significant differences were found between groups over time for most variables. However, the MTA group showed significant improvements in pain intensity, central sensitization, general health, sleep quality, and anxiety compared with the MMA group. CONCLUSIONS: Despite the lack of between-group differences in all variables over time, MTA may be useful in the treatment of fibromyalgia, reducing pain, central sensitization, and negative emotional symptoms, as well as improving general health and sleep quality. Due to problems during the study, randomization was abandoned. This problem becomes a virtue by taking advantage of the situation to apply statistical compensation methods, which will serve as a guide for future research that suffers from this problem. We suggest the inclusion of longer follow-up periods in future studies.

The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder.

OBJECTIVE: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD: This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.

Psychological determinants of the effectiveness of conjugated linoleic acid supplementation in overweight and obese women-a randomized controlled trial.

Introduction: Previous studies investigating the effectiveness of conjugated linoleic acid (CLA) supplementation in body weight reduction provided unequivocal results. We hypothesized that psychological factors such as self-efficacy, locus of control or dispositional optimism can affect the success of the intervention. Therefore, this study aimed to determine the psychological factors that modulate the effectiveness of CLA supplementation in overweight or obese women and affect the ability to successfully complete the study. Methods: In total, 74 subjects were recruited into this three-month randomized trial and divided into intervention and control groups receiving, respectively, capsules containing 3 g 80% CLA per day and capsules containing 3 g of sunflower oil. The following psychological tests were performed before the intervention: Multidimensional Health Locus of Control scale, Acceptance of Illness Scale, Satisfaction with Life Scale (SWLS), General Self Efficacy Scale (GSES), Health Behavior Inventory scale and Life Orientation Test (LOT-R). Results: A total of 60 women completed the study and the subjects who dropped out obtained higher scores in the GSES (p = 0.0490) and the LOT-R (p = 0.0087) tests than subjects who completed the trial. Besides, multivariate linear regression demonstrated that the SWLS test (p = 0.0345) results were independent predictors of body weight changes. Conclusion: In conclusion, psychological factors like self-efficacy and optimism may be associated with a higher risk of withdrawal from the study, while satisfaction with life may have an impact on the effectiveness of body weight reduction.Clinical trial registration: [https://drks.de/search/en], identifier [DRKS00010462].

Integrated pest management adoption among citrus growers in Iran: an application of the protection motivation theory.

BACKGROUND: Integrated pest management (IPM) is recognized as a sustainable approach to pest control. However, adoption rates among farmers in Iran have been observed to be low. This study investigates the adoption of IPM practices among citrus farmers in Iran and assesses the applicability of the protection motivation theory (PMT) in explaining farmers' behavior towards IPM. RESULTS: Overall, farmers reported poor levels of IPM use, paying attention only to monitoring practices among the three groups of IPM practices examined (prevention, monitoring, and suppression). The perceived severity of the consequences of chemical pest control (ß = 0.389, P < 0.001), the response efficacy of IPM practices (ß = 0.254, P < 0.001), and the perceived self-efficacy of using IPM practices (ß = 0.199, P < 0.001) positively predicted adoption of IPM practices, while response cost/barriers of IPM practices (ß = -0.355, P < 0.001) negatively predicted adoption of IPM practices. CONCLUSION: The PMT model presents a unique and interesting perspective to understand if and how IPM practices against the threat of pests are motivated. The perceived severity of the consequences of chemical pest control showed the strongest positive effect, whereas the response cost/barriers of IPM practices showed the strongest negative effect on IPM adoption. © 2024 Society of Chemical Industry.

A Bayesian approach to reveal the role of psychological factors on turnover intention among nurses during the COVID-19 pandemic.

BACKGROUND: Turnover intention is considered a significant challenge for healthcare and treatment organizations. The challenging conditions of treating COVID-19 patients and the physical and mental stress imposed on nurses during the pandemic may lead them to leave their jobs. The present study aimed to determine the role of psychological factors (general health, mental workload, work-family conflicts, and resilience) on turnover intention using a Bayesian approach during the COVID-19 pandemic. METHODS: The present cross-sectional study was carried out during the winter of 2021 at three hospitals in Khuzestan Province, Iran. To collect data for this investigation, 300 nurses were chosen based on Cochran's formula and random sampling technique. Seven questionnaires, including General Health, Mental Workload, Work-Family Conflict, Resilience, Job Stress, Fear of COVID-19, and Turnover Intention Questionnaires. Bayesian Networks (BNs) were used to draw probabilistic and graphical models. A sensitivity analysis also was performed to study the effects of the variables. The GeNIe academic software, version 2.3, facilitated the examination of the Bayesian network. RESULTS: The statistically significant associations occurred between the variables of fear of COVID-19 and job stress (0.313), job stress and turnover intention (0.302), and resilience and job stress (0.298), respectively. Job stress had the highest association with the fear of COVID-19 (0.313), and resilience had the greatest association with the work-family conflict (0.296). Also, the association between turnover intention and job stress (0.302) was higher than the association between this variable and resilience (0.219). At the low resilience and high job stress with the probability of 100%, the turnover intention variable increased by 20%, while at high resilience and low job stress with the probability of 100%, turnover intention was found to decrease by 32%. CONCLUSION: In general, the results showed that four psychological factors affect job turnover intention. However, the greatest impact was related to job stress and resilience. These results can be used to manage job turnover intention in medical environments, especially in critical situations such as COVID-19.

Is cardiac rehabilitation after pci as effective as cabg? The first experience from the eastern mediterranean region cardiac rehabilitation registry.

BACKGROUND: The effectiveness of cardiac rehabilitation (CR) programs following either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) has been separately studied. Few studies have compared the effects of similar CR programs between PCI and CABG. This study aimed to compare the effects of CR in patients recruited following either PCI or CABG on coronary heart disease risk factors, psychological variables, and functional capacity. METHODS: For this retrospective study, the documents of the CR program registry of the Isfahan Cardiovascular Research Institute were reviewed from 2008 to 2021. Patients with ischemic heart disease undergoing PCI or CABG were enrolled in an 8-week exercise-based cardiac rehabilitation program. Demographics, smoking status, clinical data, echocardiographic parameters, laboratory data, functional capacity, and psychological status were assessed. RESULTS: Patients who underwent CABG (n=557) were more likely to be referred to CR than those who underwent PCI (n=440). All variables changed significantly after the CR program compared to their baseline value in both the PCI and CABG groups. However, low-density lipoprotein and total cholesterol levels, peak systolic blood pressure, and resting and peak diastolic blood pressure did not change in any of the groups, and fasting blood sugar (p=0.01) and triglyceride (TG) (p=0.01) levels significantly decreased only in the PCI group. Between-group comparisons indicated that after adjustment, no significant difference was observed between the PCI and CABG groups except for TG, which was significantly reduced in the PCI group (p=0.01). CONCLUSION: The CR program was equally effective in patients who underwent either PCI or CABG.

One step further in mistreatment research: Assessing the scalability of the Explicit Discrimination Scale among Brazilian working-age adult respondents.

Though the Explicit Discrimination Scale (EDS) has been subjected to extensive psychometric evaluation in Brazil, the instrument has yet to be comprehensively assessed among working-age adult respondents in the country. This study aimed to fill this knowledge gap. Data from around 1200 diverse members of a cohort investigation were used to examine: (1) the positioning of respondents along the continuum of the EDS latent trait; (2) how well the corresponding items represent the EDS construct map; and (3) the extent to which the EDS items follow their expected levels of intensity. We assessed these properties with Loevinger's H, Guttman errors, and Item Response Theory parameters. Findings suggest that two abridged versions of the instrument-but especially the eight-item EDS-may adequately arrange respondents along the latent trait continuum. Analyses also revealed that scale items are reasonably spread over the construct map, with some discrepancy between the expected levels of intensity and their empirical positioning in the corresponding plot. The shortened versions of EDS have good psychometric properties among Brazilian working-age adult respondents. In addition to examining the invariance of the EDS across multiple groups, future psychometric evaluations should assess the external validity of the scale.

Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey.

BACKGROUND: Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees. OBJECTIVE: To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. METHODS: A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12-16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay. RESULTS: A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels. CONCLUSIONS: There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high-risk population groups.

Genetic polymorphisms and their association with neurobiological and psychological factors in anorexia nervosa: a systematic review.

Background and aims: Anorexia nervosa (AN) is a complex neuropsychiatric disorder. This systematic review synthesizes evidence from diverse studies to assess and investigate the association between gene polymorphisms and psychological and neurobiological factors in patients with AN. Methods: A systematic search across PubMed, PsycINFO, Scopus, and Web of Science databases, along with manual searching, was conducted. The review protocol was approved by PROSPERO (CRD42023452548). Out of 1,250 articles, 11 met the inclusion criteria. The quality of eligible articles was assessed using the Newcastle-Ottawa Scale (NOS) tool. The systematic review followed the PRISMA guidelines. Results: The serotoninergic system, particularly the 5-HTTLPR polymorphism, is consistently linked to altered connectivity in the ventral attention network, impaired inhibitory control, and increased susceptibility to AN. The 5-HTTLPR polymorphism affects reward processing, motivation, reasoning, working memory, inhibition, and outcome prediction in patients with AN. The dopaminergic system, involving genes like COMT, DRD2, DRD3, and DAT1, regulates reward, motivation, and decision-making. Genetic variations in these dopaminergic genes are associated with psychological manifestations and clinical severity in patients with AN. Across populations, the Val66Met polymorphism in the BDNF gene influences personality traits, eating behaviors, and emotional responses. Genes like OXTR, TFAP2B, and KCTD15 are linked to social cognition, emotional processing, body image concerns, and personality dimensions in patients with AN. Conclusion: There was an association linking multiple genes to the susceptibly and/or severity of AN. This genetic factor contributes to the complexity of AN and leads to higher diversity of its clinical presentation. Therefore, conducting more extensive research to elucidate the underlying mechanisms of anorexia nervosa pathology is imperative for advancing our understanding and potentially developing targeted therapeutic interventions for the disorder.Systematic review registration: [https://clinicaltrials.gov/], identifier [CRD42023452548].

Similarities and differences in the psychological factors associated with generalised problematic internet use, problematic social media use, and problematic online gaming.

Problematic online behaviours are a concern among university students. Although previous research has identified that psychological distress, cognitive distortions, conscientiousness and neuroticism traits, motor impulsivity, and emotion regulation strategies have a significant direct effect on generalised problematic Internet use (GPIU), problematic social media use (PSMU), and problematic online gaming (POG), it is still necessary to determine the extent to which these psychological factors, taken together, are associated with each of the problematic online behaviours. In a sample of 690 Spanish university students, the present study examined the relationship of these psychological factors with GPIU, PSMU, and POG. Correlation and regression analyses were performed. Results reported that (1) high psychological distress, low conscientiousness trait and high motor impulsivity were common associated factors of GPIU and PSMU, but not of POG; (2) high levels of cognitive distortions and cognitive reappraisal were common associated factors of GPIU, PSMU and POG; and (3) expressive suppression and neuroticism trait had no effect on any of the three problematic online behaviours. The findings will help to develop effective prevention and intervention strategies for each problematic online behaviour in the university context.

Integrating socio-psychological factors in the SEIR model optimized by a genetic algorithm for COVID-19 trend analysis.

The global spread of COVID-19 has profoundly affected health and economies, highlighting the need for precise epidemic trend predictions for effective interventions. In this study, we used infectious disease models to simulate and predict the trajectory of COVID-19. An SEIR (susceptible, exposed, infected, removed) model was established using Wuhan data to reflect the pandemic. We then trained a genetic algorithm-based SEIR (GA-SEIR) model using data from a specific U.S. region and focused on individual susceptibility and infection dynamics. By integrating socio-psychological factors, we achieved a significant enhancement to the GA-SEIR model, leading to the development of an optimized version. This refined GA-SEIR model significantly improved our ability to simulate the spread and control of the epidemic and to effectively track trends. Remarkably, it successfully predicted the resurgence of COVID-19 in mainland China in April 2023, demonstrating its robustness and reliability. The refined GA-SEIR model provides crucial insights for public health authorities, enabling them to design and implement proactive strategies for outbreak containment and mitigation. Its substantial contributions to epidemic modelling and public health planning are invaluable, particularly in managing and controlling respiratory infectious diseases such as COVID-19.

How often do you cheat? Dispositional influences and intrapersonal stability of dishonest behavior.

Dishonesty, including lying, cheating, deception, and deviating from societal norms, has far-reaching implications across various aspects of modern society. From minor consequences like social discontent to severe outcomes such as economic damage through tax evasion, dishonest behavior affects us in multiple ways. This study investigates whether gender and psychological traits contribute to dishonest behavior, and whether unethical conduct is stable across diverse tasks. We examined 63 participants using a "Difference Spotting Task" (DST) and two motor tasks (1. coordinative throwing; 2. isometric strength). Dishonesty was measured by comparing self-reported performance with actual performance, allowing for a comprehensive analysis of both occurrence and extent of dishonesty. Our findings indicate that gender does not significantly influence the occurrence or extent of dishonest behavior. Moreover, we discovered that "Social Desirability" positively influences the extent of dishonesty, while "Task Orientation" increases the likelihood of engaging in dishonest acts. The study also reveals that the level of dishonesty remains relatively stable across all three tasks at an intrapersonal level.

Are demographics, physical function and psychological response associated with return to sport at one year following ACL-reconstruction?

OBJECTIVE: To determine the relative contribution of each of the following aspects: demographics, physical function, and patient-reported outcome measures (PROMs), including both physical and psychological constructs, to return to sport (RTS) (any level) one-year post anterior cruciate ligament reconstruction (ACLR). DESIGN: Cross-sectional cohort study. METHODS: We included data for 143 participants (73 women, mean (SD) age 24 (5.8) years) âˆ¼ one-year post-ACLR. Data comprised demographics, physical function (hop performance, hip and knee peak torque) and PROMs (Knee Osteoarthritis Outcome Score subscales, perceived stress, and ACL Return to Sport after Injury scale (ACL-RSI)). We then used a Z-normalized multivariable logistic regression model to establish the relative contribution of factors associated with RTS. RESULTS: Sixty-four (45%) of the participants had returned to sport at one year post-ACLR. In the regression model, greater hip abduction peak torque (OR = 1.70, 95% CI; 1.01 to 2.84) and greater psychological readiness to RTS (OR = 2.32, 95% CI; 1.30 to 4.12) were the only variables associated with RTS (R2 = 0.352). CONCLUSIONS: The significant contribution of hip abduction strength and psychological readiness to RTS was still relatively small, suggesting other potential factors explaining RTS which may not be captured by common RTS criteria.

The Influence of Pain Hypersensitivity and Psychological Factors on Pain and Disability in the Transition From Acute to Chronic Low Back Pain: A Longitudinal Exploratory Investigation and Cluster Analysis.

Pain hypersensitivity is present in some people with acute low back pain (LBP) and thought to be involved in the development of chronic LBP. Early evidence suggests that pain hypersensitivity in acute LBP precedes poor long-term outcome. We aimed to examine whether the presence of pain hypersensitivity in acute LBP influenced recovery status at 6 months and differentiated how pain and disability changed over time. Participants with acute nonspecific LBP (<6 weeks after pain onset, N = 118) were included in this longitudinal study. Quantitative sensory testing, including pressure and heat pain thresholds, and conditioned pain modulation and questionnaires were compared at baseline and longitudinally (at 3 and 6 months) between recovered and unrecovered participants. Using k-means clustering, we identified subgroups based on baseline sensory measures alone, and in combination with psychological factors, and compared pain and disability outcomes between subgroups. Sensory measures did not differ at baseline or longitudinally between recovered (N = 50) and unrecovered (N = 68) participants. Subgrouping based on baseline sensory measures alone did not differentiate pain or disability outcomes at any timepoint. Participants with high psychological distress at baseline (N = 19) had greater disability, but not pain, at all timepoints than those with low psychological distress, regardless of the degrees of pain sensitivity. Our findings suggest that pain hypersensitivity in acute LBP does not precede poor recovery at 6 months or differentiate how pain and disability change over time. High psychological distress during acute LBP is associated with unremitting and pronounced disability, while pain severity is unaffected. PERSPECTIVE: Pain hypersensitivity is thought to be involved in the transition to chronic LBP. Contradictory to prevailing hypothesis, our findings suggest pain hypersensitivity alone in acute LBP does not precede poor recovery. High psychological distress in acute LBP has a stronger influence than pain hypersensitivity on long-term disability, but not pain outcomes.