Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

Biopsychosocial factors and global perceived effect scale on the subject with chronic pain: an analytic cross-sectional study

Graziella Cristina Roque, Tiago Tsunoda del Antonio, Fabrício José Jassi, Thais Cristina Chaves

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Background: Chronic pain is an emotional and sensorial experience that triggers functional incapacity guided especially by the biopsychosocial changes, that lead to its aggravation directly affecting the recovery of the patient. Objective: To verify the presence of biopsychosocial factors in the subject with chronic pain on the physiotherapeutic care undergone in a clinical physiotherapy school. Method: A cross-sectional study, conducted in the physiotherapy clinic of the Health Sciences Center of the Universidade Estadual do Norte do Paraná, in which were evaluated 26 subjects with chronic pain through the Pain Numerical Rating Scale; Hospital Anxiety and Depression Scale; Pain Catastrophizing Scale; Fear Avoidance Beliefs Questionnaire; and Global Perceived Effect Scale. The statistical analysis had significance value of P≤0.05. Results: Even with reduction of pain intensity with P=0.04, the values do not indicate clinically relevant difference. The global perceived effect scale does not indicate a significant improvement of the subjects; however this is justified because the treatment does not address biopsychosocial aspects, being a technical approach. Conclusion: The treatment of chronic pain associated with a biopsychosocial approach would be the most indicated in clinical practice.


Chronic Pain; Biological Factors; Emotional Adjustment.


[1] Bliss, TVP, Collingridge GL, Kaang BK, Zhuo M. Synaptic Plasticity in the Anterior Cingulate Cortex in Acute and Chronic Pain. Nature Reviews Neuroscience. 2016;17: 485–96.

[2] Goldberg DS, McGee SJ. Pain as a global public health priority. BMC Public Health. 2011;11: 770.

[3] Vasconcelos HF, Araújo GC. Prevalence of chronic pain in Brazil: a descriptive study. BrJP. 2018;1: 176-179.

[4] Salvetti MG, Kurita GP, Longo ES, Pimenta CAM. Efeitos da intervenção Exposição ao Vivo e Atividades Graduais sobre a incapacidade e a crença de medo e evitação em pacientes com dor lombar crônica. Rev. Bras. Ter. Comport. e Cogn. 2013;14: 123–33.

[5] Cássia E De, Chaves L. Assessment and correlation between subjective and physiological variables of chronic spinal pain. Rev. dor. 2017;18: 194–8.

[6] Ferretti F, Santos DT, Giuriatti L, Gauer APM, Teo CRPA. Sleep quality in the elderly with and without chronic pain. BrJP. 2018;1: 141-146

[7] Marques ES, Filho NAM, Gouvea MER, Ferreira PS, Nogueira LAC. Functionality, psychosocial factors and quality of life in women with predominance of central sensitization. Rev dor. 2017;18: 112–8.

[8] Edwards RR, Dworkin RH, Sullivan MD, Turk DC, Wasan AD. The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain. J. Pain. 2016;17: 70–92.

[9] Wernicke S, Huberts JW, Wippert PM. The pain of being misunderstood: Invalidation of pain complaints in chronic low back pain patients. J. Health Psychol. 2015;22: 135-147.

[10] McParland J, Hezseltine L, Serpell M, Eccleston C, Stenner P. An investigation of constructions of justice and injustice in chronic pain. J. Health Psychol. 2011;16: 873–83.

[11] Folstein MF, Folstein SE MP. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr Res. 1975;12: 189–98.

[12] Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. Int Assoc Study Pain. 2011;152: 2399-404.

[13] Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr. Scand. 1983;67: 361–70.

[14] Pais-Ribeiro J, Silva I, Ferreira T, Martins A, Meneses R, Baltar M. Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychol. Heal. Med. 2007;12: 225–7.

[15] Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. J .Psychosom Res. 2002;52: 69–77.

[16] Sehn F, Chachamovich E, Vidor LP, Dall-Agnol L, Souza ICC, Torres ILS et al. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the pain catastrophizing scale. Pain Med. 2012;13: 1425–35.

[17] Sullivan MJL, Bishop SR PJ. The Pain Catastrophizing Scale: Development and validation. Psychol. Assess. 1995;7: 524–32.

[18] Waddell G, Newton M, Henderson I, Somerville D MC. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52: 157–68.

[19] Abreu AM, Faria CDCM, Cardoso SMV, Teixeira-Salmela LF. The Brazilian version of the Fear Avoidance Beliefs Questionnaire. Cad Saude Publica. 2008;24: 615–23.

[20] Kamper SJ, Maher CG, Mackay G. “Global Rating of Change Scales: A Review of Strengths and Weaknesses and Considerations for Design. ” J Man Manip Ther 2009;17: 163–70.

[21] Wijma A, Wilgen CPV, Meeus M, Nijs J. Clinical biopsychosocial physiotherapy assessment of patients with chronic pain The first step in pain neuroscience education. Physiother. Theory Pract. 2016;32: 368–84.

[22] Farrar JT, Young JP, Lamoreaux L, Werth JL, Poole RM. Clinical Importance of Changes in Chronic Pain Intensity Measured on an 11-Point Numerical Pain Rating Scale. 2001; 94: 149–58.

[23] Rooij A, Leeden MVD, Roorda LD, Steultjens MPM, Dekker J. Predictors of outcome of multidisciplinary treatment in chronic widespread pain: an observational study. BMC Musculoskelet Disord. 2013;14: 133.

[24] Nava-Bringas TI, Macias-Hernandez SI, Vasquez-Rios JR, Coronado-Zarco R, Miranda-Duarte A, Cruz-Medina E et al. Fear-avoidance beliefs increase perception of pain and disability in mexicans with chronic low back pain. Rev. Bras. Reumatol. 2016:1–5.

[25] Feitosa ASA, Lopes JB, Bonfa E, Halpern ASR. A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain. Rev. Bras. Reumatol. 2016;56: 384–90.

[26] Marchand GH, Myhre K, Leivseth G, Sandvik L, Lau B, Bautz-Holter E et al. Change in pain, disability and influence of fear-avoidance in a workfocused intervention on neck and back pain: A randomized controlled trial. BMC Musculoskelet Disor. 2015;16: 1–11.

[27] Nijs J, Goubert D, Ickmans K. Recognition and Treatment of Central Sensitization in Chronic Pain Patients: Not Limited to Specialized Care. J Orthop. Sport. Phys. Ther. 2016;46: 1024–8.

[28] Silva ID, Silveira MFA. A humanização e a formação do profissional em fisioterapia. Cien Saude Colet. 2011;16: 1535–46.

[29] Guzmán J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C. Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain. Cochrane Database Syst. Rev. 2014; 1–209.

[30] Björnsdóttir SV, Triebel J, Arnljótsdóttir M, Tómasson G, Valdimarsdóttir UA. Long-lasting improvements in health-related quality of life among women with chronic pain, following multidisciplinary rehabilitation. Disabil Rehabil. 2017;0: 1–9.

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