Psychosocial factors and physical function in higher education students with musculoskeletal pain attending direct access physiotherapy: An observational longitudinal study.

Abstract

Introduction: Musculoskeletal pain and mental health problems commonly coexist in students, potentially impacting physical function. However, there is a lack of follow-up studies investigating the relationship between changes in psychosocial stress and physical function among higher education students.

Objective: We examined whether psychosocial factors at baseline or the change in psychosocial profile over 3 months were associated with physical function at a 3-month follow-up in higher education students with musculoskeletal pain.

Methods: Participants were students attending direct access physiotherapy due to musculoskeletal pain (n = 133). Psychosocial factors were measured with the Short Form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-SF), and with the Mental Health Index (MHI-5). Physical function was measured using the Patient-Specific Functional Scale. The associations were analyzed using linear regression analysis adjusted for gender and age.

Results: A higher load of psychosocial factors, measured by the ÖMPSQ-SF at baseline, was associated with lower physical function at the 3-month follow-up, regression coefficient beta (ß) -0.557, 95% confidence interval (CI) [-1.04, -0.08]. No association was found between physical function and the MHI-5. The median of the ÖMPSQ-SF score decreased seven points (p < .001) between the baseline (32, interquartile range (IQR) 25-42) and 3-month follow-up (25, IQR 17-38). A reduction in the ÖMPSQ-SF score was associated with better physical function at 3 months (ß -0.332; CI 95% -0.50 to -0.16).

Conclusion: A reduced psychosocial load over three months is associated with better physical function in students with musculoskeletal pain. Addressing psychosocial factors appears to be important in direct access physiotherapy for patients with reduced physical function.