2 Citations (Scopus)


BACKGROUND: A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychological factors being suggested. Whether or not to include these factors in the assessment of movement-evoked pain has not yet been determined.

OBJECTIVES: The aim of this systematic review is to explore the association between psychological factors and movement-evoked pain scores in people with musculoskeletal pain.

METHODS: For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transformations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

RESULTS: Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain.

CONCLUSIONS: Movement-evoked pain is weakly to moderately associated to depressive symptoms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.

Original languageEnglish
Article number100453
JournalBrazilian Journal of Physical Therapy
Issue number6
Early online date2022
Publication statusPublished - 1 Nov 2022

Bibliographical note

Funding Information:
We wish to thank Dr Nicolas Delvaux and Dr Trudy Bekkering from the Belgian Centre for Evidence-Based Medicine for their help with the design and finalization the summary of findings tables. Funding for this study was obtained from the grant Wetenschappelijk Fonds Willy Gepts (WFWG) of the UZ Brussels .

Publisher Copyright:
© 2022 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia

Copyright 2022 Elsevier B.V., All rights reserved.


  • Meta-analysis
  • Movement-evoked pain
  • Musculoskeletal pain
  • Psychological factors
  • Systematic review


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