Evidence map›Paper›PMID 39661363›Full record

Trial reportPain2025

Pain catastrophizing and pain anxiety mediate changes in physical function in a mind-body intervention for adults with traumatic orthopedic injuries.

Katherine E Gnall, Kate N Jochimsen, Julie R Brewer, Jafar Bakhshaie, Ana-Maria Vranceanu

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Pain, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Katherine E GnallDepartment of Psychological Sciences, University of Connecticut, Storrs, Connecticut.ORCID 0000-0003-3366-2249
Kate N JochimsenDepartment of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Julie R BrewerDepartment of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Jafar BakhshaieDepartment of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Ana-Maria VranceanuDepartment of Psychiatry, Center for Health Outcomes and Interdisciplinary Research (CHOIR), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Funding

Toolkit for Optimal Recovery after Orthopedic Injury; A multi-site feasibility study to prevent persistent pain and disabilityR01AT010462 · NCCIH · MASSACHUSETTS GENERAL HOSPITAL · PI VRANCEANU, ANA-MARIA · 2021 to 2023
$2.4M
Toolkit for Optimal Recovery after Orthopedic Injury; A multi-site feasibility study to prevent persistent pain and disabilityU01AT010462 · NCCIH · MASSACHUSETTS GENERAL HOSPITAL · PI VRANCEANU, ANA-MARIA · 2020 to 2020
$800k
Web-based mind-body treatment to enhance resilience among patients with painful nontraumatic upper extremity conditions and comorbid risky substance useK23AT012364 · NCCIH · MASSACHUSETTS GENERAL HOSPITAL · PI Jafar Bakhshaie · 2023 to 2026
$681k
Development and feasibility of a mind-body intervention to improve physical activity for patients with chronic hip painK23AT011922 · NCCIH · WEST VIRGINIA UNIVERSITY · PI Kate Jochimsen · 2023 to 2026
$578k
Examining Interoceptive Awareness as a Mechanism of Change in Yoga for Chronic Low Back PainF31AT012315 · NCCIH · UNIVERSITY OF CONNECTICUT STORRS · PI GNALL, KATHERINE E · 2023 to 2024
$90k
NCCIH NIH HHS F31 AT012315NCCIH NIH HHS F31AT012315NCCIH NIH HHS K23 AT011922NCCIH NIH HHS K23AT011922NCCIH NIH HHS K23 AT012364NCCIH NIH HHS K23AT012364NCCIH NIH HHS R01 AT010462NCCIH NIH HHS R01AT010462NCCIH NIH HHS U01 AT010462NCCIH NIH HHS U01AT010462
6 · The paper itself

Abstract

abstractTraumatic orthopedic injuries are common and frequently associated with persistent pain, disability, and emotional distress. Risk factors of persistent pain and disability include pain catastrophizing and pain anxiety, though most interventions for orthopedic injuries are primarily biomedical (eg, surgeries, pharmacology, physiotherapy/exercise). The Toolkit for Optimal Recovery (TOR) is a brief, live video mind-body program designed to directly target pain catastrophizing and anxiety in patients with recent traumatic orthopedic injury to prevent persistent disability. This study was a secondary analysis from a recently completed multisite feasibility RCT of TOR compared with Minimally Enhanced Usual Care (MEUC). We examined the extent to which the purported mechanisms of change in TOR (ie, reductions in pain catastrophizing and anxiety) mediate improvement in physical function. Participants with a recent orthopedic trauma (N = 195; Mage = 44.01) recruited from 4 Level I trauma centers were randomized to TOR or MEUC and completed self-report surveys at baseline, postintervention, and follow-up (3 months after baseline). A multiple mediation analysis using multilevel structural equation modeling (MSEM) demonstrated that pain catastrophizing (b = -5.22, SE = 3.02, Bootstrapped 95% CIs = -0.04, -12.37) and pain anxiety (b = -8.45, SE = 3.59, Bootstrapped 95% CIs = -0.04, -12.37) each significantly mediated improvement in physical function. Overall, findings elucidate the mechanistic role of TOR's primary treatment targets (ie, reductions in pain catastrophizing and anxiety) in improving physical function. Findings highlight the importance of targeting pain catastrophizing and pain anxiety early after orthopedic injury through psychosocial interventions such as TOR.

Indexed as

AnxietyCatastrophizationMind-Body TherapiesAdultFemaleHumansMaleMiddle AgedPain MeasurementChronic painDisabilityInterventionMechanismsMusculoskeletalOrthopedicPrevention

Identifiers

PMID39661363
PMCPMC12188628

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.