Recent studies highlight an interplay between pain perception and emotional responses. This necessitates a thorough investigation into how beliefs and motivational influences respond to visual stimuli of movements. Such an analysis is crucial for understanding the extent to which these factors contribute to disability levels associated with shoulder pain. We aimed to investigate the relationship between the perception of harm and the valence in images depicting shoulder movements and determine how these perceptions are linked to disability levels associated with shoulder pain. This cross-sectional study recruited 42 individuals with chronic shoulder pain. Participants were presented with 58 shoulder movements images. Each participant evaluated these images for emotional valence and arousal using the self-assessment manikin. For every image, they provided their level of avoidance, fear, and perception of harm in a numerical scale. We measured disability levels and pain catastrophizing using the Shoulder Pain and Disability Index and the Pain Catastrophizing Scale. A direct acyclic graph was used. Multiple linear regression analysis was conducted with shoulder disability as the dependent variable and perception of harm and valence as independent variables, adjusted for the confounders catastrophizing and arousal. This analysis resulted in a significant model (F4,37 = 11.44; adjusted R2 = 0.547; P < 0.01). The perception of harm to shoulder movement (β = 0.11; P < 0.001; 95% confidence interval = 5.6-11.8) was significantly associated with the level of shoulder disability, whereas valence did not show a significant association (β = 0.26; P = 0.15; 95% confidence interval = 1.7-10.8). The perception of harm associated with shoulder movements images during daily activities was associated with disability. Individuals who believe that shoulder movements are harmful have greater disability.

中文翻译：

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对伤害的感知和肩部运动图像的效价与与慢性肩痛相关的残疾水平之间的关联。


最近的研究强调了疼痛感知和情绪反应之间的相互作用。这需要彻底调查信念和动机影响如何响应运动的视觉刺激。这样的分析对于了解这些因素在多大程度上导致与肩痛相关的残疾水平至关重要。我们旨在调查对伤害的感知与描绘肩部运动的图像中的效价之间的关系，并确定这些感知如何与与肩痛相关的残疾水平相关联。这项横断面研究招募了 42 名患有慢性肩痛的人。向参与者展示了 58 张肩部运动图像。每个参与者都使用自我评估人体模型评估这些图像的情绪效价和唤醒。对于每张图像，他们都以数字比例提供了他们的回避、恐惧和对伤害的感知程度。我们使用肩痛和残疾指数（Shoulder Pain and Disability Index）和疼痛灾难化量表（Pain Catastrophizing Scale）测量残疾程度和疼痛灾难化。使用了直接无环图。以肩部残疾为因变量，以伤害和效价的感知为自变量进行多元线性回归分析，针对混杂因素灾难化和唤醒进行调整。该分析产生了一个显著的模型 （F4,37 = 11.44;调整后的 R2 = 0.547;P < 0.01）。对肩部运动伤害的感知 （β = 0.11;P < 0.001;95% 置信区间 = 5.6-11.8） 与肩部残疾水平显著相关，而效价未显示显著关联 （β = 0.26;P = 0.15;95% 置信区间 = 1.7-10.8）。 日常活动中与肩部运动图像相关的伤害感知与残疾有关。认为肩部运动有害的人有更大的残疾。