Motivational impact, self-reported fear, avoidance, and harm perception of shoulder movements pictures in people with chronic shoulder pain

Objectives: (1) to represent in pictures a group of items from the International Classification of Functioning (ICF) that represent daily situations; (2) to compare valence and arousal evoked by these pictures between chronic shoulder pain and pain-free control groups and assess self-reports of fear, avoidance, and harm perception. Methods: This is a cross-sectional observational study and approved by Research Ethics Committee. Selected pictures representing items from the ICF were judged by members of the general public using an online form. We used the set of International Affective Picture System and the Self-Assessment Manikin to compare valence and arousal between groups. The chronic shoulder pain group answered questions regarding self-reports of fear, avoidance, and harm perception. Results: The protocol consisted of 58 pictures. A repeated measures ANOVA for valence revealed a main effect of group, F(1, 9)=24.81;p < 0.005, and no effect on the arousal, F(1,9)=2.00;p < 0.190. The shoulder pain group judged shoulder pictures more aversive. The picture that represents the movement of carrying on shoulder presented the highest medians of self-reports of fear, avoidance, and harm perception 10(8-10). Conclusion: The pictures represent daily activities that correspond to the items from the ICF. The valence of the shoulder pictures was different between the groups, shoulder pictures were considered more aversive for the group with chronic shoulder pain. The responses of avoidance, fear, and harm perception showed higher median in the carrying on shoulders, hip, and back picture.