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Early Self-Efficacy Predicts Short- and Long-Term Pain and Functional Outcomes Following Lower Extremity Fracture

The aim of this study was to identify which early psychosocial measures are most predictive of pain severity, pain interference, physical function and chronic pain throughout recovery from lower extremity fractures (LEF). Prospective Cohort Study. Le...

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Body Mind State EditorialJune 22, 2026 · 1 min read

Key Findings

The aim of this study was to identify which early psychosocial measures are most predictive of pain severity, pain interference, physical function and chronic pain throughout recovery from lower extremity fractures (LEF). Prospective Cohort Study. Level 1 Trauma Center. 240 patients (43 ± 15 years) with acute LEF. Not Applicable. In this prospective cohort study, 240 adults with surgically treated lower extremity fractures completed psychosocial questionnaires six weeks after surgery. Pain severity, pain interference, and physical function outcomes were assessed longitudinally at three, six, 12, and 24 months and the outcome of chronic pain at 12 and 24 months each using validated patient-reported outcome measures. Hierarchical regression analyses examined the predictive value of early psychosocial factors on outcomes over time. 163 participants (67%) completed this study through 24 months. Pain catastrophizing was associated with pain interference across all timepoints through 24 months (p ≤ .049), while self-efficacy was associated at three, six, and 24 months (p ≤ .002). Self-efficacy was consistently associated with physical function across follow-up (p ≤ .01). Pain catastrophizing and self-efficacy were associated with chronic pain at 12 months (p ≤ .04), with self-efficacy remaining associated with chronic pain at 24 months (p = .017). While early pain catastrophizing and self-efficacy were associated with pain and disability-related outcomes throughout 24 months of recovery from a LEF, pain self-efficacy was most consistently associated with each outcome. Early assessment of self-efficacy may provide useful prognostic information regarding pain and functional outcomes following lower extremity fracture.

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