Authors: (including presenting author): :
Tsui MFW, Tang LWF, Wong WYE
Affiliation: :
Physiotherapy Department, Kwai Chung Hospital
Keyword 2: :
Schizophrenia
Keyword 3: :
Physiotherapy
Keyword 4: :
Psychological distress
Introduction: :
Pain experience in people with schizophrenia has received relatively little attention in clinical setting. Yet a meta-analysis found that 35% of them reported clinical pain, which is associated with disability, psychological distress and poorer quality of life. Pain assessment and management targeting this particular group need to address unique challenges such as altered pain perception, under-attended and non-verbalized somatic pain condition. Physiotherapy has been provided pain management service in KCH psychiatric adult day hospital throughout these years, in the good will to induce pain coping skill and prevent relapse. Retrospective data analysis will steer the direction of physiotherapy service in pain management for patients with schizophrenia.
Objectives: :
To evaluate the effectiveness of physiotherapy program in managing somatic pain for patients with schizophrenia.
Methodology: :
The clinical outcomes from our Physiotherapy Department were evaluated from February 2024 to September 2025. Inclusion criteria were psychiatric adult day hospital patients referred for pain management. In addition to usual physiotherapy pain assessment, self-report questionnaires and pain behavior observation were integrated to formulate a more tailored treatment plan. Apart from conventional physiotherapy interventions, psychoeducation, empowerment on coping strategies, relaxation skill and mindful stretching exercise were delivered according to individual’s need. Outcome measures included Numeric Pain Rating Scale (NPRS), Pain Interference (PI) part of Brief Pain Inventory-Short Form and Depression Anxiety Stress Scale (DASS-21). A one group pre- and post-test design with paired t-test was used for evaluation.
Result & Outcome: :
A total of 20 patients (Mean age: 56.7) were evaluated. Most patients had back and neck pain(50%). Significant improvement was shown in NPRS(from 7.1 to 3.4; p< 0.001, mean difference 3.7(95%CI 2.6-4.8)) Significant improvement was shown in PI(from 5.4 to 2.6; p< 0.001, mean difference 2.8(95%CI 1.6-4.0)) Significant improvement was shown in DASS-21
Depression: from mild to normal, p< 0.005, mean difference 6.9(95%CI 2.6-11.2)
Anxiety: from moderate to normal, p< 0.002, mean difference 4.0(95%CI 1.7-6.3)
Stress: from mild to normal, p< 0.002, mean difference 7.7(95%CI 3.3-12.2) People with schizophrenia may experience under-attended somatic pain from general population. A comprehensive physiotherapy assessment facilitated their expression of pain, therefore guided more specific interventions. The specialized individual physiotherapy treatment was found effective to manage the somatic pain and promote their pain coping skill. Subsequently, it was well-evident to achieve reduction of psychological stress in patients with schizophrenia.
