{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:20:31Z","timestamp":1768389631107,"version":"3.49.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to characterize 1-year pain trajectories in children with Duchenne muscular dystrophy (DMD) and identify predictors across physical, psychosocial, and quality-of-life domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a 1-year prospective cohort study involving young males with genetically confirmed DMD. Baseline assessments included sociodemographic characteristics, clinical history, chronic pain profile, fatigue, psychological distress, and health-related quality of life (HRQoL). Follow-up assessments were completed approximately 1 year later through structured telephone interviews with participants and their primary caregivers. Outcomes at follow-up included the presence of chronic pain, pain intensity, and pain interference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 73 participants (median age\u202f=\u202f10.6\u202fyears; range\u202f=\u202f8\u201316\u202fyears) completed the 1-year follow-up assessment. Multivariable logistic regression analysis indicated that physical function (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028; OR\u202f=\u202f0.929, 95% CI [0.586, 0.988]) and psychological distress (OR\u202f=\u202f1.502, 95% CI [1.157, 5.508],\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004) were significant independent predictors of chronic pain. Physical function also demonstrated a modest indirect effect through psychological distress (indirect effect\u202f=\u202f\u22120.048, 95% CI [\u22120.369, \u22120.0004]). Fatigue (indirect effect\u202f=\u202f\u22120.116, 95% CI [\u22120.567, \u22120.038]) and HRQoL (indirect effect\u202f=\u202f\u22120.064, 95% CI [\u22120.428, \u22120.022]) influenced pain outcomes only indirectly via psychological distress. Multivariable linear regression further showed that both psychological distress (severity:\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f0.208,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; 95% CI [0.105, 0.307]; interference:\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f0.193,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; 95% CI [0.100, 0.279]) and fatigue (severity:\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f\u22120.054,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.037; 95% CI [\u22120.107, \u22120.006]; interference:\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f\u22120.047,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.020; 95% CI [\u22120.085, \u22120.008]) were associated with increased pain burden. Physical function predicted pain severity (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f\u22120.036,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001; 95% CI [\u22120.057, \u22120.012]) but not pain interference, whereas HRQoL did not show a significant effect in either model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This prospective study identifies psychological distress and reduced physical function as independent contributors to chronic pain outcomes in DMD, with psychological distress mediating the effects of fatigue and HRQoL. Physical function was primarily associated with pain severity, whereas psychological distress and fatigue predicted the broader pain burden, including functional interference. These findings support a biopsychosocial model in which psychosocial factors translate underlying biological vulnerability into clinically significant pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1758612","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T06:34:29Z","timestamp":1768372469000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological and functional predictors of chronic pain outcomes in youth with Duchenne muscular dystrophy"],"prefix":"10.3389","volume":"14","author":[{"given":"Ruihao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Turong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunming","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meihuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/S1474-4422(18)30024-3","article-title":"Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management","volume":"17","author":"Birnkrant","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1111\/dmcn.14248","article-title":"Fatigue in young people with Duchenne muscular dystrophy","volume":"62","author":"El-Aloul","year":"2020","journal-title":"Dev Med Child Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1016\/j.jpain.2021.04.001","article-title":"The prevalence, characteristics and impact of chronic pain in people with muscular dystrophies: a systematic review 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highlights lack of psychosocial Care Services for Duchenne Muscular Dystrophy","author":"Meglio","year":"2025"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1037\/a0035747","article-title":"Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research","volume":"69","author":"Ehde","year":"2014","journal-title":"Am Psychol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"S99","DOI":"10.1542\/peds.2018-0333L","article-title":"Psychosocial management of the patient with Duchenne muscular dystrophy","volume":"142","author":"Colvin","year":"2018","journal-title":"Pediatrics"}],"container-title":["Frontiers in Public 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