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A longitudinal study on the predictive validity of the fear-avoidance model in low back pain.
Pain. 2005 Sep; 117(1-2):162-70.PAIN

Abstract

Recently, fear-avoidance models have been quite influential in understanding the transition from acute to chronic low back pain (LBP). Not only has pain-related fear been found to be associated with disability and increased pain severity, but also treatment focused at reducing pain-related fear has shown to successfully reduce disability levels. In spite of these developments, there is still a lack in well-designed prospective studies examining the role of pain-related fear in acute back pain. The aim of the current study was to prospectively test the assumption that pain-related fear in acute stages successfully predicts future disability. Subjects were primary care acute LBP patients consulting because of a new episode of LBP (<or=3 weeks). They completed questionnaires on background variables, fear-avoidance model variables and LBP outcome (Graded Chronic Pain Scale, GCPS) at baseline, 3, 6, and 12 months follow-up and at the end of the study. Two-hundred and twenty-two acute LBP patients were included, of whom 174 provided full follow-up information (78.4%). A backward ordinal regression analysis showed previous LBP history and pain intensity to be the most important predictors of end of study GCPS. Of the fear-avoidance model variables, only negative affect added to this model. Our results do not really support the longitudinal validity of the fear-avoidance model, but they do feed the discussion on the role of pain-related fear in early stages of LBP.

Authors+Show Affiliations

Department of General Practice, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. judith.sieben@hag.unimaas.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16099095

Citation

Sieben, Judith M., et al. "A Longitudinal Study On the Predictive Validity of the Fear-avoidance Model in Low Back Pain." Pain, vol. 117, no. 1-2, 2005, pp. 162-70.
Sieben JM, Vlaeyen JW, Portegijs PJ, et al. A longitudinal study on the predictive validity of the fear-avoidance model in low back pain. Pain. 2005;117(1-2):162-70.
Sieben, J. M., Vlaeyen, J. W., Portegijs, P. J., Verbunt, J. A., van Riet-Rutgers, S., Kester, A. D., Von Korff, M., Arntz, A., & Knottnerus, J. A. (2005). A longitudinal study on the predictive validity of the fear-avoidance model in low back pain. Pain, 117(1-2), 162-70.
Sieben JM, et al. A Longitudinal Study On the Predictive Validity of the Fear-avoidance Model in Low Back Pain. Pain. 2005;117(1-2):162-70. PubMed PMID: 16099095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A longitudinal study on the predictive validity of the fear-avoidance model in low back pain. AU - Sieben,Judith M, AU - Vlaeyen,Johan W S, AU - Portegijs,Piet J M, AU - Verbunt,Jeanine A, AU - van Riet-Rutgers,Sita, AU - Kester,Arnold D M, AU - Von Korff,Michael, AU - Arntz,Arnoud, AU - Knottnerus,J André, PY - 2004/12/09/received PY - 2005/05/26/revised PY - 2005/06/06/accepted PY - 2005/8/16/pubmed PY - 2006/1/6/medline PY - 2005/8/16/entrez SP - 162 EP - 70 JF - Pain JO - Pain VL - 117 IS - 1-2 N2 - Recently, fear-avoidance models have been quite influential in understanding the transition from acute to chronic low back pain (LBP). Not only has pain-related fear been found to be associated with disability and increased pain severity, but also treatment focused at reducing pain-related fear has shown to successfully reduce disability levels. In spite of these developments, there is still a lack in well-designed prospective studies examining the role of pain-related fear in acute back pain. The aim of the current study was to prospectively test the assumption that pain-related fear in acute stages successfully predicts future disability. Subjects were primary care acute LBP patients consulting because of a new episode of LBP (<or=3 weeks). They completed questionnaires on background variables, fear-avoidance model variables and LBP outcome (Graded Chronic Pain Scale, GCPS) at baseline, 3, 6, and 12 months follow-up and at the end of the study. Two-hundred and twenty-two acute LBP patients were included, of whom 174 provided full follow-up information (78.4%). A backward ordinal regression analysis showed previous LBP history and pain intensity to be the most important predictors of end of study GCPS. Of the fear-avoidance model variables, only negative affect added to this model. Our results do not really support the longitudinal validity of the fear-avoidance model, but they do feed the discussion on the role of pain-related fear in early stages of LBP. SN - 0304-3959 UR - https://www.unboundmedicine.com/medline/citation/16099095/A_longitudinal_study_on_the_predictive_validity_of_the_fear_avoidance_model_in_low_back_pain_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0304-3959(05)00271-X DB - PRIME DP - Unbound Medicine ER -