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Clinical course and impact of fear-avoidance beliefs in low back pain: prospective cohort study of acute and chronic low back pain: II.
Spine (Phila Pa 1976). 2006 Apr 20; 31(9):1038-46.S

Abstract

STUDY DESIGN

Prospective inception cohort study.

OBJECTIVES

To compare the clinical course of fear-avoidance beliefs in acute and chronic low back pain (LBP) and investigate the contribution of fear-avoidance beliefs to predict pain and disability after 1 year.

SUMMARY OF BACKGROUND DATA

Fear-avoidance beliefs are involved in disability development. There is little knowledge on the development of fear-avoidance beliefs among different LBP subgroups.

METHODS

Patients with acute (n = 123) and chronic (n = 50) LBP completed a comprehensive assessment, including the Fear-Avoidance Beliefs Questionnaire (FABQ), and were followed at 3, 6, 9, and 12 months.

RESULTS

At baseline, patients with chronic LBP had significantly higher FABQ-scores for work (FABQ-Work) than patients with acute LBP (P < 0.001), and this difference remained unchanged over 1 year (P > 0.21). At baseline, there was no statistical significant difference in FABQ-scores for physical activity (FABQ-PA) between the two groups (P = 0.57). FABQ-PA scores decreased significantly over the first 4 weeks among patients with acute LBP during follow-up and remained unchanged thereafter, whereas in the chronic sample the FABQ-PA scores were unchanged throughout the first year (time effect, P < 0.001; and interaction effect, P < 0.001). In the acute sample, FABQ-Work predicted pain (P < 0.05) and disability at 12 months (P = 0.01). In the chronic sample, FABQ-PA predicted disability at 12 months (P = 0.03). The associations between the FABQ and pain/disability disappeared with distress included in the models.

CONCLUSION

Patients with chronic LBP had more fear-avoidance beliefs for work than patients with acute LBP. There were small changes in fear-avoidance beliefs during the year of follow-up, except for a rapid decrease during the first month in the FABQ-PA in the acute sample. Fear-avoidance beliefs predicted pain and disability at 12 months after adjusting for socio-demographic and pain variables. Distress was a stronger predictor than fear-avoidance beliefs.

Authors+Show Affiliations

National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. margreth.grotle@medisin.uio.noNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16641782

Citation

Grotle, Margreth, et al. "Clinical Course and Impact of Fear-avoidance Beliefs in Low Back Pain: Prospective Cohort Study of Acute and Chronic Low Back Pain: II." Spine, vol. 31, no. 9, 2006, pp. 1038-46.
Grotle M, Vøllestad NK, Brox JI. Clinical course and impact of fear-avoidance beliefs in low back pain: prospective cohort study of acute and chronic low back pain: II. Spine (Phila Pa 1976). 2006;31(9):1038-46.
Grotle, M., Vøllestad, N. K., & Brox, J. I. (2006). Clinical course and impact of fear-avoidance beliefs in low back pain: prospective cohort study of acute and chronic low back pain: II. Spine, 31(9), 1038-46.
Grotle M, Vøllestad NK, Brox JI. Clinical Course and Impact of Fear-avoidance Beliefs in Low Back Pain: Prospective Cohort Study of Acute and Chronic Low Back Pain: II. Spine (Phila Pa 1976). 2006 Apr 20;31(9):1038-46. PubMed PMID: 16641782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical course and impact of fear-avoidance beliefs in low back pain: prospective cohort study of acute and chronic low back pain: II. AU - Grotle,Margreth, AU - Vøllestad,Nina K, AU - Brox,Jens I, PY - 2006/4/28/pubmed PY - 2006/5/19/medline PY - 2006/4/28/entrez SP - 1038 EP - 46 JF - Spine JO - Spine (Phila Pa 1976) VL - 31 IS - 9 N2 - STUDY DESIGN: Prospective inception cohort study. OBJECTIVES: To compare the clinical course of fear-avoidance beliefs in acute and chronic low back pain (LBP) and investigate the contribution of fear-avoidance beliefs to predict pain and disability after 1 year. SUMMARY OF BACKGROUND DATA: Fear-avoidance beliefs are involved in disability development. There is little knowledge on the development of fear-avoidance beliefs among different LBP subgroups. METHODS: Patients with acute (n = 123) and chronic (n = 50) LBP completed a comprehensive assessment, including the Fear-Avoidance Beliefs Questionnaire (FABQ), and were followed at 3, 6, 9, and 12 months. RESULTS: At baseline, patients with chronic LBP had significantly higher FABQ-scores for work (FABQ-Work) than patients with acute LBP (P < 0.001), and this difference remained unchanged over 1 year (P > 0.21). At baseline, there was no statistical significant difference in FABQ-scores for physical activity (FABQ-PA) between the two groups (P = 0.57). FABQ-PA scores decreased significantly over the first 4 weeks among patients with acute LBP during follow-up and remained unchanged thereafter, whereas in the chronic sample the FABQ-PA scores were unchanged throughout the first year (time effect, P < 0.001; and interaction effect, P < 0.001). In the acute sample, FABQ-Work predicted pain (P < 0.05) and disability at 12 months (P = 0.01). In the chronic sample, FABQ-PA predicted disability at 12 months (P = 0.03). The associations between the FABQ and pain/disability disappeared with distress included in the models. CONCLUSION: Patients with chronic LBP had more fear-avoidance beliefs for work than patients with acute LBP. There were small changes in fear-avoidance beliefs during the year of follow-up, except for a rapid decrease during the first month in the FABQ-PA in the acute sample. Fear-avoidance beliefs predicted pain and disability at 12 months after adjusting for socio-demographic and pain variables. Distress was a stronger predictor than fear-avoidance beliefs. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/16641782/Clinical_course_and_impact_of_fear_avoidance_beliefs_in_low_back_pain:_prospective_cohort_study_of_acute_and_chronic_low_back_pain:_II_ DB - PRIME DP - Unbound Medicine ER -