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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.

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Authors+Show Affiliations

Grotle M
National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. margreth.grotle@medisin.uio.no
Vøllestad NK
No affiliation info available
Brox JI
No affiliation info available

MeSH

Acute DiseaseAdolescentAdultAffective SymptomsAvoidance LearningChronic DiseaseCultureDisability EvaluationEmploymentFearFemaleHumansLow Back PainMaleMiddle AgedProspective StudiesRange of Motion, ArticularRegression AnalysisSeverity of Illness IndexSurveys and Questionnaires

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_ L2 - https://doi.org/10.1097/01.brs.0000214878.01709.0e DB - PRIME DP - Unbound Medicine ER -