Nima Taheri, Luis Becker, Lena Fleig, Karolina Kolodziejczak, Lea Cordes, Bernhard U Hoehl, Ulrike Grittner, Lukas Mödl, Hendrik Schmidt, Matthias Pumberger
{"title":"Fear-avoidance beliefs are associated with changes of back shape and function.","authors":"Nima Taheri, Luis Becker, Lena Fleig, Karolina Kolodziejczak, Lea Cordes, Bernhard U Hoehl, Ulrike Grittner, Lukas Mödl, Hendrik Schmidt, Matthias Pumberger","doi":"10.1097/PR9.0000000000001249","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Psychosocial function in people with chronic low back pain (cLBP) is often impaired, indicating poor well-being. Fear-avoidance beliefs (FAB) are common concomitants of cLBP. Fear-avoidance beliefs are gaining attention as a potential prognostic factor for chronification and resulting disability in cLBP. This article aims to examine the associations of back function with FAB.</p><p><strong>Methods: </strong>This study presents data from a cohort study (DRKS00027907). In the present cross-sectional analyses, we included 914 participants (480 nonchronic LBP [ncLBP], 227 cLBP, 207 asymptomatic). Fear-avoidance beliefs were assessed using the fear-avoidance belief questionnaire (FABQ). The association between the FAB and clinical measures (Ott and Schober test, the sit-to-stand test [STS], and the finger-floor distance [FFD]) were analyzed. Back shape and function were also measured using a noninvasive device. The association between FABQ scores and clinical measures was assessed using age, body mass index, sex, and pain intensity-adjusted multiple linear regression models.</p><p><strong>Results: </strong>Associations between FAB and both clinical (Ott, Schober, STS, FFD) and noninvasive device measures were small. All relevant clinical measures were attenuated in individuals with elevated FAB.</p><p><strong>Discussion: </strong>We were able to demonstrate the association of both back shape and function in both clinical tests and noninvasive device measurements with self-reported fear-avoidance beliefs. However, the effect sizes were small. This may be attributed to the different assessment methods (objective vs self-report), resulting in reduced common method variance. In addition to the FAB, there may be other factors (eg, altered neuronal pathways; actual avoidance behavior such as reduced physical activity) that contribute to functional impairment.</p>","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":"10 2","pages":"e1249"},"PeriodicalIF":3.1000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932623/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/PR9.0000000000001249","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Psychosocial function in people with chronic low back pain (cLBP) is often impaired, indicating poor well-being. Fear-avoidance beliefs (FAB) are common concomitants of cLBP. Fear-avoidance beliefs are gaining attention as a potential prognostic factor for chronification and resulting disability in cLBP. This article aims to examine the associations of back function with FAB.
Methods: This study presents data from a cohort study (DRKS00027907). In the present cross-sectional analyses, we included 914 participants (480 nonchronic LBP [ncLBP], 227 cLBP, 207 asymptomatic). Fear-avoidance beliefs were assessed using the fear-avoidance belief questionnaire (FABQ). The association between the FAB and clinical measures (Ott and Schober test, the sit-to-stand test [STS], and the finger-floor distance [FFD]) were analyzed. Back shape and function were also measured using a noninvasive device. The association between FABQ scores and clinical measures was assessed using age, body mass index, sex, and pain intensity-adjusted multiple linear regression models.
Results: Associations between FAB and both clinical (Ott, Schober, STS, FFD) and noninvasive device measures were small. All relevant clinical measures were attenuated in individuals with elevated FAB.
Discussion: We were able to demonstrate the association of both back shape and function in both clinical tests and noninvasive device measurements with self-reported fear-avoidance beliefs. However, the effect sizes were small. This may be attributed to the different assessment methods (objective vs self-report), resulting in reduced common method variance. In addition to the FAB, there may be other factors (eg, altered neuronal pathways; actual avoidance behavior such as reduced physical activity) that contribute to functional impairment.