Transition from Acute to Persistent Low Back Pain: Do Fear-Avoidance Beliefs, Magnification, and Helplessness Cognitions Screen Best at First Medical Consultation or Afterwards at 3-, 6-, or 12-Week Follow-Up?

2012 ◽  
Vol 2 (1_suppl) ◽  
pp. s-0032-1319851-s-0032-1319851
Author(s):  
M. Melloh ◽  
A. Käser ◽  
C. Rolli Salathé ◽  
A. Elfering
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Medical Consultation ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs

Benefits of Adding Gluteal Dry Needling to a Four-Week Physical Exercise Program in a Chronic Low Back Pain Population. A Randomized Clinical Trial

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2948-2957
Author(s):  
Cristina Martín-Corrales ◽  
Irene Victoria Bautista ◽  
José Enrique Méndez-Mera ◽  
Rubén Fernández-Matías ◽  
Alexander Achalandabaso-Ochoa ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Exercise Program ◽  
Low Back ◽  
Fear Avoidance ◽  
Dry Needling ◽  
Fear Avoidance Beliefs ◽  
Pressure Pain Thresholds

Abstract Objective To determine if adding dry needling to a four-week exercise program has an additional benefit compared with adding sham dry needling to the same exercise program in subjects with chronic low back pain. Design Randomized clinical trial. Setting Physiotherapy and Pain Clinic of Alcala University. Subjects Forty-six patients with chronic low back pain. Methods Subjects were randomized to two groups: the dry needling group (N = 23) or sham dry needling group (N = 23). Both groups received a four-week exercise program and before the exercise started a session of dry needling or sham dry needling. Pain (visual analog scale), disability (Roland-Morris Questionnaire), and fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire) were assessed at baseline, after treatment, and at three-month follow-up. Pressure pain thresholds (algometer) were measured at baseline, after the dry needling or the sham dry needling, and after treatment. Results Both groups showed significant improvements for all variables. In the between-group comparison, the dry needling group improved significantly in pain at three-month follow-up and pressure pain thresholds at the end of treatment for all measures, and at three-month follow-up there was no improvement in gluteus medium. Conclusions In chronic low back patients, adding dry needling to a four-week exercise program has an additional benefit in pain and sensitivity compared with adding sham dry needling to the same exercise program.

Avaliação de Medos, Crenças e Comportamentos de Evitação em Policiais Militares de Minas Gerais Portadores de Dor Lombar Crônica/Fear-Avoidance Assessment in Minas Gerais Military Police Agents With Low Back Pain

1970 ◽  
Vol 5 (3) ◽  
pp. 18-26
Author(s):  
Marcelo von Sperling de Souza ◽  
Maximiliano Ferreira Torres de Carvalho ◽  
Anna Florence Alves Paulino Souza ◽  
Flávia Corrêa Assumpção
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Minas Gerais ◽  
Low Back ◽  
Fear Avoidance ◽  
Invasive Procedures ◽  
Military Police ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

RESUMO Objetivo: descrever os índices de medos, crenças e evitação em policiais militares portadores de dor lombar crônica, acompanhados pelo Grupo de Coluna Vertebral do Hospital da Polícia Militar de Minas Gerais (PMMG). Materiais e métodos: durante um período de três anos, estas variáveis foram medidas pelo Fear-avoidance beliefs questionnaire (FABQ) versão português-brasileira, preenchido por autorrelato. As demais variáveis utilizadas para classificação da amostra em subgrupos e comparação destes quanto aos seus escores no FABQ foram idade, sexo, histórico de procedimento invasivo de coluna, presença de radiculopatia e encaminhamento pela Junta Central de Saúde (JCS), órgão oficial de perícias médicas na PMMG. Resultados: 248 militares preencheram o questionário satisfatoriamente e foram incluídos no estudo. A média de pontuação do FABQ-Work foi de 23,18 ± 10,79, enquanto a média de pontuação do FABQ-Phys foi de 18,10 ± 6,09. Não foram encontradas diferenças significativas nos escores dos subgrupos divididos por sexo, histórico de procedimento invasivo ou presença de radiculopatia. Indivíduos com idade superior a 40 anos apresentaram maiores índices de medo e evitação para atividades físicas (FABQ-Phys). Indivíduos que se encontravam em afastamento prolongado do trabalho (encaminhados pela JCS) apresentaram maior medo e evitação tanto para atividades físicas quanto atividades de trabalho. Conclusão: estes resultados permitiram identificar características dos policias militares em risco de incapacidade prolongada, ressaltando a necessidade de medidas educativas focadas na correção de crenças errôneas sobre dor lombar crônica para um melhor prognóstico na sua reabilitação.Palavras-chave: Dor lombar, Polícia, Medo, Questionários ABSTRACTObjectives: the purpose of this study was to describe fear-avoidance levels in military police agents with chronic low back pain followed by the Spine Group of the Military Police Hospital. Materials and Methods: The Brazilian Portuguese version of the Fear-avoidance Beliefs Questionnaire (FABQ) was applied during a three-year period. Secondary variables (age, sex, history of spinal invasive procedures, presence of radiculopathy, referral from medical experts due to prolonged sick-leave) were used for subgroup analysis and FABQ mean scores comparison. Results: 248 patients filled out FABQ correctly and were included in the study. FABQ-work and FABQ-Phys means were 23.18±10.79 and 18.10±6.09, respectively. There were no differences in FABQ scores between subgroups divided by sex, invasive procedures or radiculopathy. Age subgroup comparisons revealed that older individuals (> 40-years old) showed higher FABQ-Phys scores. Individuals with prolonged sick-leave showed higher scores at both FABQ-Phys and FABQ-Work subscales. Conclusion: Our results allowed identification of variables possibly related to long-time disability in military police agents and put emphasis on the need of educational interventions in which fear-avoidance beliefs are addressed in order to improve their rehabilitation prognosis.Keywords: Low back pain, Police, Fear, Questionnaires.

A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability

Pain ◽  
1993 ◽  
Vol 52 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Gordon Waddell ◽  
Mary Newton ◽  
Iain Henderson ◽  
Douglas Somerville ◽  
Chris J. Main
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

scholarly journals The Prediction of Chronicity in Patients with Acute and Sub-Acute Non-Specific Low Back Pain and Associated Risk Factors: A Case-Control Study

2021 ◽  
Author(s):  
Mohsen Sadeghi-Yarandi ◽  
Mohammad Ghasemi ◽  
Ali Ghanjal ◽  
Mojtaba Sepandi ◽  
Ahmad Soltanzadeh
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Sleep Quality ◽  
Case Control Study ◽  
Case Control ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Control Study

Abstract Background: Chronic low back pain is one of the most common musculoskeletal disorders in different countries that people of any age can experience many times. This study aimed to predict the chronicity of non-specific acute and sub-acute LBP and related risk factors among cases referred to physiotherapy clinics.Methods: This case-control study was performed among 420 patients suffered from acute, sub-acute and chronic LBP referred to two physiotherapy centers in Tehran-Iran in 2020. Data were obtained using the Fear-Avoidance Beliefs Questionnaire (FABQ), Patient Health Questionnaire (PHQ-9), Pain Catastrophic Scale (PCS-13), Tampa Scale for Kinesiophobia (TSK-11), Pittsburgh Sleep Quality Index (PSQI), Walker's Health-Promoting Lifestyle Questionnaire, Roland Morris Disability Questionnaire (RMDQ) and Numerical Pain Rating Scale (NPRS). Data analysis was performed by applying independent sample t-test, chi-square, and multiple logistic regression in SPSS software version 25. IBM Amos version 22 was employed for path analysis.Results: The mean age and body mass index in all patients were 43.94 ± 6.72 years and 25.69 ± 3.54 kg.m-2, respectively. It was found that some demographic parameters (i.e. weight, BMI, job, type of occupational task performance, history of low back pain, work shift, underlying diseases and income), some cognitive parameters ( i.e. fear-avoidance beliefs, kinesiophobia, catastrophic pain, and depression), some lifestyle parameters (i.e. health responsibility, physical activity and interpersonal relationships), sleep quality and pain related disability were among the most critical risk factors in the chronicity of acute and sub-acute LBP (P < 0.05).Conclusion: Personal, psychological, and psychosocial parameters can be among the most critical predictors in the chronicity of acute and sub-acute non-specific LBP. Hence, paying attention to all the mentioned factors at the beginning of patients' treatment to create a targeted treatment algorithm and prevent the conversion of acute and sub-acute into chronic LBP has particular importance.

The Moderating Effect of Treatment Engagement on Fear-avoidance Beliefs in People with Chronic Low Back Pain

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Paul W. Marshall ◽  
Natalie M.V. Morrison ◽  
Annaleise Mifsud ◽  
Mitchell Gibbs ◽  
Naseeb Khan ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Treatment Engagement ◽  
Moderating Effect ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Effect Of Treatment

Changes in Pain Catastrophizing and Fear-Avoidance Beliefs as Mediators of Early Physical Therapy on Disability and Pain in Acute Low-Back Pain: A Secondary Analysis of a Clinical Trial

Pain Medicine ◽  
2021 ◽  
Author(s):  
Brittany L Sisco-Taylor ◽  
John S Magel ◽  
Molly McFadden ◽  
Tom Greene ◽  
Jincheng Shen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Pain Catastrophizing ◽  
Low Back ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Acute Low Back Pain ◽  
Early Physical Therapy

Abstract Objective The Fear-Avoidance Model of chronic pain (FAM) posits that pain catastrophizing and fear-avoidance beliefs are prognostic for disability and chronicity. In acute low-back pain, early physical therapy (PT) is effective in reducing disability in some patients. How early PT impacts short- and long-term changes in disability for patients with acute pain is unknown. Based on the FAM, we hypothesized that early reductions in pain catastrophizing and fear-avoidance beliefs would mediate early PT’s effect on changes in disability (primary outcome) and pain intensity (secondary outcome) over 3 months and 1 year. Subjects Participants were 204 patients with low-back pain of &lt; 16 days duration, who enrolled in a clinical trial (NCT01726803) comparing early PT sessions or usual care provided over 4 weeks. Methods Patients completed the Pain Catastrophizing Scale (PCS), Fear-Avoidance Beliefs Questionnaire (FABQ work and physical activity scales) and outcomes (Oswestry Disability Index and Numeric Pain Rating Scale) at baseline, 4 weeks, 3 months, and 1 year. We applied longitudinal mediation analysis with single and multiple mediators. Results Early PT led to improvements in disability and pain over 3 months, but not 1 year. In the single mediator model, four-week reductions in pain catastrophizing mediated early PT’s effects on 3-month disability and pain intensity improvements, explaining 16% and 22% of the association, respectively, but the effects were small. Pain catastrophizing and fear-avoidance beliefs did not jointly mediate these associations. Conclusions In acute low-back pain, early PT may improve disability and pain outcomes at least partly through reducing patients’ catastrophizing.

scholarly journals Are stabilisation exercises different to other treatments in improving physical activity or reducing disability for people with persistent low back pain? A systematic literature review

2020 ◽  
Vol 27 (11) ◽  
pp. 1-16
Author(s):  
Sara Gardiner ◽  
Helena Daniell ◽  
Benjamin Smith ◽  
Rachel Chester
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Confidence Interval ◽  
Patient Specific ◽  
Low Back ◽  
Fear Avoidance ◽  
Functional Scale ◽  
Disability Questionnaire ◽  
Randomised Controlled

Background/Aims Stabilisation exercises are commonly prescribed for people with persistent low back pain. However, for some patients, it has been hypothesised that stabilisation exercises could draw attention to protecting the core, promote hypervigilance and inhibit volitional movement. The aim of this study was to compare the effectiveness and reported adverse events, in particular fear avoidance, of stabilisation exercises compared with placebo or other treatments offered by physiotherapists on the outcome of disability and activity at 12- and 24-months' follow-up. Methods The following electronic databases were searched: Embase, Medline, AMED, CINAHL, from inception to June 2019. Only randomised controlled trails were included. Study selection, data extraction and appraisal of quality criteria using PEDro, were undertaken by two independent assessors. Results Seven studies (n=1820) were eligible. Of six studies that reported adverse effects in the group receiving stabilisation exercises, four reported none and two reported mild exacerbation of pain locally or elsewhere. Fear avoidance was not investigated in any of the studies. Across the studies, 12 analyses were reported and included seven different comparator groups and three outcome measures: Oswestry Disability Index (n=1), Roland Morris Disability Questionnaire (n=5), Patient Specific Functional Scale (n=4). Two studies included a 24-month follow up in addition to a 12-month follow up. Of the 12 studies, nine reported no significant differences between the effectiveness of stabilisation exercises and comparator groups. Stabilisation exercises were more effective than comparator groups for the following three analyses: compared to manual therapy or education at 12 but not 24 months for the Oswestry Disability Index (15.71, 95% confidence interval 19.3–10.01); compared to placebo for the Patient Specific Functional Scale (1.5, 95% confidence interval 0.7–2.2) but not the Roland Morris Disability Questionnaire; and compared to high load lifting for the Patient Specific Functional Scale (1.8 95% confidence interval 2.8–0.7). Conclusions Stabilisation exercises are safe and equally effective to other treatments, and possibly superior for some outcomes at some time points. No or only mild adverse effects were reported. However, none of the studies measured fear avoidance as an outcome and we recommend this be included in future randomised controlled trials measuring the effectiveness of stabilisation exercises.

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