The Relationship Between Fear Avoidance Beliefs, Muscle Strength, and Short-Term Disability After Surgical Repair of Shoulder Instability

2020 ◽  
pp. 1-8
Author(s):  
Uri Gottlieb ◽  
Shmuel Springer
Keyword(s):  
Muscle Strength ◽  
Shoulder Instability ◽  
Surgical Repair ◽  
Physical Therapist ◽  
Fear Avoidance ◽  
Short Term ◽  
Fear Avoidance Beliefs ◽  
External Rotator ◽  
Fear Avoidance Beliefs Questionnaire

Context: Arthroscopic surgical repair of the shoulder is recommended when conservative treatment for shoulder instability (SI) fails. However, many patients undergoing this procedure do not return to same level of activity. Psychological factors and muscle strength have been shown to be associated with postoperative outcomes in other musculoskeletal conditions. Objective: To investigate the association between fear avoidance, muscle strength, and short-term function in patients after surgical SI repair. Methods: Twenty-five male patients who underwent shoulder surgery following at least one event of SI were included in this study. Evaluations of fear avoidance related to physical activity and disability were performed at baseline (during the first encounter with the physical therapist) and 7 to 8 weeks postsurgery. Fear avoidance beliefs were assessed using the Fear Avoidance Beliefs Questionnaire. Disability was assessed using the Disabilities of Arm, Shoulder, and Hand questionnaire and the Western Ontario SI index. The follow-up evaluation (weeks 7–8) included measurement of maximal isometric strength of the internal and external rotators. Nonparametric Kendall tau was used to determine the correlations between baseline fear avoidance, muscle strength, and disability at follow-up. Results: Disabilities of Arm, Shoulder, and Hand questionnaire at follow-up was significantly correlated with baseline Disabilities of Arm, Shoulder, and Hand questionnaire (τ = .520, P < .001), baseline fear avoidance (τ = .399, P = .008), and both internal rotator (τ = −.400, P = .005) and external rotator strength (τ = −.353, P = .014). Western Ontario SI index at follow-up was moderately correlated with baseline Western Ontario SI index (τ = .387, P = .007), internal rotator (τ = −.427, P = .003), and external rotator (τ = −.307, P = .032), but not with baseline Fear Avoidance Beliefs Questionnaire (τ = .22, P = .145). Conclusions: The results indicate a possible association between fear avoidance beliefs and short-term disability. Further studies are warranted to better explore and understand these relationships.

scholarly journals A 4-Week Multimodal Intervention for Individuals With Chronic Ankle Instability: Examination of Disease-Oriented and Patient-Oriented Outcomes

2019 ◽  
Vol 54 (4) ◽  
pp. 384-396 ◽  
Author(s):  
Cameron J. Powden ◽  
Johanna M. Hoch ◽  
Beth E. Jamali ◽  
Matthew C. Hoch
Keyword(s):  
Effect Size ◽  
Size Range ◽  
Ankle Instability ◽  
Foot And Ankle ◽  
Fear Avoidance ◽  
Balance Test ◽  
Fear Avoidance Beliefs ◽  
Ability Measure ◽  
Fear Avoidance Beliefs Questionnaire

Context Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention on a multidimensional profile of health have not been evaluated. Objective To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI. Design Controlled laboratory study. Setting Laboratory. Patients or Other Participants Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at least 1 previous ankle sprain, at least 2 episodes of “giving way” in the 3 months before the study, and a Cumberland Ankle Instability Tool score ≤24. Intervention(s) Individuals participated in 12 sessions over 4 weeks that consisted of ankle stretching and strengthening, balance training, and joint mobilizations. They also completed home ankle-strengthening and -stretching exercises daily. Main Outcome Measure(s) Dorsiflexion range of motion (weight-bearing–lunge test), isometric ankle strength (inversion, eversion, dorsiflexion, plantar flexion), isometric hip strength (abduction, adduction, flexion, extension), dynamic postural control (Y-Balance test), static postural control (eyes-open and -closed time to boundary in the anterior-posterior and medial-lateral directions), and patient-reported outcomes (Foot and Ankle Ability Measure–Activities of Daily Living and Foot and Ankle Ability Measure–Sport, modified Disablement in the Physically Active scale physical and mental summary components, and Fear-Avoidance Beliefs Questionnaire–Physical Activity and Fear-Avoidance Beliefs Questionnaire–Work) were assessed at 4 times (baseline, preintervention, postintervention, 2-week follow-up). Results Dorsiflexion range of motion, each direction of the Y-Balance test, 4-way ankle strength, hip-adduction and -extension strength, the Foot and Ankle Ability Measure–Activities of Daily Living score, the modified Disablement in the Physically Active scale–physical summary component score, and the Fear-Avoidance Beliefs Questionnaire–Physical Activity score were improved at postintervention (P &lt; .001; effect-size range = 0.72–1.73) and at the 2-week follow-up (P &lt; .001; effect-size range = 0.73–1.72) compared with preintervention. Hip-flexion strength was improved at postintervention compared with preintervention (P = .03; effect size = 0.61). Hip-abduction strength was improved at the 2-week follow-up compared with preintervention (P = .001; effect size = 0.96). Time to boundary in the anterior-posterior direction was increased at the 2-week follow-up compared with preintervention (P &lt; .04; effect-size range = 0.61–0.78) and postintervention (P &lt; .04) during the eyes-open condition. Conclusion A 4-week rehabilitation program improved a multidimensional profile of health in participants with CAI.

Translation and validation of the Finnish version of the Fear-Avoidance Beliefs Questionnaire (FABQ)

2016 ◽  
Vol 10 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Henri Terho ◽  
Marianne Haapea ◽  
Markus Paananen ◽  
Katariina Korniloff ◽  
Arja Häkkinen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Factor Analysis ◽  
Internal Consistency ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Cronbach's Alpha ◽  
The Mean ◽  
Good For ◽  
Fear Avoidance Beliefs Questionnaire

AbstractBackground and aimLow back pain (LBP) is a debilitating problem worldwide causing disability and reducing quality of life. The Fear Avoidance Beliefs Questionnaire (FABQ) was developed on the basis of the assumption that fear-avoidance beliefs play a major role in LBP-related disability. It comprises 16 items scored by the patient and includes sub-scores for fear-avoidance beliefs regarding work and physical activity. This study aimed to translate and validate the Finnish version of the FABQ and to measure its properties among Finnish patients with LBP.Material and methodsA forward-backward translation procedure was used based on modified recommended guidelines. The FABQ was applied to 66 Finnish patients with LBP. Patients answered the FABQ at baseline and again approximately two weeks later. The test-re-test reliability between the baseline and follow-up FABQwas evaluated by calculating intraclass correlation coefficients (ICC). Internal consistency between the items within total and sub-scores was evaluated by calculating Cronbach’s alpha. The items of the baseline FABQ were grouped using factor analysis and the correlations between the FABQ pain intensity in visual analogue scale (VAS) and Oswestry Disability Index (ODI) were assessed using linear regression analysis.ResultsThe Finnish version of the FABQ was successfully adapted. The mean age of patients was 46. Almost all patients (97%) reported LBP, most patients (76%) had chronic pain lasting more than 3 months and the mean intensity of LBP was 58 mm on VAS. The follow-up time between the first and second questionnaire ranged from 2 days to 59 days with the median of 16 days. The ICC value for reliability between the baseline and follow-up questionnaires was excellent for the total score (0.91) and work sub-score (0.89), and good for the physical activity sub-score (0.73). The items regarding work showed high or excellent reliability throughout, with ICC values ranging from 0.63 to 0.89. The ICC values for the items related to physical activity ranged from 0.43 to 0.66, displaying moderate to good reliability. Cronbach’s alpha for internal consistency was excellent for the total score (0.92) and work (0.89), and good for physical activity (0.71). The best factor analysis solution yielded three factors characterized by the fear that pain aggravates due to (1) work or (2) physical activity, and (3) fear-avoidance beliefs concerning work. Higher total FABQ score was associated significantly with higher VAS (p-value 0.021) and ODI (<0.001).Conclusion and implicationsThe expert committee successfully created an applicable Finnish versionof the FABQ. The Finnish FABQ is a valid and reliable instrument for assessing LBP patients’ fear avoidancebehaviour and has similar properties to those found in other validation studies of the FABQ. Thus it canbe used for assessing the risk of disability due to fear avoidance behaviour in Finnish-speaking patientswith LBP for both clinical and scientific purposes.

scholarly journals Response Shift After a 4-Week Multimodal Intervention for Chronic Ankle Instability

2019 ◽  
Vol 54 (4) ◽  
pp. 397-402 ◽  
Author(s):  
Cameron J. Powden ◽  
Matthew C. Hoch ◽  
Beth E. Jamali ◽  
Johanna M. Hoch
Keyword(s):  
Ankle Instability ◽  
Response Shift ◽  
Rehabilitation Program ◽  
Foot And Ankle ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Individual Level ◽  
Ability Measure ◽  
Fear Avoidance Beliefs Questionnaire

Context The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown. Objective To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program. Design Controlled laboratory study. Setting Laboratory. Patients or Other Participants Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at least 1 previous ankle sprain, at least 2 episodes of the ankle “giving way” in the 3 months before the study, and a score ≤24 on the Cumberland Ankle Instability Tool. Intervention(s) Individuals participated in 12 intervention sessions over 4 weeks and daily home ankle strengthening and stretching. Main Outcome Measure(s) Patient-reported outcomes (PROs) were assessed at 4 times (baseline, preintervention, postintervention, and 2-week follow-up). At the postintervention and 2-week follow-up, participants completed then-test assessments to measure RS. Then-test assessments are retrospective evaluations of perceived baseline function completed after an intervention. The PROs consisted of the Foot and Ankle Ability Measure-Activities of Daily Living and Sport subscales, the modified Disablement in the Physically Active scale physical and mental summary components, and the Fear-Avoidance Beliefs Questionnaire Physical Activity and Work subscales. We used repeated-measures analyses of variance to compare preintervention with then-test measurements. Individual-level RSs were examined by determining the number of participants who experienced preintervention to then-test differences that exceeded the calculated minimal detectable change. Results We did not identify an RS for any PRO (F &gt; 2.338, P &gt; .12), indicating no group-level differences between the preintervention and retrospective then-test assessments. Individual-level RS was most prominent in the Foot and Ankle Ability Measure-Sport subscale (n = 6, 30%) and the Fear-Avoidance Beliefs Questionnaire Physical Activity subscale (n = 9, 45%). Conclusions No group-level RS was identified for any PRO after a 4-week multimodal rehabilitation program in individuals with CAI. This finding indicates that traditional assessment of self-reported function was accurate for evaluating the short-term effects of rehabilitation in those with CAI. Low levels of individual-level RS were identified.

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.

Translation, cross-cultural adaptation and psychometric evaluation of the Thai version of the fear-avoidance beliefs questionnaire in patients with non-specific neck pain

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Taweewat Wiangkham ◽  
Nattawan Phungwattanakul ◽  
Patcharin Tedsombun ◽  
Isara Kongmee ◽  
Wanisara Suwanmongkhon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Factor Analysis ◽  
Neck Pain ◽  
Psychometric Evaluation ◽  
Cross Cultural ◽  
Fear Avoidance ◽  
Retest Reliability ◽  
Fear Avoidance Beliefs ◽  
Test Retest Reliability ◽  
Fear Avoidance Beliefs Questionnaire

AbstractObjectivesFear-avoidance beliefs questionnaire (FABQ) is a self-report, valid and reliable questionnaire to quantify fear and avoidance beliefs related to physical activity and work. Furthermore, it can be used to predict prolong disability in patients with non-specific neck pain. Although it was originally developed to manage patients with low back pain, it has also been studied in individuals with neck pain. This questionnaire was translated into several languages following reports of potential benefits in patients with neck pain. Recently, Thai neck clinical trials, international multi-centre trials and data sharing are growing throughout the world but no validated Thai version of the FABQ is available for clinical and research uses. Our objectives were to translate and cross-culturally adapt the FABQ into Thai version and evaluate its psychometric properties in Thai patients with non-specific neck pain.MethodsCross-cultural translation and adaptation of the FABQ were conducted according to standard guidelines. A total of 129 participants with non-specific neck pain were invited to complete the Thai versions of the FABQ (FABQ-TH), neck disability index and visual analogue scale for pain intensity. Psychometric evaluation included exploratory factor analysis, internal consistency, test-retest reliability, agreement, and convergent validity. Thirty participants completed the FABQ-TH twice with a 48-h interval between tests to assess the test-retest reliability.ResultsFactor analysis identified four components for the FABQ-TH (66.69% of the total variance). The intraclass correlation coefficient of test-retest reliability was excellent for the total score (0.986), work attitudes (0.995), physical activity attitudes (0.958), physical activity experiences (0.927), and expected recovery (0.984). Cronbach’s alpha for internal consistency was excellent (range 0.87–0.88) for all items. The minimal detectable change of the FABQ-TH was 5.85. The FABQ-TH correlated to its subscales (range 0.470–0.936), indicating the strongest association with work attitude. The weakest correlation was observed between the FABQ-TH and disability (rs=0.206, p=0.01). Missing data and significant floor or ceiling effects were not found.ConclusionsThe Thai version of the FABQ for non-specific neck pain was successfully adapted. It is a valid and reliable instrument to quantify fear and avoidance beliefs among patients with non-specific neck pain who speak and read Thai.

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

Injury-Related Fear in Individuals With and Without Chronic Ankle Instability: A Systematic Review

2021 ◽  
pp. 1-10
Author(s):  
Ashley M.B. Suttmiller ◽  
Ryan S. McCann
Keyword(s):  
Systematic Review ◽  
Ankle Sprain ◽  
Methodological Quality ◽  
Ankle Instability ◽  
Evidence Synthesis ◽  
Chronic Ankle Instability ◽  
Fear Avoidance ◽  
Physically Active ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

Context: Injury-related fear has recently been recognized to exist in ankle sprain populations. It is unclear, however, if injury-related fear levels differ between those who develop chronic ankle instability (CAI) and those who do not and the best tools for assessing these differences. Objective: The purpose of this study was to conduct a comprehensive systematic review investigating differences in injury-related fear between individuals with and without CAI. Evidence Acquisition: Relevant studies from CINAHL Plus with full text, PubMed, and SPORTDiscus through November 2020 were included. All studies used the Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, or Athlete Fear Avoidance Questionnaire as either a descriptor or a main outcome and provided comparison data between a CAI group and ankle sprain copers (COP) or controls (CON). The authors independently assessed methodological quality using the modified Downs and Black Quality Index. Studies were then grouped by between-group comparisons including CAI and CON, CAI and COP, and COP and CON. The authors calculated Hedge g effect sizes and 95% confidence intervals to examine group differences. Evidence Synthesis: A total of 11 studies were included in this review. In total, 8 studies provided data for the CAI and CON comparison, 7 for CAI and COP comparisons, and 4 for COP and CON comparisons. Methodological quality scores ranged from 60.0% to 86.7%, with 2 high-, and 9 moderate-quality studies. Overall, the evidence suggests that physically active individuals with CAI report higher levels of injury-related fear when compared with both COP and CON. Although limited, ankle sprain COP do not seem to differ from CON. Conclusion: Available evidence emphasizes the importance of injury-related fear in individuals who develop chronicity after ankle sprain injury. The Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia are useful for the identification of injury-related fear in individuals after sustaining an ankle sprain and should be used to inform rehabilitation strategies and to monitor efficacy in fear reduction.

scholarly journals Versão brasileira do Fear Avoidance Beliefs Questionnaire

2008 ◽  
Vol 24 (3) ◽  
pp. 615-623 ◽  
Author(s):  
Ana Maria de Abreu ◽  
Christina Danielli Coelho de Morais Faria ◽  
Sônia Maria Vicente Cardoso ◽  
Luci Fuscaldi Teixeira-Salmela
Keyword(s):  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

O objetivo deste estudo foi investigar as propriedades psicométricas e validar a versão em português do Fear Avoidance Beliefs Questionnaire (FABQ-Brasil): um instrumento de avaliação sobre as crenças e medos dos indivíduos com dor lombar e de como esta dor pode afetar suas atividades físicas, subescala FABQ-Phys, e ocupacionais, subescala FABQ-Work. O questionário foi traduzido para o português segundo metodologia recomendada e aplicado em 53 indivíduos com dor lombar crônica não específica. Coeficientes de correlação intraclasse (CCI) do teste-reteste e consistência interna do instrumento (a de Cronbach) foram adequadas, tanto para a FABQ-Phys (0,84 e 0,80, respectivamente) quanto para a FABQ-Work (0,91 e 0,90, respectivamente). A regressão múltipla stepwise revelou correlação significativa entre todos os itens isolados e suas respectivas subescalas, com a variação dos escores em cada uma delas sendo explicada em 99% pelo conjunto de seus itens. Correlação de Pearson entre as subescalas não foi significativa, mas entre estas e a intensidade da dor (escala visual numérica) e a incapacidade física (Questionário de Roland-Morris-Brasil) foi significativa e positiva. Portanto, o FABQ-Brasil apresentou propriedades psicométricas adequadas para ser utilizado na população brasileira com dor lombar crônica.

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