Fear of Movement Is Not Associated With Objective and Subjective Physical Activity Levels in Chronic Nonspecific Low Back Pain

Author(s)

Carvalho, Flavia A. ; Maher, Chris G. ; Franco, Marcia R. ; Morelhao, Priscila K. ; Oliveira, Crystian B. ; Silva, Fernanda G. ; Pinto, Rafael Z.

• Document type: Journal article
• Source: ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION; v. 98, n. 1, p. 96-104, JAN 2017.
• Web of Science Citations: 5

Abstract

Objectives: To assess the association of physical activity measures, derived with an accelerometer and a self-reported questionnaire, with fear of movement in patients with chronic nonspecific low back pain (LBP) and to investigate the association between disability and fear of movement in this population. Design: Cross-sectional study. Setting: Outpatient physical therapy university clinics. Participants: Patients (N=119) presenting with nonspecific LBP of >3 months' duration. Interventions: Not applicable. Main Outcome Measures: Physical activity levels measured objectively with an accelerometer (ie, counts per minute, time spent in moderate to -vigorous and light physical activity per day, number of steps per day, and number of 10-minute bouts of moderate-to-vigorous physical activity per day) and subjectively with a self-reported questionnaire (Baecke Physical Activity Questionnaire); fear of movement (Tampa Scale of Kinesiophobia); pain (11-point numerical rating scale); disability (Roland Morris Disability Questionnaire); and depression (Beck Depression Inventory). The associations were examined with correlational, univariate, and multivariable linear regression analyses. Results: None of the objective physical activity measures were associated with fear of movement. The apparent association of self-reported physical activity levels with fear of movement (correlational analyses: r=-.18; P<.05; univariate regression analyses: (beta=-.04; 95% confidence interval {[}CI], -.07 to -.01; P=.04) was not confirmed in multivariable analyses. Fear of movement was consistently associated with disability in both correlational (r=.42; P<.01) and multivariable (beta=.21; 95% CI, .11-31; P<.001) analyses. Conclusions: Our data support one aspect of the fear-avoidance model-that higher fear of movement is associated with more disability-but not the aspect of the model linking fear of movement with inactivity. (C) 2016 by the American Congress of Rehabilitation Medicine (AU)

• FAPESP's process: 15/17093-7 - Is there an association between fear of movement and physical activity levels in patients seeking care for chronic non-specific low back pain?
• Grantee: Flávia Alves de Carvalho
• Support Opportunities: Scholarships abroad - Research Internship - Scientific Initiation
• FAPESP's process: 15/07704-9 - Effects of senior dance on risk factors for falls in older adults: a randomised controlled clinical trial
• Grantee: Marcia Rodrigues Franco Zambelli
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 15/02744-2 - Comparing the responsiveness of objective and subjective physical activity-related measures in patients with non-specific chronic low back pain
• Grantee: Priscila Kalil Morelhão
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 14/14077-8 - Investigating the role of physical activity domains in the prognosis of non-specific low back pain
• Grantee: Rafael Zambelli de Almeida Pinto
• Support Opportunities: Research Grants - Young Investigators Grants