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: β=−.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 (β=.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.
Keywords
List of abbreviations:
BMI (body mass index), CI (confidence interval), IQR (interquartile range), LBP (low back pain), MVPA (moderate-to-vigorous physical activity), RMDQ (Roland Morris Disability Questionnaire), TSK (Tampa Scale of Kinesiophobia), V⋅o2max (maximal oxygen consumption)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 03, 2016
Footnotes
Supported by the São Paulo Research Foundation (grant nos. 2015/17093-7, 2015/07704-9, 2015/02744-2, and 2014/14077-8).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
