The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status

被引:347
作者
Fritz, JM
George, SZ
Delitto, A
机构
[1] Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA 15260 USA
[2] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Pittsburgh, PA 15260 USA
[3] Ctr Rehab Serv, Pittsburgh, PA USA
关键词
low back pain; fear avoidance beliefs; screening; secondary prevention;
D O I
10.1016/S0304-3959(01)00333-5
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Fear-avoidance beliefs have been identified as an important psychosocial variable in patients with chronic disability doe to low back pain. The importance of fear-avoidance beliefs for individuals with acute low back pain has not been explored. Seventy-eight subjects with work-related low back pain of less than 3 weeks' duration were studied. Measurements of pain intensity, physical impairment, disability, nonorganic signs and symptoms, and depression were taken at the initial evaluation. Fear-avoidance beliefs were measured with the work and physical activity subscales of the Fear-avoidance Beliefs Questionnaire. Disability and work status were re-assessed after 4 weeks of physical therapy. Patterns of correlation between fear-avoidance beliefs and other concurrently-measured variables were similar to those reported in patients with chronic low back pain. Fear-avoidance beliefs did not explain a significant amount of the variability in initial disability levels after controlling for pain intensity and physical impairment. Fear-avoidance beliefs about work were significant predictors of 4-week disability and work status even after controlling for initial levels of pain intensity, physical impairment, and disability, and the type of therapy received. Fear-avoidance beliefs are present in patients with acute low back pain, and may be an important factor in explaining the transition from acute to chronic conditions. Screening for fear-avoidance beliefs may be useful for identifying patients at risk of prolonged disability and work absence. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.
引用
收藏
页码:7 / 15
页数:9
相关论文
共 46 条
  • [1] [Anonymous], SPINE S
  • [2] Bigos S., 1994, Clinical practice guideline
  • [3] PSYCHOSOCIAL PREDICTORS OF OUTCOME IN ACUTE AND SUBCHRONIC LOW-BACK TROUBLE
    BURTON, AK
    TILLOTSON, KM
    MAIN, CJ
    HOLLIS, S
    [J]. SPINE, 1995, 20 (06) : 722 - 728
  • [4] EXPECTANCIES AND FUNCTIONAL IMPAIRMENT IN CHRONIC LOW-BACK PAIN
    COUNCIL, JR
    AHERN, DK
    FOLLICK, MJ
    KLINE, CL
    [J]. PAIN, 1988, 33 (03) : 323 - 331
  • [5] Avoidance and confrontation of painful, back-straining movements in chronic back pain patients
    Crombez, G
    Vervaet, L
    Lysens, R
    Baeyens, F
    Eelen, P
    [J]. BEHAVIOR MODIFICATION, 1998, 22 (01) : 62 - 77
  • [6] Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability
    Crombez, G
    Vlaeyen, JWS
    Heuts, PHTG
    Lysens, R
    [J]. PAIN, 1999, 80 (1-2) : 329 - 339
  • [7] Do pain expectancies cause pain in chronic low back patients? A clinical investigation
    Crombez, G
    Vervaet, L
    Baeyens, F
    Lysens, R
    Eelen, P
    [J]. BEHAVIOUR RESEARCH AND THERAPY, 1996, 34 (11-12) : 919 - 925
  • [8] A TREATMENT-BASED CLASSIFICATION APPROACH TO LOW-BACK SYNDROME - IDENTIFYING AND STAGING PATIENTS FOR CONSERVATIVE TREATMENT
    DELITTO, A
    ERHARD, RE
    BOWLING, R
    [J]. PHYSICAL THERAPY, 1995, 75 (06): : 470 - 485
  • [9] Predicting long-term functional limitations among back pain patients in primary care settings
    Dionne, CE
    Koepsell, TD
    VonKorff, M
    Deyo, RA
    Barlow, WE
    Checkoway, H
    [J]. JOURNAL OF CLINICAL EPIDEMIOLOGY, 1997, 50 (01) : 31 - 43
  • [10] Fairbank J C, 1980, Physiotherapy, V66, P271