Is there an association between fear of movement and physical activity levels in patients seeking care for chronic non-specific low back pain?

Abstract

In the field of chronic musculoskeletal pain, there is strong evidence that pain-related cognitive and behavioral responses have a major role in the development and maintenance of chronic or persistent symptoms. Fear of movement or (re)injury, also referred as kinesiophobia, is related to the more specific fear that physical activity will cause (re)injury. Fear of movement has shown to be a powerful predictor of chronicity in patients with low back pain. Theoretical models in the field of chronic musculoskeletal pain postulate that higher pain-related fear is associated with the development of avoidance behavior, eventually leading to disability and disuse. Although the role of fear of movement in the maintenance of chronic low back pain is well documented, the evidence regarding the association of fear of movement and lower levels of physical activity remains equivocal. A possible explanation for the lack of association in previous studies is the use of subjective methods to measure physical activity levels. A promising approach to objectively measure physical activity levels in this population is to use activity monitors, such as accelerometers. The main objective of this study is to determine whether fear of movement is independently associated with levels of physical activity. The sample for this study is derived from an ongoing project funded by FAPESP. This project is currently recruiting people with chronic non-specific low back pain. Data collection includes demographic and anthropometric data and measures of disability, pain, depression, fear of movement and objective measure of physical activity levels. The analysis of data and interpretation of the results will happen during the candidate's research internship at the George Institute at Global Health in Sydney/Australia under the supervision of Prof. Chris Maher. (AU)