Fear-avoidance beliefs about back pain in patients with subacute low back pain

Poiraudeau, Serge; Rannou, François; Baron, Gabriel; Hénanff, Anne Le; Coudeyre, Emmanuel; Rozenberg, Sylvie; Huas, Dominique; Martineau, Chloé; Jolivet-Landreau, Isabelle; Garcia-Macé, J.; Revel, Michel; Ravaud, Philippe

doi:10.1016/j.pain.2006.04.019

Cited by 113 publications

(64 citation statements)

References 24 publications

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“…or chronic LBP patients in previous French studies (23,(28)(29)(30)(31)(32). Thus, the population of our study is likely to be a mix of pain-free workers (as expected) with other workers suffering from "highly recurrent" LBP.…”

Section: Chaléat-valayer Et Almentioning

confidence: 78%

Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence: a randomized controlled trial

Chaléat-Valayer¹,

Denis²,

Abelin-Genevois³

et al. 2016

Scand J Work Environ Health

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This paper notes that a careful case definition of workers with previous history of low-back pain (LBP) is needed to better characterize sub-groups based on their recurrences profile. Workers with highly recurrent LBP may require a stepped secondary prevention in order to prevent recurrences and sick leave. The value of a workplace component reducing physical and psychosocial risks in secondary prevention of LBP must be explored.

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Section: Chaléat-valayer Et Almentioning

confidence: 78%

Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence: a randomized controlled trial

Chaléat-Valayer¹,

Denis²,

Abelin-Genevois³

et al. 2016

Scand J Work Environ Health

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show abstract

“…Our participants had all consulted for low back pain in the previous 6 months and had significant ongoing problems. They might, however, not be the same population as those currently attending for treatment who will tend to have more severe symptoms (36,37).…”

Section: Discussionmentioning

confidence: 99%

Predicting response to a cognitive–behavioral approach to treating low back pain: Secondary analysis of the BeST data set

Underwood¹,

Mistry²,

Lall³

et al. 2011

Arthritis Care & Research

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Objective. Identifying factors that predict who is likely to gain the greatest benefit from different treatments for low back pain is an important research priority. Here we report moderator analyses of the Back Skills Training Trial (BeST) that tested a cognitive-behavioral approach for low back pain. Methods. We recruited 701 participants ages >18 years with at least moderately troublesome low back pain present for >6 weeks from 56 general practices in 7 localities across England to a trial adding a group cognitive-behavioral approach to active management advice. The cognitive-behavioral package had a moderate effect on primary outcomes (Roland Morris Disability Questionnaire [RMDQ] and modified Von Korff scales). At 12-month followup, we tested for interaction between randomized groups on 2 prespecified baseline variables (troublesomeness and fear avoidance) and 10 post hoc (exploratory) variables identified from previous studies. Results. Neither troublesomeness nor fear avoidance moderated treatment effect on any of our primary outcomes. In the final model, the only moderation by baseline variables of the effect of randomization was on the RMDQ outcome. Being younger and currently working both moderated treatment effect, resulting in larger improvements as a response to treatment. Conclusion. Although BeST is one of the larger trials of back pain treatment, it is still too small to reliably detect moderation if it exists. Since the significant moderation effects were only observed for 1 outcome measure in 3 of 10 post-hoc analyses, we cannot conclude that these are true moderation effects.

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“…Klaber-Moffett et al [23] recommended a cut-off score [ 13 based on a median split of baseline scores, and found that patients with chronic LBP scoring above this cut-off were more likely to benefit from an exercise program instead of usual care. Poiraudeau and colleagues [34] found that patients with sub-acute LBP scoring above this threshold had higher levels of disability and anxiety.…”

Section: Introductionmentioning

confidence: 97%

Predictive validity of initial fear avoidance beliefs in patients with low back pain receiving physical therapy: is the FABQ a useful screening tool for identifying patients at risk for a poor recovery?

2007

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Several prospective studies examining patients receiving physical therapy support the predictive validity of FABQ subscale scores. This has lead to the proposition that the FABQ would be a useful screening tool, permitting early identification of patients at risk for a poor outcome with an opportunity to modify the treatment accordingly. However, the predictive validity of the FABQ within physical therapy practice has yet to be examined. Predictive validity was analyzed between the FABQ-PA, FABQ-W using both disability and pain as the dependent variables using Pearson correlation coefficients and stepwise hierarchical linear regression modeling controlling for baseline variables. Separate analyses were run for patients with private health insurance and those receiving workers' compensation. Further analysis of predictive validity was performed by dichotomizing the outcome of physical therapy. Patients were coded as having a poor outcome if they failed to achieve a minimum clinically important change in disability over the course of treatment. The accuracy of previously reported cut-off scales for both the FABQ-W and FABQ-PA were examined for both payor types. Results of the hierarchical linear regression analyses for patients with private insurance showed neither the FABQ-PA nor the FABQ-W score significantly improved the explained variance in change in pain or disability. For patients receiving workers' compensation, only the FABQ-W subscale score significantly contributed to the model after controlling for the other baseline variables for both changes in disability and pain. Only the FABQ-W subscale was predictive of poor outcome and this was only identified in the worker's compensation group. The results suggest that the work subscale of the FABQ might be an appropriate screening tool to identify patients with work-related LBP who are at risk for a poor outcome with routine physical therapy. Neither FABQ subscale was predictive of outcome for patients with private insurance, and the use of the FABQ, as a screening tool for patients with non-workrelated LBP was not supported.

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Fear-avoidance beliefs about back pain in patients with subacute low back pain

Cited by 113 publications

References 24 publications

Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence: a randomized controlled trial

Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence: a randomized controlled trial

Predicting response to a cognitive–behavioral approach to treating low back pain: Secondary analysis of the BeST data set

Predictive validity of initial fear avoidance beliefs in patients with low back pain receiving physical therapy: is the FABQ a useful screening tool for identifying patients at risk for a poor recovery?

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