Kinesiophobia in chronic low back pain patients—does the startle paradigm support the hypothesis?

Kronshage, Uta; Kroener-Herwig, Birgit; Pfingsten, M.

doi:10.1207/s15327558ijbm0804_5

Cited by 18 publications

(17 citation statements)

References 21 publications

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“…Our findings support the hypothesis proposed by Kronshage et al (2001) and Leonhardt et al (2009) that increased scores of fear of movement is associated with specific movement avoidance, perceived as a dangerous component of a task, rather than general task avoidance.…”

Section: Discussionsupporting

confidence: 92%

The influence of kinesiophobia on trunk muscle voluntary responses with pre-programmed reactions during perturbation in patients with chronic low back pain

Ramprasad

Shenoy

Sandhu

et al. 2011

Journal of Bodywork and Movement Therapies

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Section: Discussionsupporting

confidence: 92%

The influence of kinesiophobia on trunk muscle voluntary responses with pre-programmed reactions during perturbation in patients with chronic low back pain

Ramprasad

Shenoy

Sandhu

et al. 2011

Journal of Bodywork and Movement Therapies

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“…The authors suggest that viewing pictures is analogous to the postencounter stage of the defense cascade model, characterized by decreased startle reflex and deceleration in cardiac response. Therefore, it is not surprising that studies showing pictures of harmful movements 26 failed to find an elevated startle reflex or HR.…”

Section: Discussionmentioning

confidence: 99%

“…Vlaeyen et al 48 investigated muscular reactivity of highly fearful and avoidant (high FA) patients, with inconclusive results. In a study by Kronshage et al, 26 patients with high FA back pain did not show the predicted startle potentiation while viewing pictures of potentially pain-evoking movements. Barke et al 3 recently published an fMRI study on neural correlates of fear-avoidance and found that high FA participants did not show fear-related activation while viewing photographs depicting aversive movements.…”

Section: Introductionmentioning

confidence: 85%

Do patients with chronic pain show autonomic arousal when confronted with feared movements? An experimental investigation of the fear–avoidance model

Glombiewski

Riecke

Holzapfel

et al. 2015

Pain

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The relevance of a phobia-based conceptualization of fear for individuals with chronic pain has been much debated in the literature. This study investigated whether patients with highly fearful chronic low back pain show distinct physiological reaction patterns compared with less fearful patients when anticipating aversive back pain-related movements. We used an idiosyncratic fear induction paradigm and collected 2 different measures of autonomic nervous system activation and muscle tension in the lower back. We identified 2 distinct psychophysiological response patterns. One pattern was characterized by a moderate increase in skin conductance, interbeat interval (IBI) increase, and muscle tension increase in the lower back. This response was interpreted as an attention reaction to a moderately stressful event. The other pattern, found in 58% of the participants, was characterized by a higher skin conductance response, IBI decrease, and muscle tension increase in the lower back. According to Bradley and Lang defense cascade model, this response is typical of a fear reaction. Participants showing the psychophysiological pattern typical of fear also had elevated scores on some self-report measures of components of the fear-avoidance model, relative to participants showing the reaction pattern characteristic of attention. This study is the first to provide psychophysiological evidence for the fear-avoidance model of chronic pain.

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“…All of the identified questionnaires (FABQ, FAPS, FPQ, PASS and TSK) were already designed before the introduction of Vlaeyen's fear avoidance model in 1995. This fear avoidance model has been further elaborated on by several other researchers [61–63]. In addition, two recent models have tried to incorporate alternative activity-related behavioural strategies, among these are the Ergomania model [64] and the Avoidance-Endurance model [65].…”

Section: Discussionmentioning

confidence: 99%

Pain-Related Fear: A Critical Review of the Related Measures

Lundberg

Grimby-Ekman

Verbunt

et al. 2011

Pain Research and Treatment

123

142

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Objectives: In regards to pain-related fear, this study aimed to: (1) identify existing measures and review their measurement properties, and (2) identify the optimum measure for specific constructs of fear-avoidance, pain-related fear, fear of movement, and kinesiophobia. Design: Systematic literature search for instruments designed to measure fear of pain in patients with persistent musculoskeletal pain. Psychometric properties were evaluated by adjusted Wind criteria. Results: Five questionnaires (Fear-Avoidance Beliefs Questionnaire (FABQ), Fear-Avoidance of Pain Scale (FAPS), Fear of Pain Questionnaire (FPQ), Pain and Anxiety Symptoms Scale (PASS), and the Tampa Scale for Kinesiophobia (TSK)) were included in the review. The main findings were that for most questionnaires, there was no underlying conceptual model to support the questionnaire's construct. Psychometric properties were evaluated by diverse methods, which complicated comparisons of different versions of the same questionnaires. Construct validity and responsiveness was generally not supported and/or untested. Conclusion: The weak construct validity implies that no measure can currently identify who is fearful. The lack of evidence for responsiveness restricts the current use of the instruments to identify clinically relevant change from treatment. Finally, more theoretically driven research is needed to support the construct and thus the measurement of pain-related fear.

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Kinesiophobia in chronic low back pain patients—does the startle paradigm support the hypothesis?

Cited by 18 publications

References 21 publications

The influence of kinesiophobia on trunk muscle voluntary responses with pre-programmed reactions during perturbation in patients with chronic low back pain

The influence of kinesiophobia on trunk muscle voluntary responses with pre-programmed reactions during perturbation in patients with chronic low back pain

Do patients with chronic pain show autonomic arousal when confronted with feared movements? An experimental investigation of the fear–avoidance model

Pain-Related Fear: A Critical Review of the Related Measures

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