The Fear Avoidance Model Disentangled: Improving the Clinical Utility of the Fear Avoidance Model

Abstract

Future research should elucidate whether the proposed subgrouping of patients with avoidance behavior is helpful. Further research should focus on developing more accurate and psychometrically sound assessment tools as well as targeted interventions to improve activities and participation of patients with chronic disabling musculoskeletal pain disorders.

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

“…In conclusion, only variables for neck flexibility and trajectory movement control showed significant associations with clinical characteristics such as, pain, disability and GPE. (Pincus et al, 2010, Wideman et al, 2013. In addition, a study of low back pain patients found a considerable overlap between the three psychological variables used in this thesis, and suggested that they reflect the same underlying construct, namely psychological emotional distress related to pain and disability .…”

A Self-Regulation Perspective on Avoidance and Persistence Behavior in Chronic Pain

“…Nevertheless, the fear-avoidance model has also been criticized, because interventions based on the model have not delivered convincing results, and observations from clinical practice suggest that this may be due to suboptimal identification and assessment of subgroups within the population of fearful-avoidant patients 11 . Furthermore, it has become increasingly clear that the typical fearavoidance pattern is not the default mode for all patients suffering from chronic pain.…”

A brief primary care intervention to reduce fear of movement in chronic low back pain patients

“…Early primary care-based efforts to translate interventions designed explicitly to change fear avoidance behavior and disability were no better than control/comparison interventions [8]. Interventions were found ineffective because of insufficient training for practitioners, and failure to select patients high on psychosocial risk factors such as fear avoidance [8].…”

“…The PCB intervention included a single education session [8], an in vivo rather than imagined exposure to the fearful stimuli of movement [9], and visual performance feedback (VPF). Single session pain education sessions have Policy: Health care reform models and reimbursement policies should include access to integrated biopsychosocial treatments designed to improve function in chronic pain patients treated in primary care settings.…”

“…Interventions were found ineffective because of insufficient training for practitioners, and failure to select patients high on psychosocial risk factors such as fear avoidance [8]. We addressed these issues by designing a treatment approach based on previously successful interventions that could be delivered within the time and space constraints of a busy primary care setting by staff well trained in the delivery of biopsychosocial-based interventions for CNP [19].…”