Background: Before an intervention can be implemented to improve pain-related self-efficacy, assessment is required. The aim of the present study was to provide a systematic review on which self-efficacy scales are being used among patients with back pain and to evaluate their psychometric properties. Methods: A systematic search was executed in January 2019 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist served as a guide for conducting the study. Electronic databases included Cinahl, Medline, PubMed, PsycINFO, PSYNDEX, and SportDiscus. Publications in English or German language that focused on the adult patient population with back pain and which provided validation or reliability measures on pain-related self-efficacy were included. Results: A total of 3512 records were identified resulting in 671 documents after duplicates were removed. A total of 233 studies were screened full-text, and a total of 47 studies addressing 19 different measures of pain-related self-efficacy were included in the quality analysis. The most commonly used instruments were the Pain Self-Efficacy Questionnaire and the Chronic Pain Self-Efficacy Scale. All studies reported internal consistency, but many studies lacked other aspects of reliability and validity. Conclusions: Further research should focus on assessing validity and interpretability of these questionnaires, especially in pain-related target groups. Researchers should select questionnaires that are most appropriate for their study aims and the back pain population and contribute to further validation of these scales to best predict future behavior and develop intervention programs. This systematic review aids selection of pain-related assessment tools in back pain both in research and practice.

Background Mental health is an emerging topic on university campuses, with students reporting higher levels of psychological distress than the general population of the same age. Increasing physical activity and reducing sedentary time have been proved promising measures to promote mental health in the general population. However, to derive and implement effective measures to promote mental health among university students, further exploration of the associations between physical activity, sedentary time, and perceived stress in this specific setting is needed. Objective This study aims to identify associations between physical activity, sedentary time, and perceived stress after controlling for sociodemographic and behavioral variables among university students in Germany. We hypothesize that perceived stress is inversely related to physical activity and positively associated with sedentary time. Furthermore, we hypothesize that combined associations of concurrently high physical activity and low sedentary time on perceived stress are stronger compared with either alone and that the association between physical activity and perceived stress depends on activity intensity. Methods We conducted cross-sectional analyses from a large-scale internet-based student health survey (n=4189; response rate=10.0%). Physical activity, sedentary time, and engaging in moderate and vigorous activity intensities were assessed using the International Physical Activity Questionnaire Short Form with categorization into low, intermediate, and high levels. We measured perceived stress using the 10-item Perceived Stress Scale (range 0-40). Results The results indicate that higher physical activity and lower sedentary time are associated with reduced levels of perceived stress. Following adjustment for gender, BMI, income, fruit and vegetable intake, alcohol consumption, and sleep quality, perceived stress scores were lower for students reporting high physical activity levels and low sedentary time compared with the least active and highly sedentary students (Perceived Stress Scale –2.2, 95% CI –2.9 to –1.5, P<.001 for physical activity and –1.1, CI 95% –1.7 to –0.5, P<.001 for sedentary time). Combined associations with perceived stress revealed that students concurrently reporting high total physical activity and low sedentary time reported the lowest perceived stress scores of all possible combinations following adjustment for confounders (Perceived Stress Scale –3.5, CI 95% –4.6 to –2.5, P<.001 compared with students reporting low physical activity levels and concurrently high sedentary time). Associations between vigorous physical activities and perceived stress were not stronger compared with moderate activity intensities. Conclusions Self-reported physical activity and low sedentary time are favorably associated with perceived stress, while the intensity of physical activities seems to be of minor importance. These results help to effectively implement health-promoting measures on campus among university students through increasing physical activity and reducing sedentary time.

Objective: Chronic back pain (CBP) is responsible for considerable suffering across the world and is frequently associated with decreased functional capacity, quality of life, and substantial health care costs. Fear avoidance beliefs (FAB) comprise cognitions and fears about the potential for physical activities to produce pain and harm and are common among people with CBP. Collectively, research shows that FAB are frequently associated with low levels of physical activity, poorer work outcomes, and disability. Therefore, the purpose of this systematic review is to systematically locate and synthesize the current evidence regarding the effectiveness of psychological interventions on fear avoidance beliefs and fear avoidance behavior in patients with CBP. Design: A systematic literature search was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included the databases Web of Science, PubMed, Cochrane, CINAHL, Medline, and PsycINFO. Results: A total of 5,052 records were identified resulting in 2,448 documents after duplicates were removed. We screened 147 studies full text. Twenty-two studies were included in the qualitative synthesis. FAB were assessed by the Fear Avoidance Beliefs Questionnaire, the Tampa Scale of Kinesiophobia and the Avoidance Exercise Questionnaire. Interventions included cognitive behavior therapy (CBT), psychoeducation (PE), and other psychological approaches like motivational interviewing. Twelve of 22 studies demonstrated significant improvements in FAB for people with CBP who underwent a PE or CBT intervention or a different psychological approach. Conclusion: CBT and PE interventions are mainly used to address FAB among people with CBP. However, there is still inconsistent evidence as to which psychological interventions are most effective to treat FAB among people with CBP. Impact and ImplicationsThere is some promising evidence to support that cognitive behavior therapy (CBT) is effective in treating fear avoidance beliefs (FAB) among people with chronic back pain (CBP). Future research should focus on stratifying the pain neuroscience education and identifying which aspects of CBT are most effective for changing beliefs. Future research efforts should be directed toward developing and testing tailored interventions to address individualized patient pain problems. Potential collaborations looking at individual patient data meta-analysis or network meta-analysis may help isolate aspects of CBT that are most worthwhile pursuing for changing fear avoidance outcomes.

Die Beobachtung ist ein zentrales Verfahren der wissenschaftlichen Datenerhebung. Sie gewinnt durch die technische Entwicklung noch weiter an Bedeutung: Geräte ermöglichen die automatisierte Aufzeichnung von Verhalten, Bewegungen und (Körper-)Reaktionen auch über längere Zeiträume. Die Autor:innen stellen die methodischen Spezifika von Beobachtungen dar und erläutern die Durchführung von qualitativen und quantitativen Formen der Beobachtung sowie die daraus entstehenden Daten. Auf dieser Grundlage werden exemplarisch relevante Beobachtungsstudien aus der Sportwissenschaft vorgestellt und fachtypische Fragestellungen untersucht. Dabei gehen die Autor:innen unter anderem auf Spielanalysen, Bewegungsanalysen und die Beobachtung von physiologischen Prozessen ein.

BACKGROUND Regular physical activity treatment has been advocated for the prevention and rehabilitation of patients at risk of cardiovascular diseases and depressive symptoms. How physical activity is related to depressive symptoms is widely discussed. OBJECTIVE The aim of this internet-based study was to investigate the role of perceived social support in the relationship between physical activity habit strength and depressive symptoms. METHODS In total, 790 participants (mean 50.9 years, SD 12.2, range 20-84 years) who were interested in reducing their cardiovascular risk were recruited in Germany and the Netherlands. Data collection was conducted via an internet-based questionnaire addressing physical activity habit strength, depressive symptoms, and perceived social support. Cross-sectional data analysis was done with SPSS version 24 using the Macro PROCESS version 2 16.3 by Hayes with bootstrapping (10,000 samples), providing 95% CIs. RESULTS Physical activity habit strength was negatively related to depressive symptoms (r=–.13, P=.006), but this interrelation disappeared when controlling for perceived social support (beta=–.14, SE 0.09, P=.11). However, there was an indirect relationship between physical activity habit strength and depressive symptoms, which was mediated via perceived social support (beta=–.13; SE 0.04, 95% CI –0.21 to 0.06). The negative relationship between physical activity habit strength and depressive symptoms was fully mediated by perceived social support. CONCLUSIONS We suggest that physical activity treatment in people interested in reducing their cardiovascular risk should also embed social support to target depressive symptoms. Internet-based interventions and electronic health may provide a good option for doing so. CLINICALTRIAL ClinicalTrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/73Y9RfdiY)