Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance

Abstract

SummaryTwo studies are presented that investigated 'fear of movement/(re)injury' in chronic musculoskeletal pain and its relation to behavioral performance. The 1st study examines the relation among fear of movement/(re)injury (as measured with the Dutch version of the Tampa Scale for Kinesiophobia (TSK-DV)) (Kori et al. 1990), biographical variables (age, pain duration, gender, use of supportive equipment, compensation status), pain-related variables (pain intensity, pain cognitions, pain coping) and affective distress (fear and depression) in a group of 103 chronic low back pain (CLBP) patients. In the 2nd study, motoric, psychophysiologic and self-report measures of fear are taken from 33 CLBP patients who are exposed to a single and relatively simple movement. Generally, findings demonstrated that the fear of movement/(re)injury is related to gender and compensation status, and more closely to measures of catastrophizing and depression, but in a much lesser degree to pain coping and pain intensity. Furthermore, subjects who report a high degree of fear of movement/(re)injury show more fear and escape/avoidance when exposed to a simple movement. The discussion focuses on the clinical relevance of the construct of fear of movement/(re)injury and research questions that remain to be answered.

Comparison of a high-intensity and a low-intensity lumbar extensor training program as minimal intervention treatment in low back pain: a randomized trial

“…Baseline scores on functional disability (RDQ and OSW) were comparable to those of other study populations with moderate severe low back pain [2,8,12]. However, scores on fear of movement (TSK) [25,26] and selfexperienced health (SF-36) [9,29] were generally higher. Compared to a Dutch population of healthy men between 25 and 55 years of age [29], our CLBP population scored 8 points lower on the SF-36 Overall Summary Score, 16 points lower on the SF-36 Physical Component Score and only 1 point lower on the SF-36 Mental Component Score.…”

“…A high score reflects a high rate of pain-indicated limitations. This scale is considered to be complementary to the RDQ, as it is more sensitive to severe disability [1] -Tampa Scale for Kinesiophobia (TSK): a 17-item scale, ranging from 4 to 68 points, measuring the extent to which a chronic back patient fears physical damage due to movement [7,25]. A high score reflects a high degree of fear of movement -MOS 36-item Short Form Health Survey (SF-36): ranging from 0 to 100%, to score self-experienced health related to quality of life [30].…”

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

“…It is a summary score of five questions related to anxiety, depression, loss of behavioural/emotion control and psychological well-being experienced during the previous month [47]. The Tampa Scale for Kinesiophobia (TSK) with a score range of 17-68 (low-high) was used to measure the patient's current painrelated fear of movement/(re)injury [45]. The Self-Efficacy Scale (SES) with a score range of 8-64 (low-high) was used to measure patient's belief in their ability to perform physical activities [11].…”

Pain Catastrophizing Is Associated With Health Indices in Musculoskeletal Pain: A Cross-Sectional Study in the Dutch Community.

“…More recently, a cognitively oriented model was pre-sented in which pain catastrophizing and pain-related fear are postulated as central mechanisms in the development of chronic pain problems (Vlaeyen, Kole Snijders, Boeren, & van Eek, 1995;Vlaeyen, Kole Snijders, Rotteveel, & Ruesink, 1995). In this model, pain catastrophizing, defined as an exaggerated negative orientation toward pain (Sullivan, Bishop, & Pivik, 1995), is conceptualized as a precursor of pain-related fear, more specifically, fear of movement or (re)injury.…”