Are fear-avoidance beliefs in low back pain patients a risk factor for low physical activity or vice versa? A cross-lagged panel analysis.
Are fear-avoidance beliefs in low back pain patients a risk factor for low physical activity or vice versa? A cross-lagged panel analysis.
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DOI：
10.3205/psm000057
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发表时间：
2009-04-29
期刊：
影响因子：
--
通讯作者：
Becker A
中科院分区：
文献类型：
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作者：
Leonhardt C;Lehr D;Chenot JF;Keller S;Luckmann J;Basler HD;Baum E;Donner-Banzhoff N;Pfingsten M;Hildebrandt J;Kochen MM;Becker A
目的：下背痛（LBP）患者由于高度恐惧回避信念而遭受“废用”的假设目前正在辩论中。二次分析用于调查恐惧避免信念是否与LBP患者的身体活动水平（PAL）在横截面和纵向上相关。 方法：共有787人（57%急性LBP和43%慢性LBP）进行了为期一年的随访，测量了恐惧回避信念和身体活动水平。通过FABQ（恐惧回避信念问卷）的身体活动分量表测量关于身体活动的恐惧回避信念，使用德国自我报告问卷以加权代谢当量（MET）小时/周评估身体活动水平。数据进行了研究的结构方程模型在交叉滞后面板设计的整个样本，分别为急性和慢性腰痛。结果：急性和慢性亚样本在一年后的总体力活动水平显着增加。结构方程模型的结果并不支持恐惧回避信念模型中固有的废用方面。交叉滞后路径系数较低（分别为0.04和0.05），因此，不允许通过最初的恐惧回避信念预测最终的体力活动，反之亦然。 讨论内容：因此，由于缺乏联系之间的恐惧回避信念和身体活动的纵向设计，恐惧回避信念模型的假设受到质疑。这些发现与最近公布的其他调查结果一致。最有可能的是，“恐惧回避信念”代表了一种认知模式，它并不限制活动本身，而只是针对避免特定的运动。
Objective: The assumption that low back pain (LBP) patients suffer from “disuse” as a consequence of high fear-avoidance beliefs is currently under debate. A secondary analysis served to investigate whether fear-avoidance beliefs are associated cross-sectionally and longitudinally with the physical activity level (PAL) in LBP patients. Methods: A total of 787 individuals (57% acute and 43% chronic LBP) were followed up over a period of one year with measurements of fear-avoidance beliefs and physical activity level. Fear-avoidance beliefs concerning physical activity were measured by the physical-activity subscale of the FABQ (Fear-Avoidance Beliefs Questionnaire), the physical activity level was assessed in weighted metabolic equivalents (MET) hours/week with a German self-report questionnaire. Data were investigated by structural equation modelling in a cross-lagged panel design for the whole sample and separately for acute and chronic LBP. Results: The acute and chronic sub sample increased their total physical activity level significantly after one year. The structural equation modelling results did not support the disuse-aspect inherent in the fear-avoidance belief model. Cross-lagged path coefficients were low (.04 and .05 respectively) and, therefore, did not allow to predict final physical activity by initial fear-avoidance beliefs or vice versa. Discussion: Consequently, due to missing links between fear-avoidance beliefs and physical activity in a longitudinal design, the assumptions of the fear-avoidance belief model have to be questioned. These findings are in line with other investigations published recently. Most probably, “fear-avoidance belief” represents a cognitive scheme that does not limit activity per se, but only is directed to the avoidance of specific movements.