Predicting Recurrence of Low Back Pain - Study #2

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DESCRIPTION (provided by applicant): The primary aims of this proposal are to determine how physical and psychological factors interact in the recovery process following an initial episode of low back pain and to determine how these factors contribute to risk for recurrence. Specifically, we propose to assess the relationship between motor coordination strategies (changes in lumbar and pelvic movement patterns) and levels of kinesiophobia (fear of painful re-injury upon physical movement) following an initial episode of low back pain. Two studies are proposed. Study 1 will examine movement patterns during performance of standardized reaching tasks in low back pain patients with high versus low levels of kinesiophobia. Participants will be assessed at 3, 6, and 12 weeks after onset of symptoms to track changes in motor coordination. By examining the relative magnitude of lumbar and pelvic motions used by low back pain patients who are high and low kinesiophobia, this design will allow us to track changes in the dynamic relationship between motor coordination and kinesiophobia during the process of recovery from acute low back pain. We hypothesize that lumbar motion will be significantly reduced in low back pain patients who are high versus low in kinesiophobia. Study 2 will examine movement patterns during standardized reaching tasks in individuals who have recently recovered from low back pain. Using a longitudinal design, we will develop a survival model to assess the risk for recurrence in the year following an initial episode of low back pain based on measures of spinal motion and kinesiophobia. We hypothesize that the highest risk of recurrent back pain will be observed in those who are high in kinesiophobia and who exhibit reduced spinal motion. The current proposal brings together promising ideas from motor coordination and health psychology literatures to provide an innovative integration of the best predictors of recurrent low back pain. The short-term goal of this research is characterize how spinal motion parameters and kinesiophobia interact to promote or delay recovery from acute low back pain. Our long-term goal is to use this information to develop an assessment protocol that can be easily adopted into clinical practice.