Evaluation of cognitive deficits and limit of stability in chronic low back pain patients with and without fear-avoidance beliefs.

OBJECTIVE

This study aimed to compare the cognitive performance and limit of stability parameters between chronic low back pain (CLBP) patients with and without fear-avoidance beliefs (FABs) and healthy control subjects.

METHODS

Thirty-four CLBP patients with and without FABs and 17 healthy controls were recruited into the study. Three cognitive components, including working memory, attention, and problem-solving, were assessed using Wechsler's Digit Span subtest, the Tower of London test, and the Integrated Visual and Auditory Continuous Performance Test (IVACPT), respectively. The study assessed the limit of stability using MARS software. One-way ANOVA with Bonferroni-corrected post-hoc comparisons revealed between-group differences. Additionally, Hedge's g effect size was calculated.

RESULTS

There was no significant difference between CLBP patients with and without FABs in Wechsler's Digit span and the Tower of London test. However, CLBP patients with FABs had lower scores and slower reaction times in the IVACPT(p < 0.05).The statistical analysis of movement velocity during the limit of stability (LOS) tasks revealed no significant difference between chronic low back pain patients with and without fear-avoidance beliefs in all directions. However, CLBP patients with FABs exhibited significantly slower reaction times in the forward (p = 0.001), backward (p = 0.001), and right (p = 0.001) directions.

CONCLUSION

The study indicates that chronic low back pain (CLBP) patients with FABs experience more pronounced cognitive impairments and balance disturbances compared to CLBP patients without FABs. These results underscore the significance of considering psychological factors when assessing the functional abilities of individuals with chronic low back pain.