Taheri Nima, Becker Luis, Fleig Lena, Kolodziejczak Karolina, Cordes Lea, Hoehl Bernhard U, Grittner Ulrike, Mödl Lukas, Schmidt Hendrik, Pumberger Matthias
Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Berlin Institute of Health, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Pain Rep. 2025 Mar 21;10(2):e1249. doi: 10.1097/PR9.0000000000001249. eCollection 2025 Apr.
Psychosocial function in people with chronic low back pain (cLBP) is often impaired, indicating poor well-being. Fear-avoidance beliefs (FAB) are common concomitants of cLBP. Fear-avoidance beliefs are gaining attention as a potential prognostic factor for chronification and resulting disability in cLBP. This article aims to examine the associations of back function with FAB.
This study presents data from a cohort study (DRKS00027907). In the present cross-sectional analyses, we included 914 participants (480 nonchronic LBP [ncLBP], 227 cLBP, 207 asymptomatic). Fear-avoidance beliefs were assessed using the fear-avoidance belief questionnaire (FABQ). The association between the FAB and clinical measures (Ott and Schober test, the sit-to-stand test [STS], and the finger-floor distance [FFD]) were analyzed. Back shape and function were also measured using a noninvasive device. The association between FABQ scores and clinical measures was assessed using age, body mass index, sex, and pain intensity-adjusted multiple linear regression models.
Associations between FAB and both clinical (Ott, Schober, STS, FFD) and noninvasive device measures were small. All relevant clinical measures were attenuated in individuals with elevated FAB.
We were able to demonstrate the association of both back shape and function in both clinical tests and noninvasive device measurements with self-reported fear-avoidance beliefs. However, the effect sizes were small. This may be attributed to the different assessment methods (objective vs self-report), resulting in reduced common method variance. In addition to the FAB, there may be other factors (eg, altered neuronal pathways; actual avoidance behavior such as reduced physical activity) that contribute to functional impairment.
慢性下腰痛（cLBP）患者的心理社会功能常受损，表明其幸福感较差。恐惧回避信念（FAB）是cLBP常见的伴随症状。恐惧回避信念作为cLBP慢性化及导致残疾的潜在预后因素正受到关注。本文旨在研究背部功能与恐惧回避信念之间的关联。
本研究呈现了一项队列研究（DRKS00027907）的数据。在本次横断面分析中，我们纳入了914名参与者（480名非慢性下腰痛[ncLBP]患者、227名cLBP患者、207名无症状者）。使用恐惧回避信念问卷（FABQ）评估恐惧回避信念。分析了恐惧回避信念与临床测量指标（奥特和朔贝尔试验、坐立试验[STS]以及手指-地面距离[FFD]）之间的关联。还使用一种非侵入性设备测量背部形态和功能。使用年龄、体重指数、性别和疼痛强度调整的多元线性回归模型评估FABQ评分与临床测量指标之间的关联。
恐惧回避信念与临床（奥特、朔贝尔、STS、FFD）及非侵入性设备测量指标之间的关联较小。在恐惧回避信念较高的个体中，所有相关临床测量指标均减弱。
我们能够证明，在临床测试和非侵入性设备测量中，背部形态和功能与自我报告的恐惧回避信念均有关联。然而，效应量较小。这可能归因于不同的评估方法（客观评估与自我报告），从而减少了共同方法偏差。除了恐惧回避信念外，可能还有其他因素（例如，神经元通路改变；实际的回避行为，如体力活动减少）导致功能受损。
