Article

Self-report measures for assessing specific fear of activities have
not been reported in the peer-reviewed literature, but are necessary to
adequately test treatment hypotheses related to fear-avoidance models. OBJECTIVE:
This study described psychomotor properties of a novel self-report measure, the
Fear of Daily Activities Questionnaire (FDAQ). DESIGN: A prospective cohort
design was used. METHODS: Reliability and validity cohorts were recruited from
outpatient physical therapy clinics. Analyses for the reliability cohort included
internal consistency and 48-hour test-retest coefficients, as well as standard
error of measurement and minimal detectable change estimates. Analyses for the
validity cohort included factor analysis for construct validity and correlation
and multiple regression analyses for concurrent and predictive validity.
Four-week responsiveness was assessed by paired t test, effect size calculation,
and percentage of patients meeting or achieving MDC criterion. RESULTS: The FDAQ
demonstrated adequate internal consistency (Cronbach alpha=.91, 95% confidence
interval=.87-.95) and 48-hour test-retest properties (intraclass correlation
coefficient=.90, 95% confidence interval=.82-.94). The standard error of
measurement for the FDAQ was 6.6, resulting in a minimal detectable change of
12.9. Factor analysis suggested a 2- or 3-factor solution consisting of loaded
spine, postural, and spinal movement factors. The FDAQ demonstrated concurrent
validity by contributing variance to disability (baseline and 4 weeks) and
physical impairment (baseline) scores. In predictive validity analyses, baseline
FDAQ scores did not contribute variance to 4-week disability and physical
impairment scores, but changes in FDAQ scores were associated with changes in
disability. The FDAQ scores significantly decreased over a 4-week treatment
period, with an effect size of .86 and 55% of participants meeting the minimal
detectable change criterion. LIMITATIONS: The validity cohort was a secondary
analysis of a clinical trial, and additional research is needed to confirm these
findings in other samples. CONCLUSIONS: The FDAQ is a potentially viable measure
for fear of specific activities in physical therapy settings. These analyses
suggest the FDAQ may be appropriate for determining graded exposure treatment
plans and monitoring changes in fear levels, but is not appropriate as a
screening tool.

Langue : ANGLAIS