Article

OBJECTIVES: To determine whether fear avoidance beliefs (FABs) in older adults
with chronic low back pain (CLBP) are significantly associated with gait speed
decline and/or self-report of greater disability. DESIGN: Cross-sectional
analysis. SETTING: An academic medical center (single site). PARTICIPANTS: Two
hundred English-speaking participants aged 65 years and older with CLBP every day
or almost every day of moderate or greater intensity for >/=3 months. MAIN
OUTCOME MEASUREMENTS: The physical activity portion of the FAB questionnaire
assessed FABs. Disability was measured with gait speed and the Roland Morris
Questionnaire. Covariates measured included age, gender, body mass index, chronic
disease (Cumulative Illness Rating Scale), depression (Geriatric Depression
Scale), and pain (McGill Pain Questionnaire Short Form). RESULTS: FABs were
significantly associated with the Roland Morris Questionnaire (P < .0001) and
gait speed (P = .002) after controlling for all covariates. CONCLUSION: FABs
related to physical activity in older adults with CLBP were significantly
associated with both self-reported and performance-based disability after
controlling for known confounders. Previous studies have reported similar
associations between self-reported measures of disabling back pain and FABs. Ours
is the first study to examine the relationship between FAB and gait speed, a
powerful predictor of morbidity and mortality. Future work should examine whether
targeting fear avoidance in addition to other psychosocial measures in older
adults with CLBP improves gait speed and functional independence.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS