Goal of the Study?
This study aims to assess whether someone is generally fearful of painful movement or is it related to a specific task. It is common for those with chronic low back pain to experience an avoidance and fear of movement, likely because the movement has triggered a pain episode in the past. In this research paper published in Pain Reports1, the authors sought to see if kinesiophobia ( fear of movement ) is related to a specific movement or is it related to a general fear a person has developed.
Why are they doing this study?
One of the problems regarding questionnaires that are often used to evaluate fear avoidance is they do not replace an astute clinician who carefully assesses the presenting patient’s movement. Establishing an assessment strategy for the fear of specific movements would be more helpful.2
“The self-reported questionnaires administered before performing a particular
movement may not reflect the “actual” fear during the movement
because the questionnaires evaluate fear of general movement, not
the target movement.”
To better understand which movements may contribute to kinesiophobia, the researchers looked at 51 people and monitored lumbar flexion (bending forward). They used two accelerometers attached to the top and bottom of the lumbar spine and evaluated task-specific fear.
What did they find?
Task-specific fear was significantly more related to the kinematics of lumbar flexion, particularly in the speed of return to the starting position. In their 2 measures,task-specific fear and general kinesiophobia, they found task-specific fear was more closely related to peak angular velocity of the return from bending forward rather than fear avoidance general questionnaires.
Why do these findings matter?
The researchers of this paper concluded that specific tasks should be considered when fear of movement is part of the clinical picture for chronic low back pain patients.
At Dynamic Disc Designs, we believe the pain onset from flexion likely relates to instability, and if a patient with chronic low back pain can be shown the mechanical cause and the solutions to reduce pain, then a reduction in fear of the specific task can empower patients about their movements. Consider our L2-5 Hypermobility Dynamic Disc Model as a teaching tool.
- Task-specific fear rather than general kinesiophobia assessment is associated with kinematic differences in chronic low back pain during lumbar flexion: a preliminary investigation ↩
- The fear avoidance model disentangled: improving the clinical utility of the fear avoidance model. Clin J Pain 2010;26:739–46. ↩