Background/Purpose:

·         Low back pain is a debilitating and costly condition with complex biological, psychological, and social factors contributing to the development of chronic low back pain (CLBP).

·         Kinesiophobia is defined as an “excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury” (1).

·         According to cognitive behavioral models of fear and avoidance, maladaptive thoughts may lead to avoiding activity, which in turn may lead to illness behavior and increased disability.

·         Previous research suggests that depression, anxiety and kinesiophobia contribute to pain perception and physical function. 

·         Yet, little is known about how kinesiophobia and anxiety and depression may interact to predict disability.  

·         The objective of the present study was to explore the moderating effect of kinesiophobia on the relationship between depression and anxiety and disability in a sample of adults with chronic low back pain (CLBP).

Methods:

·         The study included 283 new patients seeking treatment for chronic pain.

·         New patients completed the Oswestry Disability Index, the Hospital Anxiety and Depression Scale, and the Tampa Scale of Kinesiophobia (TSK).  High kinesiophobia was defined as a score greater than 37 on the TSK.

Results:

·         High kinesiophobia was reported in 64% (N=181) of participants. 

·         Kinesiophobia, depression and anxiety were associated with greater disability. 

·         The moderated effect of depression was nonsignificant.   

·         Kinesiophobia modified the association between anxiety and disability (Table 1).  Namely, anxiety contributed to greater disability at high levels, but not low levels, of kinesiophobia (Figure 1).

Conclusion:

·         Kinesiophobia, anxiety, and depression were associated with greater disability. However, kinesiophobia moderated the relationship between anxiety and disability, such that having anxiety and high kinesiophobia was associated with a worse outcome.   

·         Kinesiophobia and anxiety are both modifiable psychological factors that can be addressed using cognitive restructuring and exposure based behavioral interventions.    

References:

·         Kori, S. H., et al. (1990). Kinisophobia: A new view of chronic pain behavior. Pain Management, 3, 35-43.