Does Kinesiophobia Mediate the Relationship between Pain Intensity and Disability in Individuals with Chronic Low-Back Pain and Obesity?

Giorgia Varallo,Gianluca Castelnuovo,Anna Guerrini Usubini,Federica Scarpina,Paolo Capodaglio,Emanuele Maria Giusti,Roberto Cattivelli

doi:10.3390/brainsci11060684

Abstract

Individuals suffering from chronic low-back pain and obesity face severe physical and functional limitations. According to the fear-avoidance model, kinesiophobia might play a crucial role in the relationship between pain intensity and disability. Thus, the purpose of this study was to verify the role of kinesiophobia as a mediator in the association between pain intensity and disability in individuals with both chronic low-back pain and obesity. A total of 213 individuals with chronic low-back pain and obesity were included in the study. The level of kinesiophobia, pain intensity and disability were all assessed using self-reported questionnaires. We verified through a simple mediation analysis that kinesiophobia partially mediated the association between pain intensity and disability in our sample. According to our findings, we emphasize the crucial role of kinesiophobia as a psychological factor that should be addressed in chronic low-back pain rehabilitative protocols to reduce disability in individuals with obesity.

Highlights

Chronic low-back pain (CLBP) occurs when pain lasts for more than three months and is associated with emotional distress, decreased physical functioning, and is not better accounted for by another disease [1]
The direct effect ((iv); c’) was reduced compared to the total effect (c), but remained significant (b = 0.449, SE = 0.161, p = 0.005). These findings revealed that the relationships between the level of pain intensity and the level of pain-related disability were partially mediated by the level of kinesiophobia
We suggested addressing kinesiophobia in therapeutic interventions especially in the case of associated obesity since individuals suffering from obesity and CLBP might not fully engage in treatments

Summary

Introduction

Chronic low-back pain (CLBP) occurs when pain lasts for more than three months and is associated with emotional distress, decreased physical functioning, and is not better accounted for by another disease [1]. Individuals with CLBP and obesity experience significant functional limitations and disability [9,10]. They do, face a dual problem: movement difficulties caused by excess weight, as well as pain interference in daily life due to CLBP [11]. Both conditions have an impact on one another. Reduced physical activity due to pain can result in weight gain [12,13]

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Conclusion