Kinesiophobia, functional disability and physical deconditioning evaluation in chronic low back pain

Abstract

Chronic low back pain, which represents only 5 to 10% of the cases, is the cause of high health and social costs. Non-specific chronic low back pain has negative effects for physical activities and patient psychology. The aim of this study was to evaluate kinesiophobia, functional abilities and physical deconditioning in a population with chronic low back pain. The Tampa Scale of Kinesiophobia (TSK) Arabic version was used to evaluate pain beliefs and fear of movement/(re) injury. To evaluate functional abilities, we used both Oswestry Disability index (ODI) and Visual Analog Scale (VAS) of functional discomfort. Pain intensity was measured in calculating VAS of pain intensity. In order to assess endurance-responses, the following tests were used: Sorensen and Shirado tests. In addition, we studied relations between Kinesiophobia, Pain Intensity, Functional Disabilities and Endurance tests. To verify the significance of the correlations between the different variables, we used the Spearman correlation coefficient. The significance level was set at 5% ( P < 0.05). A total of 50 patients with non-specific chronic low back pain were recruited from Department of Physical Medicine and Functional Rehabilitation, Habib Bourguiba University Hospital of Sfax, Tunisia. The average Kinesiophobia score was high in our patients (48.5 ± 10.2). The mean Oswestry index was 34.4 ± 12.5%, whereas the functional VAS was 5.86 ± 2.13. High positive correlation was founded between global score of TSK and ODI ( r = 0.6, P < 0.001). Moreover, TSK was significantly correlated with VAS of functional discomfort ( r = 0.7, P < 0.001) and VAS of pain intensity ( r = 0.46, P = 0.001). About endurance variables, TSK showed negative correlations according Shirado test ( r = −0.51, P < 0.001) and Sorensen test ( r = −0.39, P = 0.004) on a moderate to low level. Given these results, Kinesiophobia presents a real problem in chronic low back pain patients since it has been significantly correlated with functional abilities and physical deconditioning. We intend to propose multidisciplinary therapeutic management programs. These programs will rely on psychological education and cognitive-behavioral therapies that allow patients to change their erroneous beliefs and to promote functional recovery.