@article{Christe:11815,
      recid = {11815},
      author = {Christe, Guillaume and Benaim, Charles and Luthi, François  and Jolles, Brigitte M. and Favre, Julien},
      title = {Reduction in pain‐related fear is not associated with  improvement in spinal biomechanics but with decrease in  movement‐evoked pain in patients with chronic low back  pain},
      journal = {Pain practice},
      address = {2022-12},
      number = {ARTICLE},
      pages = {11 p.},
      abstract = {Background and  aims:  While  a  causal  relationship   between  pain-  related  fear  and  spinal  movement   avoidance  in  patients  with  chronic  low  back  pain   (CLBP)  has  frequently  been  postulated,  evidence   supporting  this  relationship  is  limited.  This study  aimed to test if decreases in pain- related fear or  catastrophizing were associated with improvements  in   spinal  biomechanics,  accounting  for  possible  changes  in movement-evoked pain. Methods: Sixty-two  patients  with   CLBP  were  assessed  before  and  after  an   interdisciplinary rehabilitation program (IRP). Pain-  related fear was assessed with general and  task-specific   measures.  Lower and  upper  lumbar  angular  amplitude   and  velocity  as  well  as  paraspinal  muscle  activity   were  recorded  during  five  daily-life  tasks  to   evaluate  spinal  biomechanics.  Relationships were tested  with  multivariable linear regression analyses. Results:  The  large  decreases  in  pain-  related  fear  and   catastrophizing  following  the  IRP  were  scarcely  and   inconsistently  associated  with  changes  in  spinal   biomechanics (<   3% of the models reported a statistically  significant association). Results remained comparable for  activities inducing more or less fear, for specific or  general measures of pain- related fear, and for analyses  performed on the entire population or  limited  to   subgroups  of  patients  with  higher  levels  of   task-specific  fear.  In contrast,  reductions  in   task-specific  pain-  related  fear  were  significantly   associated  with  decreases  in  movement-evoked  pain  in   all  tasks  (r=  0.26– 0.62, p ≤ 0.02).Conclusion: This  study does not support an association between pain- related  fear and spinal movement avoidance. However, it provides  evidence supporting a direct relationship between decreased  pain- related fear and decreased movement-evoked pain,  possibly explaining some mechanisms of the rehabilitation  programs.},
      url = {http://arodes.hes-so.ch/record/11815},
      doi = {https://doi.org/10.1111/papr.13191},
}