TY - GEN AB - 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. AD - HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland AD - Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland ; Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland AD - Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland ; Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland AD - Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland ; Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland AD - Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland ; The Sense Innovation and Research Center, Lausanne and Sion, Switzerland AU - Christe, Guillaume AU - Benaim, Charles AU - Luthi, François AU - Jolles, Brigitte M. AU - Favre, Julien DA - 2022-12 DO - 10.1111/papr.13191 DO - DOI ID - 11815 JF - Pain practice KW - Santé KW - low back pain KW - physical therapy KW - rehabilitation L1 - https://arodes.hes-so.ch/record/11815/files/Christe_2023_reduction_in_pain%E2%80%90related_fear.pdf L2 - https://arodes.hes-so.ch/record/11815/files/Christe_2023_reduction_in_pain%E2%80%90related_fear.pdf L4 - https://arodes.hes-so.ch/record/11815/files/Christe_2023_reduction_in_pain%E2%80%90related_fear.pdf LA - eng LK - https://arodes.hes-so.ch/record/11815/files/Christe_2023_reduction_in_pain%E2%80%90related_fear.pdf N2 - 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. PY - 2022-12 SN - 1530-7085 T1 - 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 TI - 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 UR - https://arodes.hes-so.ch/record/11815/files/Christe_2023_reduction_in_pain%E2%80%90related_fear.pdf VL - March 2023, vol. 23, no. 3, pp. 290-300 Y1 - 2022-12 ER -