Association of Physical Performance and Fear-Avoidance Beliefs in Adults with Chronic Low Back Pain

BACKGROUND: Low back pain is a commonest musculoskeletal disorder affecting majority of people. Activity limitations are difficulties an individual may have in executing activities resulting from person's functioning and disability. According to the fear-avoidance model of low back pain, individuals who perceive pain as a sign of potential damage are more likely to avoid behaviors that increase their anxiety and show sub-maximal performance during physical activity. AIM: Purpose of this study was to find the association between activity limitation and fear avoidance belief in patients with chronic low back pain. SUBJECTS AND METHODS: Thirty subjects with chronic low back pain were included in the study. Activity limitation was measured using Back Performance Scale (BPS). Patients' fear of pain and avoidance of physical activities was assessed with Fear Avoidance Belief Questionnaire (FABQ). RESULTS: It was observed that performance was affected in roll up, fingertip to floor and lift test. In the two subscales of FABQ, 47 percent had more fear in physical activity component and 27 percent had more fear in work component. The scores of BPS and FABQ were correlated using Pearson's correlation test showed strong positive correlation (r = 0.685, P value < 0.01). Higher scores on FABQ are indicative of greater fear and avoidance beliefs. CONCLUSION: Higher scores on the FABQ 47% in physical activity and 27% in work component are indicative of greater fear and avoidance beliefs. A strong relationship exists between elevated fear avoidance beliefs (FABQ) and activity limitation (BPS) in patients with chronic low back pain.