Task-specific fear rather than general kinesiophobia assessment is associated with kinematic differences in chronic low back pain during lumbar flexion: a preliminary investigation

INTRODUCTION: Kinematic data obtained during a movement task by individuals with chronic low back pain seem to be related to pain-related fear. General kinesiophobia assessments, such as Tampa Scale for Kinesiophobia, are often used to assess pain-related fear. However, these questionnaires could suffer from a lack of sensitivity and do not measure the fear of specific movements. OBJECTIVES: The purpose of this study was to investigate whether the task-specific assessment of pain-related fear exhibits a closer association with trunk kinematics during lumbar flexion compared with the general kinesiophobia in individuals with chronic low back pain. METHODS: We assessed pain-related factors, task-specific fear, and Tampa Scale for Kinesiophobia-11 scores of 51 company employees. The lumbar angle during a lumbar flexion task was recorded by 2 wireless Axivity Ax3 accelerometers attached to the subject's spinous process (L3) and sacral spine (S2). Only task-specific fear was evaluated after the lumbar flexion task. We calculated the maximum lumbar flexion angle (°) and the peak angular velocity of lumbar flexion/return from flexion (°/s(2)). We conducted a hierarchical multiple linear regression analysis to determine variance explained in lumbar flexion task performance by task-specific fear after controlling for demographic, pain, and general kinesiophobia. RESULTS: The results showed that task-specific fear was associated with the peak angular velocity of lumbar return from flexion (R(2) adj. = 0.36, P < 0.01) and lumbar flexion (R(2) adj. = 0.3, P = 0.01). DISCUSSION: Our results suggest that clinicians should consider the potential added value of task-specific fear assessment over the sole use of conventional kinesiophobia assessment.