Model of Fear of Movement/(Re)injury Runs Clockwise From Catastrophizing: Evidence From a Sample of Outpatients With Chronic Nonspecific Low Back Pain.

IF 2.4 4区医学 Q1 REHABILITATION American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2025-01-13 DOI:10.1097/PHM.0000000000002659

Marco Monticone, Federico Arippa, Luca Frigau, Calogero Foti, Silvano Ferrari, Marco Guicciardi, Barbara Rocca

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Abstract

Objective: The aim of the study is to provide evidence that catastrophizing is the primer of the cognitive-behavioral model of fear of movement/(re)injury.

Design: A cross-sectional analysis of 180 outpatients with chronic nonspecific low back pain who completed the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, the Roland-Morris Disability Questionnaire, the Hospital Anxiety and Depression Scale-Depression, and a pain intensity numerical rating scale. The intercorrelations of the outcome measures were estimated using Pearson's correlation coefficient (r), and regression analyses were used to examine their predictive values by following the left side of the fear of movement/(re)injury clockwise from the Pain Catastrophizing Scale ( P = 0.05). A postdictive analysis dichotomizing the sample into high- and low-level catastrophizers evaluated the effects of addressing catastrophizing on disability and pain.

Results: The intercorrelations of the Pain Catastrophizing Scale with the Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire, Hospital Anxiety and Depression Scale-Depression and numerical rating scale were respectively r = 0.59, r = 0.54, r = 0.18, and r = 0.44. Pain Catastrophizing Scale was a significant predictor of Tampa Scale of Kinesiophobia; Pain Catastrophizing Scale and Tampa Scale of Kinesiophobia significantly predicted Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale-Depression; and Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale-Depression significantly predicted numerical rating scale. The postdictive analysis showed that addressing catastrophizing reduces disability and pain experience by 14% in high-level catastrophizers and 86% in low-level catastrophizers.

Conclusions: Our findings provide evidence that catastrophizing is the primer of the fear of movement/(re)injury.

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对运动/（再）损伤的恐惧模型从灾难化顺时针运行：来自慢性非特异性腰痛门诊患者样本的证据。

目的：为巨灾化是运动/损伤恐惧（FAM）认知行为模型的引子提供证据。设计：对180例慢性非特异性腰痛门诊患者进行横断面分析，这些患者完成了疼痛灾难化量表（PCS）、坦帕运动恐惧症量表（TSK）、Roland-Morris残疾问卷（RMDQ）、医院焦虑抑郁量表-抑郁量表（HADS-D）和疼痛强度数值评定量表（NRS）。使用Pearson相关系数(r)估计结果测量的相互相关性，并通过从PCS顺时针方向沿着FAM左侧进行回归分析来检验其预测值（p = 0.05）。将样本分为高灾难化者和低灾难化者的后置分析评估了解决灾难化对残疾和疼痛的影响。结果：PCS与TSK、RMDQ、HADS-D、NRS的相关系数分别为r = 0.59、r = 0.54、r = 0.18、r = 0.44。PCS是TSK的显著预测因子；PCS和TSK显著预测RMDQ和HADS-D；PCS、TSK、RMDQ和HADS-D显著预测NRS。事后分析表明，解决灾难化可以减少高水平灾难化患者14%的残疾和疼痛体验，在低水平灾难化患者中减少86%。结论：我们的研究结果证明灾难化是FAM的引物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Physical Medicine & Rehabilitation 医学-康复医学

CiteScore

4.60

自引率

6.70%

发文量

423

审稿时长

1 months

期刊介绍： American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).