The Correlation Between Fear Avoidance Beliefs and Physical Activity in Unilateral Vestibulopathies.

Background and purpose: In individuals with unilateral vestibulopathy (UVP), physical activity (PA) is recommended to stimulate central vestibular compensation. However, the presence of fear avoidance beliefs might negatively influence PA. The objectives of this study were to investigate the relationship between fear avoidance beliefs and PA and to compare PA levels between individuals with UVP in an acute/subacute vs chronic phase.

Methods: In this cross-sectional study, PA was measured using a triaxial accelerometer. Fear avoidance beliefs were quantified using the Vestibular Activities Avoidance Instrument. The correlation between fear avoidance beliefs and PA was evaluated using regression analyses, with other potential influencing factors also considered.

Results: A total of 102 participants were included. The average age was 56.1 (SD 15.2) years, and 57.8% were male. Participants with chronic UVP presented with shorter sedentary time (4,591 vs 5129 min/wk; P = 0.004), longer standing time (1443 vs 1165 min/wk; P = 0.025), higher vigorous PA (187 vs 107 min/wk; P = 0.005), and higher total PA (773 vs 623 min/wk; P = 0.003) compared to participants with acute/subacute UVP. In participants with acute/subacute UVP, variability in total PA was explained up to 54.7% by fear avoidance beliefs, etiology of the UVP, and gender (R2 = 0.547, F4,45 = 13.6, P < 0.001). In participants with chronic UVP, fear avoidance beliefs explained 4.1% of the variability in total PA (R2 = 0.041, F1,49 = 2.086, P = 0.155).

Discussion and conclusions: In acute/subacute UVP, assessing fear avoidance beliefs helps to understand physical inactivity. In chronic UVP, no significant association between fear avoidance beliefs and PA was observed.

Video abstract available: for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A488).