The role of fear-avoidance beliefs in patients with neck pain: relationships with current and future disability and work capacity.
OBJECTIVE
To investigate the relationship between fear-avoidance beliefs and future disability and work capacity in patients with neck pain.


METHODS
A prospective observational study.


METHODS
Physiotherapy outpatient departments.


METHODS
One hundred and twenty patients with neck pain intensity sufficient to affect their work capacity.


METHODS
Patients participated in either six-week conventional physiotherapy or an exercise training programme to test whether the type of treatment received by the patients together with other outcome measures affected the predictive power of fear-avoidance beliefs.


METHODS
Patients underwent examination of the active neck range of movements and neck muscle strength and completed the Fear-Avoidance Beliefs Questionnaire, the Northwick Park Neck Pain Questionnaire, the Medical Outcomes 36-Item Short-Form Health Survey and the 11-point pain numerical rating scale. These were assessed at the beginning and at week 6 of the rehabilitation programme. Patients' work capacity was assessed at week 6 and three months after the six-week rehabilitation programme.


RESULTS
Spearman's correlation coefficients between fear-avoidance beliefs and initial and week 6 disability levels were 0.47 and 0.48, respectively. Regression analysis showed that the fear-avoidance beliefs significantly improved the goodness of fit of the model for predicting week 6 disability levels and return to complete work capacity at week 6 and three months after the rehabilitation programme, even after controlling for the physical impairments, the health status, the pain intensity and the type of treatment received.


CONCLUSIONS
The fear-avoidance beliefs factor is an important biopsychosocial variable in predicting future disability level and return to complete work capacity in patients with neck pain.
Lee
Kwok-Chung
KC
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
Chiu
Thomas T W
TT
Lam
Tai-Hing
TH
D000328:Adult; D001294:Attitude to Health; D006233:Persons with Disabilities / Q000145:classification* / Q000523:psychology; D004651:Employment / Q000523:psychology*; D005239:Fear; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000523:psychology* / Q000534:rehabilitation; D010146:Pain / Q000145:classification / Q000523:psychology*; D026741:Physical Therapy Modalities; D011795:Surveys and Questionnaires