title: Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology.
abstract: OBJECTIVE
  To determine the unique influence of pain-related fear of movement on foot and ankle disability, after accounting for pain, demographic, and physical impairment variables.
  
  
  METHODS
  Cross-sectional study using retrospective chart review.
  
  
  METHODS
  Outpatient rehabilitation clinic.
  
  
  METHODS
  Referred sample of subjects with foot- and ankle-related disability (N=85, 40 men; mean age, 33y; range, 16-77y).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Lower Extremity Functional Scale (LEFS), Shortened Tampa Scale of Kinesiophobia (TSK-11).
  
  
  RESULTS
  Hierarchical regression analysis determined the proportions of explained variance in disability (LEFS). Demographic variables were entered into the model first, followed by pain intensity and range-of-motion (ROM) deficit, and finally, TSK-11. Demographics collectively contributed 9% (P=.015) of the variance in disability scores. Pain intensity and overall ROM deficit contributed an additional 11% (P<.001) of the variance, and TSK-11 scores contributed an additional 14% (P<.001). In the overall model, age (beta=-.29, P=.004), chronicity of symptoms (beta=.23, P=.024), ROM deficit (beta=-.28, P=.003), and TSK-11 (beta=-.41, P<.001) explained 34% of the variance in the LEFS score (P<.001).
  
  
  CONCLUSIONS
  Age, chronicity of symptoms, ROM deficit, and TSK-11 scores all significantly contributed to baseline foot and ankle self-reported disability. Pain-related fear of movement was the strongest single contributor to disability in this group of patients.
authors.affiliation: Shands Rehabilitation, UF & Shands Orthopaedics and Sports Medicine Institute, Gainesville, FL 32611, USA. lentzt@shands.ufl.edu
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Lentz
authors.forename: Zach
authors.initials: Z
authors.lastname: Sutton
authors.forename: Scott
authors.initials: S
authors.lastname: Greenberg
authors.forename: Mark D
authors.initials: MD
authors.lastname: Bishop
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016512:Ankle Injuries / Q000523:psychology* / Q000534:rehabilitation; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D018409:Foot Injuries / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010146:Pain / Q000523:psychology*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult