title: Fear of movement, quality of life, and self-reported disability in obese patients with chronic lumbar pain.
abstract: OBJECTIVE
  To compare fear of movement between obese and non-obese individuals seeking therapy for chronic low back pain and to examine whether fear of movement predicted disability due to back pain, self-reported walking disability, and flexibility.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  Outpatient physical therapy clinic associated with a tertiary care hospital.
  
  
  METHODS
  Patients with chronic low back pain (N=192; 48.2±18.8 years) were stratified into obese (average body mass index [BMI] 36.9±7.1 kg/m(2) ) or non-obese status (average BMI 24.5±3.4 kg/m(2) ).
  
  
  METHODS
  The Tampa Scale of Kinesiophobia (TSK), Short-Form 8 (SF-8), and Oswestry Disability Survey results were main outcome measures.
  
  
  METHODS
  Retrospective review of medical charts was performed. Hierarchical regression modeling determined the contribution of TSK scores to the variance of self-reported disability with walking, overall Oswestry score, and flexibility.
  
  
  RESULTS
  TSK scores were higher in obese than non-obese patients (26.2±7.5 vs 23.9±6.8 points; P=0.032). The SF-8 physical and mental subscores were 6-10% lower in the obese than non-obese patients. Oswestry survey scores were higher in the obese patients (40.6 vs 31.6 points; P<0.001). TSK scores contributed to self-reported disability with walking and Oswestry disability score (both P<0.001), but not flexibility.
  
  
  CONCLUSIONS
  Among obese patients with chronic lumbar pain, pain-related fear of movement enhanced prediction of self-reported disability with walking and overall Oswestry scores. The TSK might be a useful clinical assessment to identify obese patients at higher risk for future low back disability.
authors.affiliation: Department of Orthopaedics and Rehabilitation, UF Orthopaedics and Sports Medicine Institute, University of Florida, 3450 Hull Road, Gainesville, FL 32611, USA. vincehk@ortho.ufl.edu
authors.forename: Heather K
authors.initials: HK
authors.lastname: Vincent
authors.forename: Morrow R
authors.initials: MR
authors.lastname: Omli
authors.forename: Tim
authors.initials: T
authors.lastname: Day
authors.forename: Michael
authors.initials: M
authors.lastname: Hodges
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Vincent
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003625:Data Collection; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D009765:Obesity / Q000150:complications / Q000523:psychology*; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology