Change in kinesiophobia and its relation to activity limitation after multidisciplinary rehabilitation in patients with chronic back pain.
OBJECTIVE
To explore the change in kinesiophobia in relation to activity limitation after a multidisciplinary rehabilitation programme in patients with chronic back pain.


METHODS
A prospective cohort study was made including 265 patients. Data were collected at baseline, after rehabilitation, and at 6-months follow-up. Outcome measures were the Tampa Scale for kinesiophobia (TSK) and the disability rating index (DRI). The smallest detectable change (SDC) in TSK was set to 8 scores. Relationships between kinesiophobia and activity limitation/physical ability were explored with regard to subgroups with high, medium and low baseline TSK scores, and for those patients who did or did not reach the SDC in TSK.


RESULTS
Improvements in TSK showed high effect sizes in the groups with high and medium baseline TSK scores. Improvements in DRI showed medium effect sizes in all three TSK subgroups. One third of the patients reached the SDC in TSK, and this group also improved significantly more in DRI. The correlation between change in TSK and change in DRI was low. Half of the patients with high TSK score at baseline remained having high DRI at follow-up.


CONCLUSIONS
Improvement in physical ability was not related to the initial degree of kinesiophobia but to the SDC in TSK. To prevent patients with high kinesiophobia from preserving high activity limitations, it might be useful to include targeted treatment of kinesiophobia.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. charlotte.luning.bergsten@ki.se
C
C
Lüning Bergsten
M
M
Lundberg
P
P
Lindberg
B
B
Elfving
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D001416:Back Pain / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010698:Phobic Disorders / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires