title: Fear avoidance beliefs predict disability in older adults with chronic low back pain.
abstract: OBJECTIVE
  To determine whether fear avoidance beliefs (FABs) in older adults with chronic low back pain (CLBP) are significantly associated with gait speed decline and/or self-report of greater disability.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  An academic medical center (single site).
  
  
  METHODS
  Two hundred English-speaking participants aged 65 years and older with CLBP every day or almost every day of moderate or greater intensity for ≥3 months.
  
  
  METHODS
  The physical activity portion of the FAB questionnaire assessed FABs. Disability was measured with gait speed and the Roland Morris Questionnaire. Covariates measured included age, gender, body mass index, chronic disease (Cumulative Illness Rating Scale), depression (Geriatric Depression Scale), and pain (McGill Pain Questionnaire Short Form).
  
  
  RESULTS
  FABs were significantly associated with the Roland Morris Questionnaire (P < .0001) and gait speed (P = .002) after controlling for all covariates.
  
  
  CONCLUSIONS
  FABs related to physical activity in older adults with CLBP were significantly associated with both self-reported and performance-based disability after controlling for known confounders. Previous studies have reported similar associations between self-reported measures of disabling back pain and FABs. Ours is the first study to examine the relationship between FAB and gait speed, a powerful predictor of morbidity and mortality. Future work should examine whether targeting fear avoidance in addition to other psychosocial measures in older adults with CLBP improves gait speed and functional independence.
authors.affiliation: Department of Medicine and Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. acamachosoto@gmail.com
authors.forename: Alejandra
authors.initials: A
authors.lastname: Camacho-Soto
authors.forename: Gwendolyn A
authors.initials: GA
authors.lastname: Sowa
authors.forename: Subashan
authors.initials: S
authors.lastname: Perera
authors.forename: Debra K
authors.initials: DK
authors.lastname: Weiner
mesh_terms: D000368:Aged; D001362:Avoidance Learning; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005239:Fear; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D051346:Mobility Limitation; D009043:Motor Activity / Q000502:physiology; D010147:Pain Measurement