Fear of injury and physical deconditioning in patients with chronic low back pain

Arch Phys Med Rehabil. 2003 Aug;84(8):1227-32. doi: 10.1016/s0003-9993(03)00132-1.


Objectives: To test the assumption that fear of injury leads to disability and physical deconditioning in patients with chronic low back pain (CLBP) and to evaluate the relation between disability and physical deconditioning.

Design: Survey in a cross-sectional design.

Setting: A rehabilitation center in the Netherlands.

Participants: Forty patients with nonspecific CLBP.

Interventions: Not applicable.

Main outcome measures: Fear of injury was measured with the Tampa Scale of Kinesiophobia. Physical fitness was expressed in aerobic fitness measured as predicted maximum oxygen consumption derived in a submaximal exercise test according the protocol of Siconolfi. Disability was measured with the Roland Disability Questionnaire. The association between fear of injury and physical fitness or disability was examined with correlational and multiple linear regression analyses.

Results: Fear of injury correlated significantly with disability (r=.44), but did not correlate significantly with aerobic fitness. There was no statistically significant association between disability and aerobic fitness. Multiple regression analysis revealed that aerobic fitness was predicted by gender only.

Conclusions: Fear of injury appears to be more strongly associated with perceived disability than with aerobic fitness. The assumption that fear of injury leads to physical deconditioning was not confirmed in this sample of patients with CLBP.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anthropometry
  • Cardiovascular Deconditioning / physiology*
  • Chronic Disease
  • Cross-Sectional Studies
  • Data Collection
  • Disability Evaluation
  • Fear / physiology*
  • Female
  • Humans
  • Low Back Pain / physiopathology*
  • Low Back Pain / psychology*
  • Lumbosacral Region / injuries*
  • Lumbosacral Region / pathology
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Psychological Tests
  • Regression Analysis
  • Surveys and Questionnaires
  • Wounds and Injuries