Kinesiophobia and fear-avoidance beliefs in overweight older adults with chronic low-back pain: relationship to walking endurance--part II

Am J Phys Med Rehabil. 2013 May;92(5):439-45. doi: 10.1097/PHM.0b013e318287633c.


Objective: This study determined whether kinesiophobia levels were different among older adults with chronic low back pain (LBP) and varying body mass index and whether kinesiophobia predicted perceived disability or walking endurance.

Design: This study was a secondary analysis from a larger interventional study. Older adults with obesity with LBP (N = 55; 60-85 yrs) were participants in this study. Data were stratified on the basis of body mass index: overweight (25-29.9 kg/m), obese (30-34.9 kg/m), and severely obese (35 kg/m). The participants completed a battery of surveys (the modified Tampa Scale of Kinesiophobia [TSK-11], the Fear-Avoidance Beliefs Questionnaire, the Pain Catastrophizing Scale, and the perceived disability measures of the Oswestry Disability Index and the Roland Morris Disability Questionnaire). Walking endurance time was captured using a symptom-limited graded walking treadmill test. The peak LBP ratings were captured during the walk test.

Results: Walking endurance times did not differ by body mass index group, but the peak LBP ratings were higher in the moderately and severely obese groups compared with the overweight group (3.0 and 3.1 vs. 2.1 points; P < 0.05). There was no difference in the kinesiophobia scores (the TSK-11, the Pain Catastrophizing Scale, and the Fear-Avoidance Beliefs Questionnaire work and activity subscores) or the perceived disability scores (the Oswestry Disability Index and the Roland Morris Disability Questionnaire). However, adjusted regression analyses revealed that the TSK-11 scores contributed 10%-21% of the variance of the models pain with walking and perceived disability caused by back pain. Kinesiophobia was not a significant contributor to the variance of the regression model for walking endurance.

Conclusions: In the older population with obesity with LBP, the TSK-11 might be a quick and simple measure to identify patients at risk for poor self-perception of functional ability. The TSK and the Oswestry Disability Index may be quick useful measures to assess initial perceptions before rehabilitation. Kinesiophobia may be a good therapeutic target to address to help affected older adults with obesity fully engage in therapies for LBP.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Chronic Disease
  • Cohort Studies
  • Disability Evaluation
  • Exercise Test
  • Fear / psychology*
  • Female
  • Humans
  • Low Back Pain / complications
  • Low Back Pain / psychology*
  • Low Back Pain / rehabilitation
  • Male
  • Middle Aged
  • Overweight / complications*
  • Overweight / psychology*
  • Overweight / rehabilitation
  • Pain Measurement
  • Phobic Disorders / etiology*
  • Phobic Disorders / psychology
  • Phobic Disorders / rehabilitation
  • Physical Endurance*
  • Regression Analysis
  • Risk Assessment
  • Self Concept
  • Severity of Illness Index
  • Walking / physiology*