Low back pain patients’ responses to videos of avoided movements
Article first published online: 20 JUN 2012
© 2012 European Federation of International Association for the Study of Pain Chapters
European Journal of Pain
Volume 17, Issue 2, pages 271–278, February 2013
How to Cite
Pincus, T. and Henderson, J. (2013), Low back pain patients’ responses to videos of avoided movements. European Journal of Pain, 17: 271–278. doi: 10.1002/j.1532-2149.2012.00187.x
Conflicts of interest
- Issue published online: 9 JAN 2013
- Article first published online: 20 JUN 2012
- Manuscript Accepted: 10 MAY 2012
Fear avoidance (FA) has been identified as a risk factor for poor prognosis and a target for intervention in patients with low back pain (LBP), but the mechanisms involved need clarification. Experimental studies would benefit from the use of carefully developed and controlled stimuli representing avoided movements in back pain, and matched stimuli of movements to provide a credible control stimuli. Existing stimuli depicting avoided movements in LBP are static, do not include a set of control stimuli and do not control for possible systematic observer biases.
Two studies were carried out aiming to develop and test LBP patients’ responses to videos of models depicting commonly avoided movements associated with back pain, and those associated with a control condition, wrist pain. Two samples of LBP patients rated how much pain and harm each movement would cause them. They also reported how often they avoided the movement.
The findings from the first study (n = 99) indicate that using videos of commonly avoided movements in low back pain is viable, and that movements associated with wrist pain provide an acceptable control stimuli. Participants in the second study (n = 85) consistently rated movements depicted by females as causing more harm, and more frequently avoided than the same movements depicted by males.
The use of video stimuli could advance research into the processes associated with FA through experimental paradigms. However, although small, the model gender effects should be carefully considered.