Fear of Movement, Quality of Life, and Self-Reported Disability in Obese Patients with Chronic Lumbar Pain

Authors

  • Heather K. Vincent PhD,

    Corresponding author
    1. UF Orthopaedics and Sports Medicine Institute, Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Research and Training
    Search for more papers by this author
  • Morrow R. Omli MA,

    1. UF Orthopaedics and Sports Medicine Institute, Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Research and Training
    Search for more papers by this author
  • Tim Day PT,

    1. Shands Physical Therapy
    Search for more papers by this author
  • Michael Hodges PT,

    1. Shands Physical Therapy
    Search for more papers by this author
  • Kevin R. Vincent MD, PhD,

    1. UF Orthopaedics and Sports Medicine Institute, Department of Orthopaedics and Rehabilitation, Divisions of Research and Physical Medicine and Rehabilitation, Interdisciplinary Center for Musculoskeletal Research and Training
    Search for more papers by this author
  • Steven Z. George PT, PhD

    1. Department of Physical Therapy, Center for Rehabilitation Studies, University of Florida, Gainesville, Florida, USA
    Search for more papers by this author

Heather K. Vincent, PhD, Department of Orthopedics and Rehabilitation, UF Orthopaedics and Sports Medicine Institute, 3450 Hull Road, P.O. Box 112727, Gainesville, FL 32611, USA. Tel: 352-273-7459; Fax: 352-273-7388; E-mail: vincehk@ortho.ufl.edu.

Abstract

Objective.  To compare fear of movement between obese and non-obese individuals seeking therapy for chronic low back pain and to examine whether fear of movement predicted disability due to back pain, self-reported walking disability, and flexibility.

Design.  This was a cross-sectional study.

Setting.  Outpatient physical therapy clinic associated with a tertiary care hospital.

Patients.  Patients with chronic low back pain (N = 192; 48.2 ± 18.8 years) were stratified into obese (average body mass index [BMI] 36.9 ± 7.1 kg/m2) or non-obese status (average BMI 24.5 ± 3.4 kg/m2).

Outcome Measures.  The Tampa Scale of Kinesiophobia (TSK), Short-Form 8 (SF-8), and Oswestry Disability Survey results were main outcome measures.

Methods.  Retrospective review of medical charts was performed. Hierarchical regression modeling determined the contribution of TSK scores to the variance of self-reported disability with walking, overall Oswestry score, and flexibility.

Results.  TSK scores were higher in obese than non-obese patients (26.2 ± 7.5 vs 23.9 ± 6.8 points; P = 0.032). The SF-8 physical and mental subscores were 6–10% lower in the obese than non-obese patients. Oswestry survey scores were higher in the obese patients (40.6 vs 31.6 points; P < 0.001). TSK scores contributed to self-reported disability with walking and Oswestry disability score (both P < 0.001), but not flexibility.

Conclusions.  Among obese patients with chronic lumbar pain, pain-related fear of movement enhanced prediction of self-reported disability with walking and overall Oswestry scores. The TSK might be a useful clinical assessment to identify obese patients at higher risk for future low back disability.

Ancillary