Association of pain-related threat beliefs and disability with postural control and trunk motion in individuals with low back pain: a systematic review and meta-analysis

Sanaz Shanbehzadeh, Shabnam ShahAli*, Isamael Ebrahimi Takamjani, Johan W.S. Vlaeyen, Reza Salehi, Hassan Jafari

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

PURPOSE: Low back pain (LBP) individuals with high levels of fear of pain might display changes in motor behavior, which leads to disability. This study aimed to systematically review the influence of pain-related threat beliefs or disability on trunk kinematic or postural control in LBP.

METHOD: Eight electronic databases were searched from January 1990 to July 1, 2020. Meta-analysis using random-effect model was performed for 18 studies on the association between pain-related threat beliefs or disability and lumbar range of motion. Pearson r correlations were used as the effect size.

RESULT: Negative correlations were observed between lumbar range of motion (ROM) and pain-related threat beliefs (r = - 0.31, p < 0.01, 95% CI: - 0.39, - 0.24) and disability (r =  - 0.24, p < 0.01, 95% CI: - 0.40, - 0.21). Nonsignificant correlations were reported between pain-related threat beliefs and center of pressure parameters during static standing in 75% of the studies. In 33% of the studies, moderate negative correlations between disability and postural control were observed.

CONCLUSION: Motor behaviors are influenced by several factors, and therefore, the relatively weak associations observed between reduced lumbar ROM with higher pain-related threat beliefs and perceived disability, and postural control with disability are to be expected. This could aid clinicians in the assessment and planning rehabilitation interventions.

LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.

Original languageEnglish
Pages (from-to)1802-1820
Number of pages19
JournalEuropean Spine Journal
Volume31
Issue number7
Early online date18 May 2022
DOIs
Publication statusPublished - Jul 2022

Keywords

  • CHRONIC MUSCULOSKELETAL PAIN
  • Catastrophizing
  • Disability
  • FEAR-AVOIDANCE
  • Fear of pain
  • INSTRUCTIONS
  • LUMBAR FLEXION
  • Low back pain
  • MOTOR BEHAVIOR
  • MOVEMENT
  • Motor behavior
  • RANGE
  • RECOVERY
  • SPINAL MOTION
  • VALIDITY

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