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Trials
Published in: Trials 1/2022

Open Access 01-12-2022 | Back Pain | Study protocol

Influence of kinesiophobia on pain intensity, disability, muscle endurance, and position sense in patients with chronic low back pain—a case-control study

Authors: Praveen Kumar Kandakurti, Watson Arulsingh, Sharad S Patil

Published in: Trials | Issue 1/2022

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Abstract

Background

Patients with chronic low back pain (CLBP) frequently present with kinesiophobia. Though large body of evidence reported the impact of kinesiophobia in patients with CLBP, there are paucity of studies in associating kinesiophobia to muscle endurance and position sense in patients with CLBP. The primary aim of the study is to compare the impact of kinesiophobia on lumbar extensor endurance, position sense in patient with CLBP, and asymptomatic individuals. Secondarily, we aim to examine the association between kinesiophobia and lumbar extensor endurance, position sense, pain intensity, and functional ability in patients with CLBP. Thirdly, we aim to assess the degree of association of various factors on CLBP, lumbar endurance, and position sense.

Material and methods

This case-control study will have 200 patients with CLBP and 400 controls. Kinesiophobia, lumbar endurance, and lumbar position sense will be assessed with Tampa Scale, Soren’s lumbar extensor test, and lumbar repositioning test respectively. Secondarily, the pain intensity will be assessed with visual analog scale and functional ability with Patient-specific Functional Scale in patients with CLBP. Lumbar endurance and joint position sense will be compared between subjects with and without kinesiophobia. Kinesiophobia scores will be compared with lumbar extensor endurance and proprioception joint position errors, pain intensity, and functional ability. Simple and multiple binary logistic regression will be used to determine crude and adjusted odd’s ratio for kinesiophobia, lumbar position sense and kinesiophobia, and lumbar endurance.

Discussion

The finding from this study can be generalized as this study has adequate sample size and subgroup analysis by adjusting the variables to draw a valid conclusion. The finding of this study will help the working physician to include assessment of kinesiophobia as part of musculoskeletal evaluation for patient with CLBP in a prospective diagnostic intervention.

Trial registration

ClinicalTrials.gov NCT05079893. Registered on 14 October 2021.
Appendix
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Literature
1.
Murray CJL, Atkinson C, Bhalla K, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310:591–608.PubMedCrossRef
2.
Buchbinder R, van Tulder M, Öberg B, et al. Low back pain: a call for action. Lancet. 2018;391:2384–8.PubMedCrossRef
3.
4.
Vadalà G, Russo F, Musumeci M, D’Este M, Cattani C, Catanzaro G, et al. Clinically relevant hydrogel-based on hyaluronic acid and platelet rich plasma as a carrier for mesenchymal stem cells: rheological and biological characterization. J Orthop Res. 2017;35:2109–16.PubMedCrossRef
5.
Amirdelfan K, McRoberts P, Deer TR. The differential diagnosis of low back pain: a primer on the evolving paradigm. Neuromodulation Technol Neural Interface. 2014;17:11–7.CrossRef
6.
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. Br Med J. 2006;332:1430–4.CrossRef
7.
8.
Negrini S, Zaina F. The chimera of low back pain etiology: a clinical rehabilitation perspective. Am J Phys Med Rehabil. 2013;92(1):93–7.PubMedCrossRef
9.
Lamoth CJC, Meijer OG, Daffertshofer A, et al. Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control. Eur Spine J. 2006;15:23–40.PubMedCrossRef
10.
Massé-Alarie H, Schneider C. Cerebral reorganizationin chronic low back pain and neurostimulation to improve motor control [in French]. Neurophysiol Clin. 2011;41:51Y60.
11.
Li X, Liu H, Ge L, Yan Y, Lo WLA, Li L, et al. Cortical representations of transversus abdominis and multifidus muscles were discrete in patients with chronic low back pain: evidence elicited by TMS. Neural Plast. 2021;2021:6666024.PubMedPubMedCentralCrossRef
12.
Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769–81.PubMedCrossRef
13.
Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25:173–83.PubMedCrossRef
14.
Artus M, Campbell P, Mallen CD, et al. Generic prognostic factors for musculoskeletal pain in primary care: a systematic review. BMJ Open. 2017;7:e012901.PubMedPubMedCentralCrossRef
15.
Gatchel RJ, Peng YB, Peters ML, et al. The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychol Bull. 2007;133:581–624.PubMedCrossRef
16.
Traeger AC, Buchbinder R, Elshaug AG, Croft PR, Maher CG. Care for low back pain: can health systems deliver? Bull World Health Organ. 2019;97:423–33.PubMedPubMedCentralCrossRef
17.
Uluğ N, Yakut Y, Alemdaroğlu İ, Yılmaz Ö. Comparison of pain, kinesiophobia and quality of life in patients with low back and neck pain. J Phys Ther Sci. 2016;28(2):665–70.PubMedPubMedCentralCrossRef
18.
Luque-Suarez A, Martinez-Calderon J, Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019;53(9):554–9.PubMedCrossRef
19.
Kori SH, Miller RP, Todd DD. Kinisophobia: a new view of chronic pain behavior. Pain Management. 1990;3:35–43.
20.
21.
van Tulder MW, Ostelo RW, Vlaeyen JWS, et al. Behavioral treatment for chronic low back pain. A systematic review within the framework of the Cochrane Back Review Group. Spine. 2001;26:270–81.PubMedCrossRef
22.
Linton SJ, Andersson T. Can chronic disability be prevented? A randomized trial of a cognitive-behavior intervention for patients with spinal pain. Spine. 2000;25:2825–31.PubMedCrossRef
23.
Larsson C, Hansson EE, Sundquist K, Jakobsson U. Psychometric properties of the Tampa Scale of Kinesiophobia (TSK-11) among older people with chronic pain. Physiother Theory Pract. 2014;30(6):421–8.PubMedCrossRef
24.
Palomo-López P, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, López-López D, Rodríguez-Sanz D, Romero-Morales C, et al. Kinesiophobia and pain intensity are increased by a greater hallux valgus deformity degree-kinesiophobia and pain intensity in hallux valgus. Int J Environ Res Public Health. 2020;17(2):626.PubMedCentralCrossRef
25.
Chmielewski TL, Jones D, Day T, Tillman SM, Lentz TA, George SZ. The association of pain and fear of movement/reinjury with function during anterior cruciate ligament reconstruction rehabilitation. J Orthop Sports Phys Ther. 2008;38(12):746–53.PubMedCrossRef
26.
Aydoğdu O, Zübeyir S. The association between kinesiophobia and proprioception, postural stability, activity level, knee function, and quality of life following anterior cruciate ligament reconstruction. J Exerc Ther Rehabil. 2020;7(3):247–52.
27.
Ishak NA, Zahari Z, Justine M. Kinesiophobia, pain, muscle functions, and functional performances among older persons with low back pain. Pain Res Treat. 2017;2017:3489617, 10 pages.PubMedPubMedCentral
28.
Freigang V, Müller K, Ernstberger A, Kaltenstadler M, Bode L, Pfeifer C, et al. Reduced recovery capacity after major trauma in the elderly: results of a prospective multicenter registry-based cohort study. J Clin Med. 2020;9(8):2356.PubMedCentralCrossRef
29.
Taimela S, Kankaanpaa M, Luoto S. The effect of lumbar fatigue on the ability to sense a change in lumbar position. A controlled study. Spine. 1999;24(13):1322–7.PubMedCrossRef
30.
Bailey KM, Carleton RN, Vlaeyen JW, Asmundson GJ. Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: a preliminary review. Cogn Behav Ther. 2010;39(1):46–63.PubMedCrossRef
31.
Picavet HSJ, Vlaeyen JW, Schouten JS. Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. Am J Epidemiol. 2002;156:1028–34.PubMedCrossRef
32.
Wand BM, James M, Abbaszadeh S, et al. Assessing self-perception in patients with chronic low back pain: development of a back-specific body-perception questionnaire. J Back Musculoskelet Rehabil. 2014;27(4):463–73 PMID:24614834.PubMedCrossRef
33.
Neblett R, Hartzell MM, Williams M, et al. Use of the Central Sensitization Inventory (CSI) as a treatment outcome measure for patients with chronic spinal pain disorder in a functional restoration program. Spine J. 2017;17(12):1819–29.PubMedCrossRef
34.
Christe G, Crombez G, Edd S, Opsommer E, Jolles BM, Favre J. Relationship between psychological factors and spinal motor behaviour in low back pain: a systematic review and meta-analysis. Pain. 2021;162(3):672–86.PubMedCrossRef
35.
36.
Roy SH, De Luca CJ, Emley M, Buijs RJ. Spectral electromyographic assessment of back muscles in patients with low back pain undergoing rehabilitation. Spine. 1995;20:38–48.PubMedCrossRef
37.
Nelson BW, Miller M, Hogan M, Wegner JA, Kelly C. The clinical effects of intensive, specific exercise on chronic low back pain: a controlled study of 895 consecutive patients with 1-year follow up. Orthopedics. 1995;18:971–81.PubMedCrossRef
38.
Mbada CE, Ayanniyi O, Ogunlade SO, Orimolade EA, Oladiran AB, Ogundele AO. Rehabilitation of back extensor muscles’ inhibition in patients with long-term mechanical low-back pain. Int Sch Res Notices. 2013;2013:928956, 11 pages.
39.
Conway R, Behennah J, Fisher J, Osborne N, Steele J. Associations between trunk extension endurance and isolated lumbar extension strength in both asymptomatic participants and those with chronic low back pain. Healthcare (Basel). 2016;4(3):70.CrossRef
40.
Suuden E, Ereline J, Gapeyeva H, Paasuke M. Low back muscle fatigue during Sorensen endurance test in patients with chronic low back pain: relationship between electromyographic spectral compression and anthropometric characteristics. Electromyogr Clin Neurophysiol. 2008;48:185–92.PubMed
41.
Boyce RO, Boone E, Stallings J, Wilde C. A multidisciplinary approach to a time efficient low back exercise intervention in a small manufacturing plant: a case study. J Exerc Physiol. 2008;11:12–24.
42.
Holm S, Indahl A, Solomonow M. Sensorimotor control of the spine. J Electromyogr Kinesiol. 2002;12:219–34.PubMedCrossRef
43.
Brumagne S, Cordo P, Lysens R, Verschueren S, Swinnen S. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine. 2000;25:989–94.PubMedCrossRef
44.
Solomonow M. Sensory - motor control of ligaments and associated neuromuscular disorders. J Electromyogr Kinesiol. 2006;16:549–67.PubMedCrossRef
45.
46.
Rosenbloom BN, Pagé MG, Isaac L, et al. Fear of movement in children and adolescents undergoing major surgery: a psychometric evaluation of the Tampa Scale for Kinesiophobia. Eur J Pain. 2020;24:1999–2014.PubMedCrossRef
47.
Schouppe S, Clauwaert A, Van Oosterwijck J, et al. Does experimentally induced pain-related fear influence central and peripheral movement preparation in healthy people and patients with low back pain? Pain. 2020;161:1212–26.PubMedCrossRef
48.
Behennah J, Conway R, Fisher J, et al. The relationship between balance performance, lumbar extension strength, trunk extension endurance, and pain in participants with chronic low back pain, and those without. Clin Biomech. 2018;53:22–30.CrossRef
49.
Alahmari KA, Reddy RS, Samuel PS, et al. Intra-rater and inter-rater reliability of neutral and target lumbar positioning tests in subjects with and without non-specific lower back pain. J Back Musculoskel Rehabil. 2020:1–11.
50.
Couper M, Tourangeau R, Conrad F, et al. Evaluating the effectiveness of visual analog scales: a web experiment. Soc Sci Comput Rev. 2006;24:227–45.CrossRef
51.
Shafshak TS, Elnemr R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain. J Clin Rheumatol. 2021;27(7):282–5.PubMedCrossRef
52.
53.
Stratford P, Gill C, Westaway M, Binkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiother Can. 1995;47(4):258–63.CrossRef
54.
Horn KK, Jennings S, Richardson G, Vliet DV, Hefford C, Abbott JH. The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure. J Orthop Sports Phys Ther. 2012;42(1):30–42.PubMedCrossRef
55.
Robson EK, Kamper SJ, Davidson S, et al. Healthy Lifestyle Program (HeLP) for low back pain: protocol for a randomised controlled trial. BMJ Open. 2019;9(9):e029290.PubMedPubMedCentralCrossRef
56.
Muga MA, Owili PO, Hsu CY, et al. Association of lifestyle factors with blood lipids and inflammation in adults aged 40 years and above: a population-based cross-sectional study in Taiwan. BMC Public Health. 2019;19:1346.PubMedPubMedCentralCrossRef
Metadata
Title
Influence of kinesiophobia on pain intensity, disability, muscle endurance, and position sense in patients with chronic low back pain—a case-control study
Authors
Praveen Kumar Kandakurti
Watson Arulsingh
Sharad S Patil
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06406-6

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