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Fear avoidance beliefs do not influence disability and quality of life in Spanish elderly subjects with low back pain.

Kovacs F, Abraira V, Cano A, Royuela A, Gil del Real MT, Gestoso M, Mufraggi N, Muriel A, Zamora J

Departamento Científico, Fundación Kovacs, Palma de Mallorca, Spain. kovacs@kovacs.org

STUDY DESIGN: Correlation between previously validated questionnaires. OBJECTIVE: To assess the association of fear avoidance beliefs (FAB) with disability and quality of life in elderly Spanish subjects. SUMMARY OF BACKGROUND DATA: As opposed to Anglo-Saxon and Northern European patients, in Spanish low back pain (LBP) patients of working age, the influence of FAB on disability and quality of life is sparse and much less than that of pain. The influence of FAB on LBP-related disability and quality of life in the elderly is unknown. METHODS: A visual analogue scale (VAS), the Roland Morris Questionnaire (RMQ), the FAB-Phys questionnaire (FABQ), and the SF-12 questionnaire were used to assess LBP, disability, fear avoidance beliefs, and quality of life in 661 institutionalized elderly in Spain, 439 of whom had LBP. RESULTS: In all subjects, FAB correlated with LBP (r = 0.477), disability (r = 0.458), the Physical Component Summary of SF-12 (PCS SF-12) (r = -0.389), and the Mental Component Summary of SF-12 (MCS SF-12) (r = -0.165). In subjects with LBP, FABs only correlated weakly with disability (r = -0.110). The stronger correlations were found between LBP and disability, both in all subjects (r = 0.803) and LBP patients (r = 0.445). Regression models including all the participants showed that the influence of FABs on physical quality of life was sparse and that FABs were not associated with either disability or mental quality of life. In elderly subjects with LBP, FABs were not associated with either disability or quality of life. CONCLUSION: In Spanish institutionalized elderly subjects, FABs only have a minor influence on physical quality of life, and none on disability or mental quality of life. In elderly subjects with LBP, differences in FABs are not associated with differences in disability or quality of life. Further studies should explore the potential value of FABs in the elderly in other settings.

Published 31 August 2007 in Spine, 32(19): 2133-8.
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