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European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Nov, 2008;17 (11): 1448-56.

Relationship between psychological factors and performance-based and self-reported disability in chronic low back pain.

H R Schiphorst Preuper, M F Reneman, A M Boonstra, P U Dijkstra, G J Versteegen, J H B Geertzen, S Brouwer
Author Information
  1. H R Schiphorst Preuper: Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, Groningen, The Netherlands. h.r.schiphorst.preuper@cvr.umcg.nl
PMID: 18795346 DOI: 10.1007/s00586-008-0772-0

Abstract

Cross sectional study, performed in an outpatient university based pain rehabilitation setting. To analyze the relationship between psychological factors (psychosocial distress, depression, self efficacy, self-esteem, fear of movement, pain cognitions and coping reactions) and performance-based and self-reported disability, as measured with a Functional Capacity Evaluation (FCE) and the Roland Morris Disability Questionnaire (RMDQ), in patients with chronic low back pain (CLBP). It has been suggested that a strong relationship exists between psychological factors and disability in patients with CLBP. In former research disability was often measured by self-report and seldom performance-based. Study sample consisted of 92 patients with CLBP admitted for multidisciplinary rehabilitation. Prior to treatment, all patients completed questionnaires to measure psychological factors and self-reported disability, and performed an FCE to measure performance-based disability. Correlation coefficients between psychological variables and FCE and self-reported disability were calculated. Multivariate linear regression analyses were performed with self-reported or performance based disability measures as outcome variables, and psychological measures as predictor variables. Out of 42 relations analyzed, 5 were statistically significant. This concerned one significant correlation between kinesiophobia and a subtest of FCE, and four correlations between psychological factors and RMDQ. No correlation was significant after the Bonferroni correction was applied (P < 0.001). The strength of significant correlations ranged from r = -0.33 to r = 0.25. The multivariate analysis revealed that psychological variables measured in this study could explain 19% of the variance of self-reported disability, with kinesiophobia being the only psychological variable that contributed significantly. The suggested strong relationship between psychological factors and performance-based and self-reported disability could not be confirmed in this study. This may implicate that the relationship between psychological factors and disability in patients with CLBP is not as unambiguous as suggested.

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MeSH Term

Activities of Daily Living
Adaptation, Psychological
Adult
Chronic Disease
Comorbidity
Cross-Sectional Studies
Disability Evaluation
Fear
Female
Humans
Illness Behavior
Low Back Pain
Male
Middle Aged
Phobic Disorders
Psychology
Regression Analysis
Self Concept
Self-Assessment
Stress, Psychological
Surveys and Questionnaires
Journal Article
Article has an altmetric score of 6

Word Cloud

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