OBJECTIVE: To assess the association of physical activity measures, derived from accelerometer and a self-reported questionnaire, with fear of movement in patients with chronic non-specific low back pain (LBP), and to investigate the association between disability and fear of movement in this population. DESIGN: Cross-sectional study. SETTING: Outpatient physical therapy university clinics. PARTICIPANTS: Patients presenting with non-specific LBP of greater than 3 months duration. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: Physical activity levels measured objectively with accelerometer (i.e. counts/min, time spent in moderate-to-vigorous and light physical activity per day, steps/day and bouts/day); and subjectively by self-reported questionnaire (Baecke Physical Activity Questionnaire); Fear of movement (Tampa Scale of Kinesiophobia); Pain (11-point Numerical Rating Scale); Disability (Roland Morris Disability Questionnaire); Depression (Beck Depression Inventory). The associations were examined with correlational, univariate linear regression and multivariable linear regression analyses. RESULTS: None of the objective physical activity measures were associated with fear of movement. The apparent association of self-reported physical activity with fear of movement (correlational analyses: r= -0.18; p<0.05; univariate regression analyses: beta= -0.04, 95% CI: -0.07 to -0.01, p = 0.04) was not confirmed in the multivariable analyses. Fear of movement was consistently associated with disability in both, correlational (r= 0.42, p<0.01) and multivariate (beta= 0.21; 95% CI: 0.11 to 0.31, p <0.001) analyses. CONCLUSIONS: Our data supports one aspect of the fear-avoidance model, that higher fear of movement is associated with more disability, but not the aspect of the model linking fear of movement with inactivity.
a1532-821X (Electronic)