Affiliation:
1. School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada
Abstract
Abstract
Objective
Although pain-related fear and catastrophizing are predictors of disability in low back pain (LBP), their relationship with guarded motor behavior is unclear. The aim of this meta-analysis was to determine the relationship between pain-related threat (via pain-related fear and catastrophizing) and motor behavior during functional tasks in adults with LBP.
Methods
This review followed PRISMA guidelines. MEDLINE, Embase, PsychINFO and CINAHL databases were searched to April 2021. Included studies measured the association between pain-related fear or pain catastrophizing and motor behavior (spinal range of motion, trunk coordination and variability, muscle activity) during movement in adults with nonspecific LBP. Studies were excluded if participants were postsurgery or diagnosed with specific LBP. Two independent reviewers extracted all data. The Newcastle-Ottawa Scale was used to assess for risk of bias. Correlation coefficients were pooled using the random-effects model.
Results
Reduced spinal range of motion during flexion-tasks was weakly related to pain-related fear (15 studies, r = −0.21, 95% CI = −0.31 to −0.11) and pain catastrophizing (7 studies, r = −0.24, 95% CI = −0.38 to −0.087). Pain-related fear was unrelated to spinal extension (3 studies, r = −0.16, 95% CI = −0.33 to 0.026). Greater trunk extensor muscle activity during bending was moderately related to pain-related fear (2 studies, r = −0.40, 95% CI = −0.55 to −0.23). Pain catastrophizing, but not fear, was related to higher trunk activity during gait (2 studies, r = 0.25, 95% CI = 0.063 to 0.42). Methodological differences and missing data limited robust syntheses of studies examining muscle activity, so these findings should be interpreted carefully.
Conclusion
This study found a weak to moderate relationship between pain-related threat and guarded motor behavior during flexion-based tasks, but not consistently during other movements.
Impact
These findings provide a jumping-off point for future clinical research to explore the advantages of integrated treatment strategies that target both psychological and motor behavior processes, compared to traditional approaches.
Publisher
Oxford University Press (OUP)
Subject
Physical Therapy, Sports Therapy and Rehabilitation
Cited by
13 articles.
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