Fear of Movement, Quality of Life, and Self-Reported Disability in Obese Patients with Chronic Lumbar Pain

Abstract

Objective. To compare fear of movement between obese and non-obese individuals seeking therapy for chronic low back pain and to examine whether fear of movement predicted disability due to back pain, self-reported walking disability, and flexibility.Design. This was a cross-sectional study.Setting. Outpatient physical therapy clinic associated with a tertiary care hospital.Patients. Patients with chronic low back pain (N = 192; 48.2 ± 18.8 years) were stratified into obese (average body mass index [BMI] 36.9 ± 7.1 kg/m2) or non-obese status (average BMI 24.5 ± 3.4 kg/m2).Outcome Measures. The Tampa Scale of Kinesiophobia (TSK), Short-Form 8 (SF-8), and Oswestry Disability Survey results were main outcome measures.Methods. Retrospective review of medical charts was performed. Hierarchical regression modeling determined the contribution of TSK scores to the variance of self-reported disability with walking, overall Oswestry score, and flexibility.Results. TSK scores were higher in obese than non-obese patients (26.2 ± 7.5 vs 23.9 ± 6.8 points; P = 0.032). The SF-8 physical and mental subscores were 6-10% lower in the obese than non-obese patients. Oswestry survey scores were higher in the obese patients (40.6 vs 31.6 points; P < 0.001). TSK scores contributed to self-reported disability with walking and Oswestry disability score (both P < 0.001), but not flexibility.Conclusions. Among obese patients with chronic lumbar pain, pain-related fear of movement enhanced prediction of self-reported disability with walking and overall Oswestry scores. The TSK might be a useful clinical assessment to identify obese patients at higher risk for future low back disability. Wiley Periodicals, Inc.