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K. Saeki1, K. Nakatsuka1, Y. Tsuboi1,2, K. Uchida1, T. Isa1, R. Kawaharada1, K. Horibe1, R. Goto1, E. Perrein1, R. Ono1
1Kobe University, Public Health, Kobe, Japan, 2BackTech inc., Kyoto, Japan
Background: Low back pain (LBP) in workers has acquired social attention as it reduces quality of life and productivity for workers. LBP flare-ups are one of the types of LBP, and are defined as “the periods of increased pain lasting at least 2 hours when your LBP intensity is distinctly worse than it has been recently”. Higher frequency of LBP flare-ups was associated with higher functional disability. Therefore, it is important to examine the factors influencing the frequency of LBP flare-ups. Kinesiophobia is one of the risk factors of LBP for onset and prolongation of LBP. It is defined as the fear of movement caused by pain. Kinesiophobia could be associated with types of LBP such as flare-ups. However, no study has yet investigated the association between kinesiophobia and LBP flare-ups.
Purpose: This study aimed to investigate the association between kinesiophobia and frequency of LBP flare-ups in workers with LBP.
Methods: This study design is a prospective cohort study. We distributed the self-reported questionnaire to 463 workers during the annual health check-ups, and 319 workers completed the questionnaire (response rate: 68.9%). The frequency of LBP flare-ups was assessed by the web-based questionnaire at follow-up. A LBP flare-up was defined as “the period of increased pain lasting at least 2 hours when your LBP intensity is distinctly worse than it has been recently”. For 12 weeks, the participants reported the frequency of LBP flare-ups per a week on the questionnaire. We calculated the average frequency of LBP flare-ups per a week, and categorized as follows: high frequency group ( >75th percentile), low frequency group (≦75th percentile). Kinesiophobia was measured by the shortened version of the Tampa Scale for Kinesiophobia-J (TSK-11-J) at baseline. Logistic regression models were applied, with the frequency of LBP flare-ups as the dependent variable and kinesiophobia as the independent variable. The following variables at baseline were used as confounding factors in adjusted model: age, sex, and smoking.
Results: Seventy workers (male: 70%) were included in this study. The median age was 47 years old (IQR: 33-53). The median score for the TSK-11-J was 23 (IQR: 21-26). The median frequency of LBP flare-ups was 0.083 (IQR: 0-0.50). After adjustment, higher kinesiophobia was significantly associated with higher frequency LBP flare-ups (adjusted OR = 1.65, 95% CI = 1.22-2.22).
Conclusion(s): In this prospective cohort study, we investigated the association between the frequency of LBP flare-ups and kinesiophobia in workers with LBP. Even after adjustments, we found that higher kinesiophobia was significantly associated with higher frequency of LBP flare-ups in workers with LBP.
Implications: Our findings suggested that Kinesiophobia is an important factor related to LBP flare-ups among workers with LBP.
Funding, acknowledgements: None declared.
Keywords: low back pain, flare-ups, kinesiophobia
Topic: Pain & pain management
Did this work require ethics approval? Yes
Institution: Kobe University Graduate School of Health Science.
Committee: by the Research Ethics Committee
Ethics number: 488-3
All authors, affiliations and abstracts have been published as submitted.
