{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T01:46:19Z","timestamp":1782524779007,"version":"3.54.5"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T00:00:00Z","timestamp":1623456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"SHRS Research Development Fund, School of Health and Rehabilitation Sciences, University of Pittsburgh"},{"name":"Academy of Geriatric Physical Therapy Adopt-a-Doc Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The purpose of this study was to determine the association between fear-avoidance beliefs and disability in 3\u00a0months in people with vestibular disorders while accounting for demographic and clinical characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective cohort study included people aged 18 to 100\u00a0years who reported dizziness. Participants were recruited from a balance disorders clinic and outpatient physical therapy clinics. All participants completed the Vestibular Activities Avoidance Instrument (VAAI) and the Hospital Anxiety and Depression Scale at baseline and the Vestibular Activities and Participation measure (VAP), dizziness Visual Analogue Scale (VAS), and 12-item Short Form Health Questionnaire at baseline and 3-month follow-up. A modified version of the VAAI included 9 items abstracted from the 81-item VAAI. The relationships between 9-item VAAI scores and follow-up measures of disability were assessed using Spearman correlation coefficients. Linear regression models were analyzed to determine the effect of fear-avoidance beliefs on follow-up VAP score while accounting for baseline outcome measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All participants (n = 404) completed the baseline assessment (mean age\u2009=\u200954 years), and 286 (71%) completed the 3-month assessment. The mean 9-item VAAI score was 25 (SD\u2009=\u200914) at baseline and was significantly associated with VAP (\u03c1\u00a0=\u20090.54), 12-item Short Form Health Questionnaire component scores (\u03c1\u2009=\u2009\u22120.53; \u22120.44), and dizziness VAS at follow-up (\u03c1\u2009=\u20090.37). Approximately 38% of the variation in VAP score at follow-up was predicted by age, number of medications, 9-item VAAI score, dizziness VAS, and Hospital Anxiety and Depression Scale-depression score when considered together (R2\u2009=\u20090.38).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Fear-avoidance beliefs are associated with measures of disability at 3\u00a0months and are predictive of activity limitations and participation restrictions at 3\u00a0months when controlling for age, medications, baseline dizziness, and depression symptom severity in people with vestibular disorders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>Measurement of fear-avoidance beliefs may provide important prognostic information, suggesting that an assessment of fear-avoidance beliefs could be used by clinicians to identify individuals at greater risk of disability after a vestibular disorder.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Lay Summary<\/jats:title>\n                  <jats:p>Fear-avoidance beliefs in people who have vestibular disorders are associated with disability at 3\u00a0months and predict limitations in daily activities at 3\u00a0months.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzab147","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T19:16:17Z","timestamp":1623266177000},"source":"Crossref","is-referenced-by-count":22,"title":["Fear Avoidance Beliefs Are Associated With Perceived Disability in Persons With Vestibular Disorders"],"prefix":"10.1093","volume":"101","author":[{"given":"Pamela M","family":"Dunlap","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, University of Pittsburgh , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Sparto","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Pittsburgh , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory F","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Duquesne University , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M","family":"Furman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P","family":"Staab","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Psychology and Otolaryngology Head and Neck Surgery, Mayo Clinic , Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Delitto","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Pittsburgh , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke N","family":"Klatt","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Pittsburgh , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L","family":"Whitney","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Pittsburgh , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,12]]},"reference":[{"key":"2023011802592898700_ref1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S0304-3959(99)00242-0","article-title":"Fear-avoidance and its consequences 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