{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T23:03:48Z","timestamp":1794351828500,"version":"4.9.0"},"reference-count":72,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>While a causal relationship between pain\u2010related fear and spinal movement avoidance in patients with chronic low back pain (CLBP) has frequently been postulated, evidence supporting this relationship is limited. This study aimed to test if decreases in pain\u2010related fear or catastrophizing were associated with improvements in spinal biomechanics, accounting for possible changes in movement\u2010evoked pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010two patients with CLBP were assessed before and after an interdisciplinary rehabilitation program (IRP). Pain\u2010related fear was assessed with general and task\u2010specific measures. Lower and upper lumbar angular amplitude and velocity as well as paraspinal muscle activity were recorded during five daily\u2010life tasks to evaluate spinal biomechanics. Relationships were tested with multivariable linear regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The large decreases in pain\u2010related fear and catastrophizing following the IRP were scarcely and inconsistently associated with changes in spinal biomechanics (&lt;\u20093% of the models reported a statistically significant association). Results remained comparable for activities inducing more or less fear, for specific or general measures of pain\u2010related fear, and for analyses performed on the entire population or limited to subgroups of patients with higher levels of task\u2010specific fear. In contrast, reductions in task\u2010specific pain\u2010related fear were significantly associated with decreases in movement\u2010evoked pain in all tasks (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.26\u20130.62, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study does not support an association between pain\u2010related fear and spinal movement avoidance. However, it provides evidence supporting a direct relationship between decreased pain\u2010related fear and decreased movement\u2010evoked pain, possibly explaining some mechanisms of the rehabilitation programs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.13191","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T17:28:24Z","timestamp":1670434104000},"page":"290-300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Reduction in pain\u2010related fear is not associated with improvement in spinal biomechanics but with decrease in movement\u2010evoked pain in patients with chronic low back pain"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-2245","authenticated-orcid":false,"given":"Guillaume","family":"Christe","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, HESAV School of Health Sciences HES\u2010SO University of Applied Sciences and Arts Western Switzerland  Lausanne Switzerland"},{"name":"Swiss BioMotion Lab, Department of Musculoskeletal Medicine Lausanne University Hospital and University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8999-0674","authenticated-orcid":false,"given":"Charles","family":"Benaim","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Orthopedic Hospital Lausanne University Hospital  Lausanne Switzerland"},{"name":"Department of Musculoskeletal Rehabilitation Clinique Romande de R\u00e9adaptation  Sion Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Luthi","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Orthopedic Hospital Lausanne University Hospital  Lausanne Switzerland"},{"name":"Department of Musculoskeletal Rehabilitation 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