{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:11:57Z","timestamp":1792087917182,"version":"4.4.0"},"reference-count":57,"publisher":"Oxford University Press (OUP)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,12,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Little information exists about the role of fear-avoidance beliefs and catastrophizing in subacromial pain syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to investigate the associations among pain, catastrophizing, fear, and disability and the contribution of fear-avoidance beliefs to disability at baseline and at 3-month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross-sectional and longitudinal analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Baseline demographic and clinical data, including fear-avoidance beliefs and catastrophizing, of 90 patients were assessed for this analysis. Disability was measured with the Shoulder Pain and Disability Index at baseline and at 3-month follow-up. First, bivariate and partial correlations were calculated among pain, fear-avoidance beliefs, catastrophizing, and disability, based on the fear-avoidance model. Second, the contribution of fear-avoidance beliefs to disability at baseline and at 3-month follow-up was examined with hierarchical regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Correlations between clinical variables and disability were largely in line with the fear-avoidance model. Regression analyses identified a significant contribution of fear-avoidance beliefs to baseline disability but not to disability at 3 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitations<\/jats:title><jats:p>Patients with subacromial pain syndrome were studied; therefore, the results should be transferred with caution to other diagnoses. A modified version of the Fear-Avoidance Beliefs Questionnaire was used, which was not validated for this patient group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fear-avoidance beliefs contribute significantly to baseline disability but not to disability change scores after 3-month follow-up. Duration of complaints and baseline disability were the main factors influencing disability change scores. Although the results help to improve understanding of the role of fear-avoidance beliefs, further studies are needed to fully understand the influence of psychological and clinical factors on the development of disability in patients with subacromial shoulder pain.<\/jats:p><\/jats:sec>","DOI":"10.2522\/ptj.20130587","type":"journal-article","created":{"date-parts":[[2014,7,25]],"date-time":"2014-07-25T03:50:21Z","timestamp":1406260221000},"page":"1775-1784","source":"Crossref","is-referenced-by-count":64,"title":["Influence of Fear-Avoidance Beliefs on Disability in Patients With Subacromial Shoulder Pain in Primary Care: A Secondary Analysis"],"prefix":"10.1093","volume":"94","author":[{"given":"Thilo O.","family":"Kromer","sequence":"first","affiliation":[{"name":"T.O. Kromer, PhD, Department of Physiotherapy, School of Therapeutic Sciences, SRH University Heidelberg, Maria-Probst-Strasse 3, 69123 Heidelberg, Germany, and CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith M.","family":"Sieben","sequence":"additional","affiliation":[{"name":"J.M. Sieben, PhD, CAPHRI School for Public Health and Primary Care, Maastricht University; Centre for Evidence-Based Physiotherapy (CEBP), Maastricht University; and Department of Anatomy and Embryology, Maastricht University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob A.","family":"de Bie","sequence":"additional","affiliation":[{"name":"R.A. de Bie, PhD, Department of Epidemiology, Maastricht University; CAPHRI School for Public Health and Primary Care, Maastricht University; and CEBP, Maastricht University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline H.G.","family":"Bastiaenen","sequence":"additional","affiliation":[{"name":"C.H.G. 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