• Physical Therapy Korea
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• v.16 no.1
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• pp.52-60
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• 2009

The objectives of this study were to investigate the relationship between fear-avoidance beliefs and functional status in individuals suffering from low back pain, and to identify factors that influence on fear-avoidance beliefs, functional status and pain. A cross-sectional study included 214 individuals with low back pain. Each of subjects completed a fear-avoidance beliefs questionnaire (FABQ) which divided into two subscales, FABQ for physical activity (FABQ-PA) and FABQ for work(FABQ-W), Oswestry disability index (ODI) and numeric pain rating scale (NPRS). Individuals with radiating pain were significantly higher in FABQ-PA, FABQ-total, and ODI scores than with no radiation pain (p<.05). Individuals who had received surgery were significantly higher in FABQ-PA, FABQ-total, ODI and NPRS scores when compared with individuals who had not received it (p<.05). And individuals with taking medication were significantly higher in all variables (FABQ-PA, FABQ-W, FABQ-total ODI and NPRS) than individuals not taking medication (p<.05). In correlation analysis. age appeared to be significantly correlated with FABQ-PA, FABQ-total and ODI scores (p<.05), and all variables was significantly correlated with each other (p<.01). These findings indicate that individuals suffering from low back pain have psychosocial problems such as fear-avoidance beliefs as well as functional status and pain. Fear-avoidance beliefs may contribute to aggravate physical symptoms, and therefore it should be carefully considered for the management of individuals with low back pain.

• Physical Therapy Korea
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• v.16 no.2
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• pp.24-30
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• 2009

The purpose of this study was to determine the reliability and validity of the fear-avoidance beliefs questionnaire (FABQ) in assessing Korean patients with low back pain. We performed translation and cross-cultural adaptation of the questionnaire and enrolled 52 patients (18 males and 34 females) with low back pain. The subjects completed a standardized self-administered questionnaire that included the FABQ assessment along with evaluations for the visual analogue scale (VAS), Oswestry disability index (ODI), self-rating anxiety scale (SAS), and Beck depression inventory-Korean version (K-BDI). The reliability of the obtained data was determined by evaluating the internal consistency on the basis of the intraclass correlation coefficient (ICC) and the Cronbach's alpha values, while the validity of the data was examined by correlating the FABQ scores to the VAS, ODI, SAS, and K-BDI scores. The translated versions of the FABQ showed good test-retest reliability: ICC (3, 1)=.90 (FABQ for physical activity) and .97 (FABQ for work) these values were statistically significant (p<.01). The Cronbach's alpha value for FABQ was .90 (p<.01). FABQ moderately correlated with pain, disability, anxiety, and depression (p<.01). The results of this study indicate that the Korean version of the FABQ is a reliable and valid instrument for measuring fear-avoidance beliefs in Korean patients with low back pain.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.203-212
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• 2013

Objectives This study was to investigate the correlation of low back pain, stress by event, and fear-avoidance beliefs caused by traffic accident. Methods We investigated 103 cases of out-patient with traffic accident. The patients answered that Visual Analogue Scale (VAS), Impact of Event Scale Revised Korean Version (IES-R-K), and Fear-Avoidance Beliefs Questionnaire (FABQ) on the first medical examination. We calculated statistical significance with this data. Results VAS, IES-R-K, and FABQ scores of the female patients with the traffic accident were higher than the male patients. VAS, IES-R-K, and FABQ scores showed low significant positive correlation and showed partial correlation between IES-R-K and FABQ, controlled by VAS, had no statistical significance in this research. Conclusions More considerations on pain, stress by event, and fear avoidance belief should be needed in treatment of the traffic accident patients.

• Physical Therapy Korea
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• v.29 no.1
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• pp.54-63
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• 2022

Background: Low back and neck pain are two of the most common medical problems in the adult population. It is estimated that between 70% and 80% adults experience an episode of low back pain at least once during their lifetime. Objects: This study aimed to compare the effects of various stretching exercises and muscle energy techniques used for treatment of iliopsoas, quadratus lumborum, and hamstrings of patients with low back pain. Methods: A total of 52 subjects were randomly assigned to the control group (n = 17), the muscle energy technology group (METG, n = 19), and the stretching exercise group (SEG, n = 16). Interventions were performed twice a week for 4 weeks. Outcomes were measured before and after 4 weeks of treatment in the three groups, using the Korean version of the Oswestry Disability Index, the Visual Analogue Scale (VAS), the Fear Avoidance Belief Questionnaire (FABQ), the Finger to Floor test (FTF), the Modified-Modified Schober Test (MMS), and the Trunk Flexion Range of Motion test. Results: This study showed significant reduction in the pre-test and post-test KODI, VAS, and FABQ scores in all the three groups (p < 0.05). The KODI, VAS, FABQ and FTF assessed in this study showed interactions between the groups and the measurement time point (p < 0.01). After intervention, the KODI, VAS, FABQ and FTF in the SEG and METG were significantly higher (p < 0.05), and there was no difference between the METG and SEG. MMS and HFROM test showed no difference between the three groups (p > 0.05). Conclusion: KODI, VAS, FABQ and FTF showed significant improvement after basic physical therapy, muscle energy technique, and stretching exercise intervention. And there was no significant difference in the intervention effect between the muscle energy group and the stretching exercise group.

• Journal of Acupuncture Research
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• v.32 no.1
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• pp.109-118
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• 2015

Objectives : This study aimed to investigate the correlation between fear-avoidance beliefs and neck pain/neck disability caused by traffic accidents. Methods : We surveyed 52 patients who were injured in traffic accidents. The patients completed baseline measures of pain, disability, fear-avoidance beliefs according to the visual analogue scale(VAS), neck disability index(NDI) and a fear-avoidance beliefs questionnaire (FABQ). At the end of medical treatment, VAS and NDI were reassessed. In order to determine the relationship between FABQ(including its subscales), change of VAS and NDI, Pearson correlation coefficients were used. To examine the accuracy of previously reported cut-off scores, we classified the patients into low and high groups and analyzed the change of VAS and NDI. The relationship was measured by Mann-Whitney U-test and a student's T-test. Results : FABQ and its subscales(total, physical activity and work) were significantly correlated with final VAS and NDI. FABQ-T showed low significant negative correlation with change of NDI. Previously reported cut-off scores did not show a statistical significance in this study Conclusions : This study suggests that screening for fear-avoidance beliefs may be useful for identifying patients at risk of prolonged pain after traffic accidents.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.29-45
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• 2024

PURPOSE: This study aimed to compare the effects of pain level, lower back pain dysfunction level, psychosocial level, hip abductor strength (HAS), number of positive lumbar instability tests, and dynamic balance (DB) by applying lumbar stabilization exercises according to the presence or absence of gluteus medius muscle weakness in chronic lower back pain (CLBP) patients with lumbar instability. METHODS: Thirty-five CLBP patients with lumbar instability were divided into the gluteus medius weakness (n = 18) and gluteus medius non-weakened (n = 17) groups using the gluteus medius manual muscle test. Intervention applied conservative physical therapy and lumbar stabilization exercises to both groups that lasted three times a week for four weeks. To compare the intervention effects, the quadruple visual analog scale (QVAS), the Korean version of the Oswestry disability index (K-ODI), fear-avoidance beliefs questionnaire (FABQ), HAS, lumbar instability tests positive response counter (LIC), and DB were measured. RESULTS: Significant differences were shown for QVAS, K-ODI, FABQ, HAS, LIC, and DB for both groups pre- and post-intervention (p < .05). Compared to the gluteus medius weakness group, the gluteus medius non-weakened group showed a significant difference (p < .05) in the changes in QVAS, K-ODI, FABQ-W, FABQ-total, and HAS. CONCLUSION: In CLBP patients with lumbar instability, having gluteus medius weakness was less effective in improving lumbar stabilization exercise than gluteus medius non-weakness regarding pain level, lower back pain dysfunction level, psychosocial level excluding physical activity, and hip abductor strength. Therefore, additional gluteus medius strengthening exercises are necessary for patients with lumbar instability and gluteus medius muscle weakness.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.1
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• pp.75-83
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• 2024

Background: This study conducted a comparative evaluation of the effects of Pilates stabilization exercise combined with pain neuroscience education (PNE) in patients with chronic low back pain. The evaluation was based on their visual analogue scale (VAS) scores, Korean Oswestry disability index (KODI) scores, and fear avoidance belief questionnaire (FABQ) scores. Methods: A total of 36 participants were recruited and randomly assigned to either a Pilates stabilization exercise group (PSE, n=18) or Pilates stabilization exercise combined with pain neuroscience education group (PPNE, n=18). Both the PSE and PPNE groups participated in 50-minute sessions of Pilates stabilization exercise, three times per week for six weeks. The VAS, KODI, and FABQ scores of the participants were measured before and after the intervention. Results: There were significant improvements in the VAS of the PSE and PPNE group, with significant difference found between them. Both groups showed a significant decline in KODI scores following the exercise interventions, with significant difference observed between the two groups. FABQ scores were significantly decline in both groups, with significant difference found between them. Conclusion: In this study, Pilates stabilization exercise combined with pain neuroscience education was found to be more effective than Pilates stabilization exercise alone in reducing the VAS, KODI, and FABQ scores of patients with chronic low back pain. Thus, Pilates stabilization exercise combined with pain neuroscience education can be used in clinical practice to treat and prevent chronic lower back pain.

• The Journal of Korean Physical Therapy
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• v.28 no.5
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• pp.321-327
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• 2016

Purpose: The purpose was to link items of questionnaires that measure functioning and disability of persons with Low Back Pain (LBP) into the International Classification of Functioning, Disability and Health (ICF). Methods: The Oswestry Disability Index (ODI), Roland and Morris Disability Questionnaire (RM), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short Form-36 health survey (SF-36) were evaluated to map items of those questionnaires into the ICF categories. The linking rule was employed and linking was performed independently by 10 health professionals. One-hundred and two patients with LBP were recruited from 19 medical institutes to this study for a field test to examine relations between the scale and its linked ICF category set. Pearson correlation coefficient was used to analyze their relationships. Results: Walking was only found to be one-to-one linking between the scale and the ICF. Sixty questions in FABQ were to be linked to 9 of ICF categories. Ten and 14 ICF categories were able to be linked to RM and ODI respectively. It was found that majority of items from ODI and RM scale had similar concept and linked to the same ICF category. SF-36 had only 15 categories of the ICF linked. Strong relationship was observed between measurement scales and linked ICF code sets (r=0.79, r=0.65, r=0.47, and r=-0.31 for ODI, RM, FABQ and SF-36 respectively). Conclusion: It was found that commonly used clinical tools for LBP may be linked to ICF. The study results may suggest that clinical data can be standardized to communicate between related professionals.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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• pp.282-287
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• 2013

Purpose: The purpose of this study was to investigate the characteristics of patients with Chronic Low Back Pain (CLBP) in disability, pain, and cognition, and to compare those characteristics to the ICF concept analyzing the association between World Health Organization Disability Assessment Schedule 2.0: 12 item-interviewer version (WHODAS 2.0) and those of scales i.e. Oswestry Disability Index (ODI), the Short-Form McGill Pain Questionnaire (SFMPQ), and the Fear avoidance & belief questionnaire (FABQ). Methods: A total of 91 patients with CLBP were invited to participate in the study. Physical therapists interviewed all participants using SFMPQ, FABQ, ODI, and WHODAS 2.0 for collection of information on pain, cognition, and functional level data. Subjects scored their disability, pain, and cognition related to LBP using WHODAS 2.0, ODI, SFMPQ, and FABQ. Data analysis was performed using the Spearman correlation coefficient. Results: A positive relationship was observed between WHODAS 2.0 and each scale indicating that lower back specific disability components could be related to the ICF concept in ODI (r=0.77). Pain intensity and pain oriented movement were found to be related to general functioning in patients with CLBP (r=0.52, r=0.55, respectively). Conclusion: It can be suggested that the specific disability scale for LBP, ODI can be related to the ICF concept, WHODAS 2.0, and it may be a useful measure for patients with CLBP.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.97-108
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• 2016

Objectives This study is planned to classify effectiveness of Korean medicine treatment on lumbar intervertebral Disc herniation patients' fear-avoidance belief. Methods We measured 84 patients with lumbar intervertebral disc herniation in Jaseng Korean Medicine Hospital. We used numeric rating scale, oswestry disability index, fear-avoidance belief questionaire for evaluating effectiveness of oriental medicine treatment on lumbar intervertebral disc herniation. And We used Magentic Resonance Imaging(MRI) for classifying the patient who has lumbar intervertebral disc or not. Results 1. There was statistical effectiveness of korean medicine treatment on lumbar intervertebral disc herniation patients' fear-avoidance belief (p<0.01). ${\Delta}NRS$ and ${\Delta}ODI$ (r=0.587) was Most statistically correlative. ${\Delta}ODI$ and ${\Delta}FABQ$ had a little of statistically correlation (r=0.313). ${\Delta}NRS$ and ${\Delta}FABQ$ has no statistically correlation (r=0.145). Conclusions This study suggests that screening for the korean medicine treatment reduces fears and negative belief of patients with the lumbar disc herniation and prevents chronic physical symptoms that come from them so that it can be a great help to controlling patients' pain clinically.