• Physical Therapy Korea
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• v.16 no.3
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• pp.60-68
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• 2009

Psychsocial factors appear to play an important role in the maintenance and development of chronic disability from low back pain. Fear of pain may be more disabling than the pain itself in patients with nonacute low back pain. The purpose of this study was to identify the contribution of gender, age, depression and pain-related fear to pain intensity and disability in nonacute low back pain patients. This was a cross-sectional survey study of eighty four patients who had low back pain for at least 4 weeks. More than moderate correlations were found between pain intensity, disability, fear-avoidance beliefs and depression. Regression analyses revealed that disability ratings and fear-avoidance beliefs for work activities significantly contributed to the prediction of pain intensity, even when controlling for age, gender and pain duration. Also, fear-avoidance beliefs for physical activity, pain intensity, age and depression, significantly contributed to the prediction of disability, even when controlling for gender and pain duration. These findings suggest that disability scores and fear-avoidance beliefs for work activities are important determinants of pain intensity. They also suggest that fear-avoidance beliefs for physical activity, pain intensity, age and depression are important determinants of disability.

• 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.

• 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.

• 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 the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.538-546
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• 2017

The purpose of this study was to investigate the effect of neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS) on muscular strength, pain, range of motion and fear-avoidance in anterior cruciate ligament reconstruction (ACLR) patients. The subjects of this study who received ACLR after arthroscopic injury were divided into two groups: NMES (n=14) and TENS (n=14). Each group received intervention after routine physical therapy. Each electrotherapy intervention was applied regularly for a total of 12 times, 3 times a day (30 minutes) for 4 weeks. The evaluation by intervention method included isokinetic muscle strength in flexion and extension of the knee joint, pain, range of motion of the knee joint, and fear-avoidance beliefs. The results showed significant improvement in pain, range of motion, and fear-avoidance beliefs in both groups (p<0.05). However, there was a significant improvement in isokinetic knee flexion and extension strength only in the NMES group (p<0.05). There was no significant difference between the two electrotherapy methods in muscle strength, pain, range of motion, and fear-avoidance beliefs. These study results suggest that NMES and TENS can be effective intervention methods for pain, range of motion, and fear-avoidance response in patients with ACLR, but to improve muscle strength NMES may be more effective.

• 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.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.66-75
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• 2021

Background: The purpose of this study is to investigate the effect of muscle energy technique and stretching on pain and pressure pain fear-avoidance beliefs questionnaire in patients with chronic back pain aged 30~40 years. Design: Pretest-Posttest design: single blind. Methods: The subjects of this study were 30, 22 males and 8 females between the ages of 30 and 40 with chronic back pain. Each group consists of three groups of 10 people. Changes in back pain were observed using Korean version of Oswestry Disability Index (K-ODI), visual analogue scale (VAS), and fear-avoidance beliefs questionnaire (FABQ). And the change in tenderness was observed using digital pressure statistics. Changes between groups after 3 weeks were compared with those before the experiment using one way ANOVA to determine the changes after 3 weeks. And the change within the group was investigated using the paired t-test. Results: As a result of the experiment, there were significant differences in the group changes in K-ODI, VAS, FABQ, and pressure pain (p<0.05). And there was a significant difference in all items after 3 weeks compared to before the experiment (p<0.05). Conclusion: In patients with chronic back pain, the muscle energy technique and stretching gave a significant difference in pain and pressure pain, fear-avoidance beliefs questionnaire changes. And this result suggests the possibility of providing basic data for future research and clinical physiotherapy intervention.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.110-116
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• 2014

Purpose: The purpose of study was to investigate the effects of combination patterns exercise of Proprioceptive Neuromuscular Facilitation (PNF) on unstable surfaces on pain, functional disability, and fear avoidance belief in patients with chronic low back pain. Methods: Twenty four patients were assigned to either the experimental group (n=12) or the control group (n=12). Patients in the experimental group performed combination patterns exercise of PNF on unstable surfaces. Patients in the control group performed combination patterns exercise of PNF on stable surfaces. Both exercises were performed for five days per week, for a period of six weeks. Pain was measured by the Visual Analogue Scale (VAS) and University of Alabama at Birmingham (UAB). Functional disability was measured using the Oswestry Disability Index (ODI) and Roland Morris Disability Questionnaire (RMDQ). Fear avoidance belief was measured using the Fear Avoidance Beliefs Questionnaire (FABQ). A paired t-test was used for determination of differences before and after treatment, and an independent t-test was used for determination of differences between treatment groups. Results: In within group comparison, the experimental group showed statistically significant difference for all variables (p<0.05). In comparison between two groups, the experimental group showed relatively greater significant difference for all variables (p<0.05). Conclusion: Based on such results, it can be said that combination patterns exercise of PNF on unstable surfaces has an effect on pain, functional disability, and fear avoidance belief in patients with chronic low back pain.

• Physical Therapy Korea
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• v.23 no.1
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• pp.38-45
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• 2016

Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.10
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• pp.209-217
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• 2019

This is a descriptive research study undertaken to confirm the relationship between depression, fear-avoidance beliefs, catastrophizing, and the quality of life in the elderly with chronic pain, and how psychological factors affect their quality of life. The subjects were 147 seniors aged 65 years or older, who visited a neuropathy clinic in A city from March 4, 2019 to March 18, 2019. Statistical analysis was achieved by applying t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analyses using the SPSS/WIN 22.0 software. Considering the demographic characteristics of the elderly, quality of life revealed significant differences with respect to age (F=3.464, p<0.001), the presence of the spouse (F=3.464, p<0.001), health condition (t=4.545, p<0.001), and pain degree (F=14.76, p<0.001). Further analysis revealed that factors affecting quality of life in the elderly with chronic pain are depression (${\beta}=-0.25$, p<0.001), pain degree (${\beta}=0.25$, p<0.001), catastrophizing (${\beta}=-0.28,$p<0.001) and health condition $({\beta}=-0.19$, p<0.001), with a total explanation power of 49%. Hence, researches on the negative psychological factors, such as depression and catastrophizing, are required to improve the quality of life for the elderly. In addition, the development of a systematic nursing arbitration program is necessary to positively recognize active pain control and health conditions.