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. 2023 Jun;10(3):1310-1318.
doi: 10.1007/s40615-022-01316-4. Epub 2022 May 2.

Avoidance-Endurance Model in Older Black Men with Low Back Pain: Exploring Relationships

Dottington Fullwood  1 , Sydney Means  2 , Raheem Paxton  3 , Brandi Wells  4 , Joseph L Riley 3rd  5 , Zachary Stickley  6 , Carolyn Tucker  7 , Lu You  8 , Marie Elie  9 , Carol Thomas  10 , Stephen Anton  2 , Marco Pahor  2 , Diana J Wilkie  11
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Avoidance-Endurance Model in Older Black Men with Low Back Pain: Exploring Relationships

Dottington Fullwood et al. J Racial Ethn Health Disparities. 2023 Jun.

Abstract

Objective: The objective of the study was to investigate functional performance and pain intensity outcomes for associations with negative cognitive orientations, avoidance behaviors, and fear of pain in older Black men with low back pain (LBP).

Methods: Sixty Black men aged 60 and older (70 years[Formula: see text]) with LBP completed the Short Physical Performance Battery (SPPB), the 400-m walk test, and subjective measures of avoidance behaviors, back performance, pain intensity, and pain catastrophizing (i.e., rumination, magnification, and helplessness). Multiple regression models were used to examine associations.

Results: Higher helplessness scores were associated with worse back performance (ß = 0.55, p = 0.02), slower walking speed (ß = 0.30, p = 0.02), and higher average pain intensity (ß = 0.22, [Formula: see text] p = 0.03). Higher rumination scores were associated with better back performance (ß = - 0.36, p = 0.04). Avoidance behaviors, fear of pain, and magnification were not significantly associated with any of the variables included in the tested models.

Conclusion: Negative cognitive internalization is associated with limitations in functional performance in older Black men with LBP. Additional research is needed to further examine the cognitive orientations for understanding experienced pain and function in this population. Such research may inform the development of interventions for improving functional performance outcomes of older Black men with LBP.

Keywords: Avoidance-Endurance Model; Black men; Functional performance; Helplessness; Low back pain.

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Conflict of interest statement

Competing Interests

The authors have no relevant financial or non-financial interests to disclose.

References

    1. Wettstein M, Eich W, Bieber C, et al. Pain Intensity, Disability, and Quality of Life in Patients with Chronic Low Back Pain: Does Age Matter? Pain Med Malden Mass 2019; 20: 464–475. - PMC - PubMed
    1. Wong AYL, Forss KS, Jakobsson J, et al. Older adult’s experience of chronic low back pain and its implications on their daily life: Study protocol of a systematic review of qualitative research. Syst Rev 2018; 7: 81. - PMC - PubMed
    1. Hasenbring MI, Verbunt JA. Fear-avoidance and Endurance-related Responses to Pain: New Models of Behavior and Their Consequences for Clinical Practice. Clin J Pain 2010; 26: 747–753. - PubMed
    1. Orhan C, Van Looveren E, Cagnie B, et al. Are Pain Beliefs, Cognitions, and Behaviors Influenced by Race, Ethnicity, and Culture in Patients with Chronic Musculoskeletal Pain: A Systematic Review. Pain Physician 2018; 21: 541–558. - PubMed
    1. Keefe FJ, Block AR. Development of an observation method for assessing pain behavior in chronic low back pain patients. Behav Ther.

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