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. 2023 Mar 15;20(6):5193.
doi: 10.3390/ijerph20065193.

The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study

Mohammad A ALMohiza  1 , Ravi Shankar Reddy  2 , Faisal Asiri  2 , Adel Alshahrani  3 , Jaya Shanker Tedla  2 , Snehil Dixit  2 , Kumar Gular  2 , Venkata Nagaraj Kakaraparthi  2
Affiliations

The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals: A Cross-Sectional Study

Mohammad A ALMohiza et al. Int J Environ Res Public Health. .

Abstract

(1) Background: Fear of movement (kinesiophobia) and impaired lumbar joint position sense (LJPS) play a vital role in developing and maintaining non-specific chronic low back pain (CLBP). However, how kinesiophobia impacts LJPS is still being determined. The aims of this study are to (1) assess the correlation between kinesiophobia and LJPS in individuals with chronic low back pain; (2) compare LJPS between individuals with CLBP and those who are asymptomatic; and (3) evaluate if pain can mediate the relationship between kinesiophobia and LJPS in CLBP individuals. (2) Methods: Eighty-three individuals (mean age = 48.9 ± 7.5 years) with a diagnosis of CLBP and 95 asymptomatic individuals (mean age = 49.4 ± 7.0 years) were recruited into this cross-sectional study. Fear of movement in CLBP individuals was assessed using the Tampa Scale for Kinesiophobia (TSK). LJPS was determined using the active target repositioning technique using a dual-digital inclinometer. LJPS was evaluated in lumbar flexion, extension, and side-bending left and right directions, and the repositioning accuracy was determined in degrees using a dual digital inclinometer. (3) Results: Kinesiophobia showed a significant (p < 0.001) moderate positive correlation with LJPS (flexion: r = 0.51, extension: r = 0.41, side-bending left: r = 0.37 and side-bending right: r = 0.34). LJPS errors were larger in CLBP individuals compared to asymptomatic individuals (p < 0.05). Mediation analyses showed that pain significantly mediated the relationship between kinesiophobia and LJPS (p < 0.05) in CLBP individuals. (4) Conclusions: Kinesiophobia and LJPS were positively associated. LJPS is impaired in CLBP individuals compared to asymptomatic individuals. Pain may mediate adverse effects on LJPS. These factors must be taken into account when assessing and developing treatment plans for those with CLBP.

Keywords: kinesiophobia; low back pain; lumbar spine; pain severity; position sense.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Assessment of lumbar joint position sense using a digital inclinometer.
Figure 2
Figure 2
Model of the potential mediating effect of pain on the relationship between kinesiophobia and lumbar joint position sense.
See this image and copyright information in PMC

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References

    1. Kamper S.J., Logan G., Copsey B., Thompson J., Machado G.C., Abdel-Shaheed C., Williams C.M., Maher C.G., Hall A.M. What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments. Pain. 2020;161:694–702. doi: 10.1097/j.pain.0000000000001751. - DOI - PubMed
    1. Carregaro R.L., Tottoli C.R., Rodrigues D.d.S., Bosmans J.E., da Silva E.N., van Tulder M. Low back pain should be considered a health and research priority in Brazil: Lost productivity and healthcare costs between 2012 to 2016. PLoS ONE. 2020;15:e0230902. doi: 10.1371/journal.pone.0230902. - DOI - PMC - PubMed
    1. Fatoye F., Gebrye T., Odeyemi I. Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol. Int. 2019;39:619–626. doi: 10.1007/s00296-019-04273-0. - DOI - PubMed
    1. Oliveira C.B., Pinheiro M.B., Teixeira R.J., Franco M.R., Silva F.G., Hisamatsu T.M., Ferreira P.H., Pinto R.Z. Physical activity as a prognostic factor of pain intensity and disability in patients with low back pain: A systematic review. Eur. J. Pain. 2019;23:1251–1263. doi: 10.1002/ejp.1395. - DOI - PubMed
    1. Urits I., Burshtein A., Sharma M., Testa L., Gold P.A., Orhurhu V., Viswanath O., Jones M.R., Sidransky M.A., Spektor B. Low back pain, a comprehensive review: Pathophysiology, diagnosis, and treatment. Curr. Pain Headache Rep. 2019;23:23. doi: 10.1007/s11916-019-0757-1. - DOI - PubMed

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