Cited by 3,167Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationSpine and Intervertebral Disc Pathology

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A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.

Waddell, Gordon, Newton, Mary, Henderson, Iain, Somerville, Douglas, Main, Chris J.·1993·Pain

DOI 10.1016/0304-3959(93)90127-b

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Abstract

Pilot studies and a literature review suggested that fear-avoidance beliefs about physical activity and work might form specific cognitions intervening between low back pain and disability. A Fear-Avoidance Beliefs Questionnaire (FABQ) was developed, based on theories of fear and avoidance behaviour and focussed specifically on patients' beliefs about how physical activity and work affected their low back pain. Test-retest reproducibility in 26 patients was high. Principal-components analysis of the questionnaire in 210 patients identified 2 factors: fear-avoidance beliefs about work and fear-avoidance beliefs about physical activity with internal consistency (alpha) of 0.88 and 0.77 and accounting for 43.7% and 16.5% of the total variance, respectively. Regression analysis in 184 patients showed that fear-avoidance beliefs about work accounted for 23% of the variance of disability in activities of daily living and 26% of the variance of work loss, even after allowing for severity of pain; fear-avoidance beliefs about physical activity explained an additional 9% of the variance of disability. These results confirm the importance of fear-avoidance beliefs and demonstrate that specific fear-avoidance beliefs about work are strongly related to work loss due to low back pain. These findings are incorporated into a biopsychosocial model of the cognitive, affective and behavioural influences in low back pain and disability. It is recommended that fear-avoidance beliefs should be considered in the medical management of low back pain and disability.

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Authors: Waddell, G., Newton, M., Henderson, I., Somerville, D., & Main, C. J.
Affiliations: Western Infirmary (GB)
Salford Royal Hospital (GB)
Corresponding author: Waddell, Gordon
ORCID: Main, Chris J.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1993-02
Volume: 52
Issue: 2
Pages: 157-168
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/0304-3959(93)90127-b
OpenAlex: W2084880898
Cited by: 3,167
References: 81
Citations by year: 2026: 96 · 2025: 128 · 2024: 119 · 2023: 119 · 2022: 106 · 2021: 147 · 2020: 161 · 2019: 135 · 2018: 147 · 2017: 111 · 2016: 138 · 2015: 128 · 2014: 130 · 2013: 136 · 2012: 126
FWCI: 16.30
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Keywords: fear-avoidance beliefs, Fear-Avoidance Beliefs Questionnaire, chronic low back pain, disability, work loss, physical activity, activities of daily living, biopsychosocial model, questionnaire development, test-retest reliability
MeSH terms: Activities of Daily Living, Adolescent, Adult, Disability Evaluation, Fear, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Regression Analysis, Sciatica, Low Back Pain

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A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.

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