The DOI matches its Crossref record; 81 of the 81 references it cites were found in a registry or an index.
A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability.
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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In the citing paper
“It has a high internal consistency with a Cronbach’s alpha coefficient of 0.88 and 0.77 (Waddell et al., 1993).”
From An evaluation of osteopathic treatment on psychological outcomes with patients suffering from chronic pain: A prospective observational cohort study collected through a health and well-being academy (2018) · cites this paper as Waddell et al., 1993
In the citing paper
“FABQ is based on the fear avoidance model, which explains why some patients with acute pain recover while others develop chronic pain.35”
From Protocol for a feasibility and acceptability study using a brief ACT-based intervention for people from Southwest Wales who live with persistent pain (2018) · cites this paper as [35]
In the citing paper
“Fear avoidance beliefs have been shown to be associated with higher levels of disability [52]”
In the citing paper
“The Fear Avoidance Beliefs Questionnaire (FABQ)43 is a reliable and valid 16-item instrument that assesses patients’ beliefs regarding the effects of physical activity and work on their lower back pain”
From An Online Self-help CBT Intervention for Chronic Lower Back Pain (2012) · cites this paper as [43]
In the citing paper
“Patients without complete cost data were younger, had more fearful beliefs about work measured with the Fear-Avoidance Beliefs Questionnaire [27], and were more frequently male and smokers.”
From Cost-effectiveness of a classification-based system for sub-acute and chronic low back pain (2012) · cites this paper as [27]
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Cited by
Sorted by citations
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
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Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance
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The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence
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The pain self-efficacy questionnaire: Taking pain into account
Nicholas, M. K. (2007) · European Journal of Pain · doi:10.1016/j.ejpain.2005.12.008 · Cited by 1,656
Metadata
- 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
- Published
- 1993-02
- Volume
- 52
- Issue
- 2
- Pages
- 157-168
- ISSN
- 0304-3959 (ISSN-L)
- 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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