The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index.
The treatment of fear of movement/(re) injury in chronic low back pain: further evidence on the effectiveness of exposure in vivo
Open accessAbstract
BACKGROUND AND OBJECTIVE: Several cognitive-behavioral factors contribute to the persistence of pain disability in patients with chronic back pain. Fear-avoidance beliefs and fear of movement/(re)injury in particular have been shown to be strong predictors of physical performance and pain disability. Patients reporting substantial pain-related fear might benefit from exposure in vivo to a set of individually tailored, fear-eliciting, and hierarchically ordered physical movements rather than more general graded activity. PATIENTS AND INTERVENTIONS: Six consecutive patients with chronic low back pain who reported substantial fear of movement/(re)injury were included in the study. After a no-treatment baseline measurement period, the patients were randomly assigned to one of two interventions. In the first intervention, patients received exposure in vivo first, followed by graded activity. In the second intervention, the sequence of treatment modules was reversed. Before each treatment module, treatment credibility was assessed. Daily measures of pain-related fear, pain catastrophizing, and pain intensity were completed using visual analog scales. In addition, standardized measures of pain disability, pain-related fear, and pain vigilance were taken before and after each treatment module and at the 1-year follow-up. To obtain more objective data on actual activity levels, an ambulatory activity monitor was carried by the patients during 1 week before and after each treatment module. RESULTS: Time series analysis of the daily measures showed that improvements in pain-related fear and pain catastrophizing occurred only during the exposure in vivo and not during the graded activity, irrespective of the treatment order. Analysis of the pretreatment to post-treatment differences also revealed that decreases in pain-related fear also concurred with decreases in pain disability and pain vigilance and an increase in physical activity levels. All improvements remained at the 1-year follow-up.
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“All 10 patients with chronic low back pain who participated in these studies exhibited very high levels of fear of movement and reinjury before intervention.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [141]
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“Results indicated that whenever graded exposure was introduced, patients exhibited substantial improvements in pain-related fear, disability, and activity level.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [141]
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“These results were maintained during the activation intervention.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [141]
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“It has been demonstrated that kinesiophobia has shown to be a strong predictor for pain disability and pain chronicity in the longer term [73] associated with higher rates of sick-leaves [74], pain vigilance and disability as well as decreased physical activity levels [75–77].”
From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [77]
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Citations
Cites
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Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance
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“At the end of the first session of each treatment module (when the rationale had been explained), patients rated three credibility items on three visual analog scales, with “not at all” and “very much” as the extremes: Do you expect that the program will help you to cope better with your pain complaints? Do you expect…”
Method
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The biopsychosocial approach to chronic pain: Scientific advances and future directions.
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.4.581 · Cited by 3,392
The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence
Leeuw, M., Goossens, M. E. J. B., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2007) · Journal of Behavioral Medicine · doi:10.1007/s10865-006-9085-0 · Cited by 2,261
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Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00733-9 · Cited by 1,345
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Metadata
- Authors
- Vlaeyen, J. W. S., de Jong, J., Geilen, M., Heuts, P. H. T. G., & van Breukelen, G.
- Affiliations
- Maastricht University (NL)
- Corresponding author
- Vlaeyen, Johan W. S.
- ORCID
- Vlaeyen, Johan W. S.
- Venue
- The Clinical Journal of Pain
- Published
- 2002-07
- Volume
- 18
- Issue
- 4
- Pages
- 251-261
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2048514270
- Cited by
- 499
- References
- 53
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 12 · 2023: 9 · 2022: 16 · 2021: 13 · 2020: 18 · 2019: 18 · 2018: 17 · 2017: 27 · 2016: 18 · 2015: 28 · 2014: 18 · 2013: 18 · 2012: 23
- FWCI
- 13.31
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- other-oa
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- chronic low back pain, kinesiophobia, fear of reinjury, graded activity, fear-avoidance beliefs, pain catastrophizing, fear of pain, pain-related disability, pain vigilance, physical activity, ambulatory activity monitoring, treatment order
- MeSH terms
- Activities of Daily Living, Adult, Avoidance Learning, Chronic Disease, Desensitization, Psychologic, Disability Evaluation, Fear, Female, Follow-Up Studies, Humans, Male, Middle Aged, Movement, Pain Measurement, Cognitive Behavioral Therapy, Treatment Outcome, Low Back Pain, Cross-Over Studies, Secondary Prevention
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