Citation

Pedler A, Sterling M. Clin. J. Pain 2011; 27(6): 502-507.

Affiliation

Centre for National Research on Disability and Rehabilitation Medicine (CONROD), The University of Queensland, Herston, Qld; Division of Physiotherapy and National Health and Medical Research Council Centre for Clinical Research Excellence in Spinal Pain, Injury and Health (CCRE Spine), School of Health and Rehabilitation Sciences, The University of Queensland, Australia.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/AJP.0b013e31820d97b0

PMID

21317772

Abstract

OBJECTIVES: To examine the development of fear avoidance behaviours following whiplash injury using two different measures of fear avoidance, the Pictorial Fear of Activities Scale-Cervical (PFActS-C), and the Tampa Scale of Kinesiophobia (TSK-17). Secondarily we assessed the capacity of these measures to predict recovery status at long term follow up and initial cervical range of movement (ROM). METHODS: Ninety-eight patients with acute WAD were recruited and completed measures of pain and disability (NDI), fear avoidance beliefs and cervical ROM at baseline (<4 weeks), 3 and 6 months post injury. Participants were grouped based on NDI scores at 6 months follow up as either recovered (NDI <10), mild (NDI 10-28) or moderate/severe (NDI≤30). RESULTS: Repeated measures, linear mixed model analysis showed a significant main effect for time and group for both TSK-17 and PFActS-C scores (p≤0.001). On both measures the moderate/severe group scored significantly higher than the mild and recovered groups. TSK-17 scores, age and initial pain intensity at baseline significantly predicted NDI scores at 6 months (p=0.002). PFActS-C scores, age and initial pain intensity at baseline significantly predicted initial cervical extension and rotation ROM (p=0.001). DISCUSSION: Fear avoidance beliefs and behaviours develop quickly following whiplash injury and influence both the initial physical presentation and long term outcome of patients with WAD. The PFActS-C may provide a measure of fear of movement which is more specific to the cervical spine in patients with WAD in comparison to the TSK-17.

Language: en