Relationship between psychological factors and spinal motor behaviour in low back pain : a systematic review and meta-analysis

Christe, Guillaume (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland) ; Crombez, Geert (Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium) ; Edd, Shannon (Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland) ; Opsommer, Emmanuelle (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Jolles, Brigitte M. (Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland ; Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland) ; Favre, Julien (Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland)

This meta-analysis investigated whether more negative psychological factors are associated with less spinal amplitude of movement and higher trunk muscle activity in individuals with low back pain. Furthermore, it examined whether pain intensity was a confounding factor in this relationship. We included studies that provided at least 1 correlation coefficient between psychological (pain-related fear, catastrophizing, depression, anxiety, and self-efficacy) and spinal motor behaviour (spinal amplitude and trunk muscle activity) measures. In total, 52 studies (3949 participants) were included. The pooled correlation coefficients (95% confidence interval; number of participants) were −0.13 (−0.18 to −0.09; 2832) for pain-related fear, −0.16 (−0.23 to −0.09; 756) for catastrophizing, −0.08 (−0.13 to −0.03; 1570) for depression, −0.08 (−0.30 to 0.14; 336) for anxiety, and −0.06 (−0.46 to 0.36; 66) for self-efficacy. The results indicated that higher levels of pain-related fear, catastrophizing, and depression are significantly associated with reduced amplitudes of movement and larger muscle activity and were consistent across subgroup and moderation analyses. Pain intensity did not significantly affect the association between these psychological factors and spinal motor behaviour and had a very small independent association with spinal motor behaviour. In conclusion, the very small effect sizes found in the meta-analyses question the role of psychological factors as major causes of spinal movement avoidance in low back pain. Experimental studies with more specific and individualized measures of psychological factors, pain intensity, and spinal motor behaviour are recommended.


Keywords:
Article Type:
scientifique
Faculty:
Santé
Branch:
Physiothérapie
School:
HESAV
Institute:
Unité de recherche en santé, HESAV
Date:
2021-03
Pagination:
15 p.
Published in:
Pain
Numeration (vol. no.):
March 2021, vol. 162, no. 3, pp. 672-686
DOI:
ISSN:
0304-3959
Appears in Collection:

Note: The file is under embargo until: 2022-04-01


 Record created 2021-05-10, last modified 2021-05-25

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