Task-specific fear rather than general kinesiophobia assessment is associated with kinematic differences in chronic low back pain during lumbar flexion: a preliminary investigation.

Introduction: Kinematic data obtained during a movement task by individuals with chronic low back pain seem to be related to pain-related fear. General kinesiophobia assessments, such as Tampa Scale for Kinesiophobia, are often used to assess pain-related fear. However, these questionnaires could suffer from a lack of sensitivity and do not measure the fear of specific movements. Objectives: The purpose of this study was to investigate whether the task-specific assessment of pain-related fear exhibits a closer association with trunk kinematics during lumbar flexion compared with the general kinesiophobia in individuals with chronic low back pain. Methods: We assessed pain-related factors, task-specific fear, and Tampa Scale for Kinesiophobia-11 scores of 51 company employees. The lumbar angle during a lumbar flexion task was recorded by 2 wireless Axivity Ax3 accelerometers attached to the subject's spinous process (L3) and sacral spine (S2). Only task-specific fear was evaluated after the lumbar flexion task. We calculated the maximum lumbar flexion angle (°) and the peak angular velocity of lumbar flexion/return from flexion (°/s2). We conducted a hierarchical multiple linear regression analysis to determine variance explained in lumbar flexion task performance by task-specific fear after controlling for demographic, pain, and general kinesiophobia. Results: The results showed that task-specific fear was associated with the peak angular velocity of lumbar return from flexion (R 2 adj. = 0.36, P < 0.01) and lumbar flexion (R 2 adj. = 0.3, P = 0.01). Discussion: Our results suggest that clinicians should consider the potential added value of task-specific fear assessment over the sole use of conventional kinesiophobia assessment.

Effect of pain neuroscience education and exercise on presenteeism and pain intensity in health care workers: A randomized controlled trial.

OBJECTIVES: Decreased workforce productivity has a significant economic impact on healthcare systems. Presenteeism, the practice of working at reduced potential, is more harmful than absenteeism. Present workers most often experience musculoskeletal pain that is not mitigated by general exercise or stretching. We aimed to assess whether a regimen of pain neuroscience education (PNE) and exercise tailored to individual healthcare workers could reduce presenteeism and improve productivity. METHODS: An independent investigator randomized 104 medical professionals into two groups (intervention and control). The control group received general feedback after answering a questionnaire, while the intervention group received a 6-month plan of exercises and PNE created by a physical therapist with 10 years of experience. Our primary outcome was the scores of the Japanese version of the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ) to investigate presenteeism; and our secondary outcomes were pain intensity, widespread pain index (WPI), and EuroQol 5-dimension (EQ5D-5L). RESULTS: In the intervention group, post intervention, we observed significant improvement in presenteeism, pain intensity, WPI, physical and psychological stress, and EQ5D-5L (P < .05). In the control group, we noted significant improvement only in the physical and psychological stress post intervention (P < .05). The results showed significant between-group differences in presenteeism post-intervention (P < .05). CONCLUSION: We demonstrated that a combination of PNE and exercise decreases presenteeism of healthcare workers. Our findings will help healthcare facilities carry out better employee management and ensure optimal productivity.