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Investigating the Fear Avoidance Model in People with Whiplash: The Association between Fear of Movement and in vivo Activity.

Pedler, Ashley PhD; Kamper, Steven J. PhD; Maujean, Annick PhD; Sterling, Michele PhD
Clinical Journal of Pain: Post Acceptance: June 6, 2017
doi: 10.1097/AJP.0000000000000524
Original Article: PDF Only

Objectives: The aims of this study were to examine the relationship between fear of movement and activity levels in people with WAD over the first 3 months post injury, to determine the mediating effect of: fear of movement on the relationship between catastrophising and activity levels, and activity levels on the relationship between fear of movement and disability in patients with WAD.

Methods: Ambulatory monitoring of physical activity was conducted for a minimum of 8 waking hours on 2 consecutive days within 4 weeks post injury and at 12 weeks post injury for 103 (74 female) people with WAD. Time spent in upright postures (uptime) and time in motion were collected along with measures of pain, disability, pain catastrophising and fear of movement. The association of self-report outcome measures with uptime and time in motion were examined. Mediation analyses were performed to determine the mediating effect of: fear of movement on the relationship between catastrophising and activity, and activity levels on the relationship between fear of movement and disability.

Results: Fear of movement was significantly related to uptime but not time in motion. Mediation analyses showed that the relationship between fear of movement and disability was not mediated by activity levels, and that the relationship between catastrophising and activity levels was not mediated by fear of movement.

Discussion: Our data suggests measures of FAM are not related to general physical activity in people with WAD. Investigation of movements specific to the cervical spine and alternative explanatory models may be required.

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