Fear of movement is related to low back disability during a two-year period in patients that have undergone elective lumbar spine surgery

Abstract Objective To evaluate change in fear of movement and the relationship of fear of movement and pain intensity to low back disability and general health-related quality of life over a two-year period. Methods Consecutive patients scheduled for lumbar spine surgery were included. In addition to clinical background variables, back pain intensity, fear of movement, low back disability, and general health-related quality of life were assessed at baseline, one year and two years after surgery. Linear mixed-effects models were used to analyze data. Results In total, 348 patients were included in the final analyses. There was a significant reduction in fear of movement and a significant interaction between fear of movement and low back disability across assessments, showing that higher levels of fear of movement were related to higher levels of disability over the two-year period. Similarly, higher levels of back pain intensity were related to lower levels of general health-related quality of life during this period. Conclusions We found that fear of movement interacted with low back disability, following lumbar spine surgery, in a longitudinal study. This shows the need to address fear of movement in prehabilitation/rehabilitation pre- or post-surgically to improve health outcomes for patients who undergo lumbar spine surgery.