Does Pain Self-efficacy influence Initial Forward Bending in Adults with Chronic Low Back Pain following Exercise? A Cohort Study.
Fiona McManus, Adrian Pranata, Julie A Simpson and 4 others
PMID 41185655WHAT IT FOUND
Baseline pain confidence did not predict how lumbar or hip movement changed after 12 weeks of exercise.
Higher confidence was linked to slightly less lumbar flexion at the start, but the difference was under 2 degrees and likely within measurement error.
Key findings
01There was no evidence that baseline pain self-efficacy influenced lumbar or hip flexion range of motion during initial forward bending following the exercise intervention.
02At baseline, participants with higher pain self-efficacy flexed their lumbar spine less than those with lower self-efficacy, but the difference was less than 2 degrees per 10-point change and may be clinically negligible.
03The observed angular differences were smaller than the typical measurement error for marker-based motion capture of the spine and hip.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The exercise program was general strengthening, not targeted specifically at improving forward bending mechanics, which may explain the lack of movement change. The sample was drawn from patients seeking treatment, meaning most had high pain self-efficacy; results may not apply to those with low confidence or severe impairment. The small differences in movement angles (less than 2 degrees) are smaller than the known measurement error for marker-based motion capture, suggesting the findings may be statistical noise. Substantial dropout occurred due to COVID-19 restrictions, with only 43 of 69 participants completing all assessments, raising concerns about bias. The analysis focused only on the first 25% of the forward bending motion, ignoring knee, ankle, and later phases of the lift.
Declared interests
The authors report there are no competing interests to declare.
The easy way to misread this
Do not assume that patients with high pain self-efficacy will maintain or improve specific lumbar movement patterns after exercise. The study found no predictive relationship, and the small baseline differences observed were likely within the margin of error for the measurement equipment used.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →