Predictive Value of the Fear-Avoidance Model on Functional Capacity Evaluation.
Johanne Tüscher, Cyrille Burrus, Philippe Vuistiner and 3 others
PMID 29094284WHAT IT FOUND
A higher cumulative psychological risk score was linked to lower lifting performance on functional capacity tests, especially when patients gave a safe maximal effort.
Lower perceived capacity was also linked to poorer lifting. This is an association, not proof of cause.
Key findings
01On the three lifting tests, each additional point on the cumulative psychological risk score was expected to lower the maximal lifted weight by 1.12 kg on the floor-to-waist lift, 0.88 kg on the waist-to-overhead lift, and 1.21 kg on the carrying test.
02Lower perceived capacity scores were consistently associated with lower performance on all three lifting tests.
03The cumulative psychological risk score was not associated with lifting performance among patients who stopped themselves, but it was associated with waist-to-overhead performance among patients who reached a safe maximal effort.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was mostly men and came from late rehabilitation after injury, so it may not fit other patients. The study was observational, so it cannot show that fear-avoidance caused lower lifting performance. The psychological risk index was modified from the original, using a different depression questionnaire and a different fear-of-movement cut-off. The subgroup of patients who stopped themselves was smaller, and the analysis could not strongly establish associations there. Other motivational and contextual factors were not measured.
The easy way to misread this
Do not read this as proof that fear-avoidance caused lower lifting performance. The study was observational, and it did not test treatment. It also did not show the same pattern in patients who stopped themselves.