• Sanaz Shanbehzadeh, Shabnam ShahAli, Isamael Ebrahimi Takamjani, VlaeyenJohan W SJWSKU Leuven - University of Leuven, Health Psychology Research Group, Leuven, Belgium.Experimental Health Psychology, Maastricht University, Maastricht, Netherlands., Reza Salehi, and Hassan Jafari.
• Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
• Eur Spine J. 2022 Jul 1; 31 (7): 1802-1820.

PurposeLow back pain (LBP) individuals with high levels of fear of pain might display changes in motor behavior, which leads to disability. This study aimed to systematically review the influence of pain-related threat beliefs or disability on trunk kinematic or postural control in LBP.MethodEight electronic databases were searched from January 1990 to July 1, 2020. Meta-analysis using random-effect model was performed for 18 studies on the association between pain-related threat beliefs or disability and lumbar range of motion. Pearson r correlations were used as the effect size.ResultNegative correlations were observed between lumbar range of motion (ROM) and pain-related threat beliefs (r = - 0.31, p < 0.01, 95% CI: - 0.39, - 0.24) and disability (r =  - 0.24, p < 0.01, 95% CI: - 0.40, - 0.21). Nonsignificant correlations were reported between pain-related threat beliefs and center of pressure parameters during static standing in 75% of the studies. In 33% of the studies, moderate negative correlations between disability and postural control were observed.ConclusionMotor behaviors are influenced by several factors, and therefore, the relatively weak associations observed between reduced lumbar ROM with higher pain-related threat beliefs and perceived disability, and postural control with disability are to be expected. This could aid clinicians in the assessment and planning rehabilitation interventions.Level Of Evidence IDiagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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