ABSTRACT

BACKGROUND/OBJECTIVE: Fear-avoidance beliefs (FAB) have been known to be one of the major causes of non-specific chronic low back pain which may also affect recovery if not investigated. However, studies on fear- avoidance beliefs among patients with non-specific chronic low back pain have not been well documented in Nigeria. This study sought to investigate the effect of stabilization exercise on fear avoidance belief of patients with non-specific chronic low back pain.

MATERIAL AND METHODS: A total of 122 individuals (44 males, 78 females) with non-specific chronic low pain back (NCLBP) participated in this study. They were recruited from Orthopaedic Clinic of Lagos University Teaching Hospital (LUTH), Idi- Araba, Lagos and National Orthopaedic Hospital Igbobi, Lagos, Nigeria. They were assigned to four different groups (1, 2, 3&4). Group 1 received stabilization exercise only. In addition to stabilization exercise, Groups 2 and 3 received Transcutaneous Electrical Nerve Stimulation (TENS), and massage therapy respectively. Group 4 was the control who received drug therapy only. Participants went through this protocol twice weekly for 8 consecutive weeks. Patients were assessed for fear avoidance belief using a structured 16 item questionnaire which assessed fear avoidance belief (FAB) for work and physical activity. The instrument has a cut-off score for FAB-physical activity and FAB-work activity which are >15 and> 34 respectively. Scores >15 and 34 shows high fear for physical and work activity respectively. Data were analysed using descriptive statistics of mean and standard deviation. Kruskal wallis test was used to analyse the FAB for physical and work activity at baseline end of 4^th week and end of 8^th week. Wilcoxon test was used to compare baseline and 8^th week values of the FAB for physical and work activity.

RESULT: Patients in three groups (1, 2 and 3) recorded significant improvement in fear avoidance belief for physical activity (FABP) and fear avoidance belief for work activity (FABW), following intervention (P<0.05). Wilcoxon - test showed that there was significant difference between pre-and post-treatment intervention assessment within each of the groups except group 4 which is the control group. While the baseline score of the participant’s for FABP in all the groups was higher than the cut-off point which is >15, while the baseline for FABW in all the groups was less than the cut-off point which is >34.

CONCLUSION: The study provides evidence that stabilization exercise only and in combination with TENS and massage is effective in managing fear avoidance belief of patients with non-specific chronic low back pain.

Key words: Stabilization exercise, Low back pain, fear avoidance belief.