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Physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs
Steven Z George1, Joel E Bialosky, Julie M Fritz
1Department of Physical Therapy, Brooks Center for Rehabilitation Study, University of Florida, PO Box 100154, Gainesville, FL 32610-0154, USA. sgeorge@phhp.ufl.edu
Background And Purpose:
Elevated fear-avoidance beliefs are believed to be a precursor of chronic disability, yet effective intervention options have not been described in the literature. The purpose of this case report is to describe physical therapist management of a patient with acute low back pain and elevated fear-avoidance beliefs.
Case Description:
The patient was a 42-year-old sales manager with acute low back pain. The patient had no previous history of activity-limiting low back pain and initially had limitations in straight leg raising, limitations in lumbar movement, and elevated fear-avoidance beliefs.
Intervention:
Treatment-based classification and graded exercise were used.
Outcome:
Disability, fear-avoidance beliefs, and pain decreased 4 weeks after starting physical therapy. Six months later, disability and fear-avoidance beliefs had increased, but were still improved when compared with the initial measurements.
Discussion:
Disability and fear-avoidance beliefs improved following a fear-avoidance-based physical therapy intervention. Research is warranted to investigate the effectiveness of this approach.
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