Gait Variability and Relationships With Fear, Avoidance, and Pain in Adolescents With Chronic Pain

Area of Science:

• Pediatric Rheumatology
• Pain Management
• Movement Science

Background:

• Chronic pain in children can lead to fear, avoidance, and disability.
• Movement adaptations in pediatric chronic pain are not well understood.
• Psychological factors like fear and avoidance may explain individual differences in movement responses.

Purpose of the Study:

• To quantify gait variability in children with chronic pain.
• To examine the relationships between pain, fear, avoidance, function, and gait variability.
• To investigate the predictive power of psychological factors on gait variability.

Main Methods:

• Cross-sectional study of children aged 8-17 with non-acute, non-systemic pain.
• Utilized Numeric Pain Rating Scale, Fear of Pain Questionnaire (FOPQ), Functional Disability Inventory, and 6-Minute Walk Test.
• Performed kinematic gait analysis to measure gait variability (GaitSD).

Main Results:

• Participants showed greater GaitSD compared to age-predicted norms.
• Fear of pain correlated with self-selected GaitSD.
• Avoidance behaviors predicted a significant portion of variability in both self-selected and standardized GaitSD.

Conclusions:

• Gait variability in children with chronic pain is linked to fear and avoidance behaviors.
• Avoidance behaviors are a strong predictor of altered gait variability.
• Findings suggest psychological drivers significantly impact movement adaptations in pediatric chronic pain.