Trial reportPain medicine (Malden, Mass.)2022
Changes in Pain Catastrophizing and Fear-Avoidance Beliefs as Mediators of Early Physical Therapy on Disability and Pain in Acute Low-Back Pain: A Secondary Analysis of a Clinical Trial.
Trial report in Pain medicine (Malden, Mass.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01726803 (Comparative Effectiveness of Management Strategies for Acute Low Back Pain), which is not on this map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparative Effectiveness of Management Strategies for Acute Low Back Pain
Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Influence of patient-reported outcomes on the effect of exercise therapy, manual therapy, and kinesiotaping in chronic low back pain: secondary statistical analysis.Scientific reports · 2025Trial
- Demographic and clinical characteristics associated with failure of physical therapy in chronic low back pain: a secondary analysis from a randomized controlled trial.European journal of physical and rehabilitation medicine · 2024Trial
- Predicting Clinical Improvement in Chronic Low Back Pain Using Exercise-Induced IVIM Perfusion: Threshold Evaluation and Disability-Dependent Effects.NMR in biomedicine · 2026Article
- Cognitive appraisal processes mediate postinjury pain and disability: A longitudinal observational study.Rehabilitation psychology · 2026Article
- Pain-related disability in functional neurological disorder (FND): the role of pain intensity and psychological factors.Journal of neurology · 2026Article
- The Role of Catastrophizing in Enhancing Pain Interference and Depressive Symptoms in Endometriosis: A Longitudinal Examination.European journal of pain (London, England) · 2026Article
- The effect of pain on fear of movement in the early period after open heart surgery according to the fear-avoidance model: the role of moderating factors.BMC nursing · 2025Article
- Multidimensional Effects of Manual Therapy Combined with Pain Neuroscience-Based Sensorimotor Retraining in a Patient with Chronic Neck Pain: A Case Study Using fNIRS.Healthcare (Basel, Switzerland) · 2025Article
- Catastrophizing and fear avoidance beliefs in chronic low back pain: a cross-sectional study.European journal of physical and rehabilitation medicine · 2025Article
- Article
- The Effectiveness of a Mindfulness-Based Intervention Integrated with Physical Therapy (MIND-PT) for Postsurgical Rehabilitation After Lumbar Surgery: A Protocol for a Randomized Controlled Trial as Part of the Back Pain Consortium (BACPAC) Research Program.Pain medicine (Malden, Mass.) · 2023Article
- Toward a causal model of chronic back pain: Challenges and opportunities.Frontiers in computational neuroscience · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe Fear-Avoidance Model (FAM) of chronic pain posits that pain catastrophizing and fear-avoidance beliefs are prognostic for disability and chronicity. In acute low-back pain, early physical therapy (PT) is effective in reducing disability in some patients. How early PT impacts short- and long-term changes in disability for patients with acute pain is unknown. Based on the FAM, we hypothesized that early reductions in pain catastrophizing and fear-avoidance beliefs would mediate early PT's effect on changes in disability (primary outcome) and pain intensity (secondary outcome) over 3 months and 1 year. SUBJECTS: Participants were 204 patients with low-back pain of <16 days duration, who enrolled in a clinical trial (NCT01726803) comparing early PT sessions or usual care provided over 4 weeks.
methodsPatients completed the Pain Catastrophizing Scale (PCS), Fear-Avoidance Beliefs Questionnaire (FABQ work and physical activity scales), and outcomes (Oswestry Disability Index and Numeric Pain Rating Scale) at baseline, 4 weeks, 3 months, and 1 year. We applied longitudinal mediation analysis with single and multiple mediators.
resultsEarly PT led to improvements in disability and pain over 3 months but not 1 year. In the single mediator model, 4-week reductions in pain catastrophizing mediated early PT's effects on 3-month disability and pain intensity improvements, explaining 16% and 22% of the association, respectively, but the effects were small. Pain catastrophizing and fear-avoidance beliefs did not jointly mediate these associations.
conclusionsIn acute low-back pain, early PT may improve disability and pain outcomes at least partly through reducing patients' catastrophizing.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.