{"doi":"10.1093/ptj/pzaf089","title":"Associations Between Fear-Avoidance or Pain Catastrophizing and Gait Quality in Chronic Low Back Pain: A Cross-Sectional Study","abstract":"IMPORTANCE: Chronic low back pain (cLBP) is associated with reduced gait speed and other gait quality impairments. Fear-avoidance and pain catastrophizing impact movement in cLBP, but their specific impact on gait quality is unknown. OBJECTIVE: This study aimed to determine associations between fear-avoidance or pain catastrophizing and gait quality in cLBP. DESIGN: This was a cross-sectional study. SETTING: This study occurred at a university. PARTICIPANTS: There were 500 individuals (56.6 [SD = 16.5] years old; 311 female) with cLBP. INTERVENTIONS: Participants completed the Fear-Avoidance Beliefs Questionnaire - Physical Activity (FABQ-PA) and 6-item Pain Catastrophizing Scale. Participants were divided into high and low fear-avoidance subgroups based on an established FABQ-PA cutoff (>14). MAIN OUTCOMES AND MEASURES: Gait speed was measured during a 4-meter walk test, while step time average, step time variability, and symmetry were derived from a lumbar inertial measurement unit worn during a 2-minute walk test. Multiple linear regression models were used to determine relationships between fear-avoidance or pain catastrophizing and gait quality. T tests were used to determine gait quality differences between high versus low fear-avoidance subgroups. RESULTS: High fear-avoidance was associated with reduced gait speed (B = -0.0039), but pain catastrophizing was not. The high fear-avoidance subgroup had slower gait speed (mean difference = 0.05 m/s), longer step time (mean difference = 0.02 s), and higher step time variability (mean difference = 0.004 s) compared to the low fear-avoidance subgroup. CONCLUSIONS: Fear-avoidance is associated with slower gait speeds, even after adjusting for demographics, pain, and disability. The established FABQ-PA cutoff is robust in detecting gait differences between high versus low fear-avoidance subgroups. RELEVANCE: It may be important to consider fear-avoidance in the delivery of multi-modal interventions to address gait impairments. Future studies are needed to determine the impact of addressing fear-avoidance alongside traditional gait interventions in cLBP.","journal":"Physical Therapy","year":2025,"id":532668,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9444,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":586719,"name":"Gina McKernan","orcid":"0000-0003-3234-7802","position":1,"is_corresponding":false},{"id":322318,"name":"Mark S. Redfern","orcid":"0000-0003-0097-4641","position":2,"is_corresponding":false},{"id":735013,"name":"Rakié Cham","orcid":"0000-0003-2595-9376","position":3,"is_corresponding":false},{"id":331944,"name":"Carol M. Greco","orcid":"0000-0002-3078-2918","position":4,"is_corresponding":false},{"id":380783,"name":"Jennifer S. Brach","orcid":"0000-0002-7793-2004","position":5,"is_corresponding":false},{"id":341577,"name":"Sara R. Piva","orcid":"0000-0002-1716-3151","position":6,"is_corresponding":false},{"id":394665,"name":"Nam Vo","orcid":"0000-0002-1265-8921","position":7,"is_corresponding":false},{"id":394663,"name":"Gwendolyn Sowa","orcid":"0000-0002-5935-0916","position":8,"is_corresponding":false},{"id":735014,"name":"Anna H Bailes","orcid":"0000-0001-8659-2729","position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":null,"created_at":"2026-07-19T02:51:27.893975Z","pmid":"40662641","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}