Changes in fear-avoidance beliefs
There was no statistically significant difference in the
short trial between the 2 programmes in fear-avoidance
beliefs from baseline to 12 months of follow-up, for
either FABQ-work scores (1.82, 95% CI –2.19 to 5.83)
or FABQ-physical activity scores (1.36, 95% CI –0.75
to 3.47). Both programmes showed a reduction in sco-
res for both the work and physical activity subscales
during follow-up (Fig. 2). Similarly, in the long trial
there was no statistically significant difference between
the 2 programmes on FABQ-work (1.14, 95% CI –2.94
to 5.22) or FABQ-physical activity (0.08, 95% CI
–2.51 to 2.67). Also in the long trial, both program-
mes showed a reduction for both subscales (Fig. 2).
Neither of the sensitivity analyses changed the findings
(results not shown).
Associations between change in fear-avoidance
beliefs and future work participation
There was an association between changes in the
FABQ-work subscale scores from the start to the end of
the rehabilitation programmes and work-participation
days during 9 months of follow-up (Table II). Partici-
pants with consistently low scores had the most work-
participation days (149 days (95% CI 136–162)), while
those with consistently high scores had 57 days less
179
(95% CI –77 to –37). Of 163 participants who answe-
red the questionnaire at both the start and the end of
the programme, 20 reduced their FABQ-work scores.
These participants had 23 fewer work days (95% CI
Table II. Associations between changes in scores on the Fear
Avoidance Beliefs Questionnaire (FABQ: work and physical activity)
before and after rehabilitation with work participation during 9
months’ follow-up
Number of work-participation days
Change
FABQ-Work
Consistently
Decreasing
Increasing
Consistently
FABQ-Physical
Consistently
Decreasing
Increasing
Consistently
n
low
95% CI for
Adjusted
adjusted
mean
Crude Crude mean mean
a
a,b
difference
difference
mean difference
73 151
20 125
11 97
59 91
high
activity
low
159 127
15 102
17 106
high
20
82
ref
–26
–54
–60 ref
–23
–53
–57 ref
–52 to 5
–89 to –18
–77 to –37
ref
–25
–20
–44 ref
–22
–15
–41 ref
–54 to 11
–46 to 16
–69 to –12
Fear-avoidance beliefs measured by FABQ. For the work subscale a cut-off of
21 was used to categorize fear-avoidance beliefs as high or low and for the
physical activity subscale a cut-off of 14 (7). Based on participants’ scores at
the start and end of the rehabilitation programmes a new categorical variable
was created classifying each participant as having: (i) consistently low fear-
avoidance beliefs; (ii) increasing from low to high scores; (iii) decreasing
from high to low scores; and (iv) consistently high fear-avoidance beliefs. The
estimates are based on linear regression analyses.
a
Mean difference: difference in number of days at work relative to the reference
group (0).
b
Adjusted for age, sex and education level. Predictions made with covariates
constant at their mean.
Occupational rehabilitation for musculoskeletal and mental disorders
Fig. 2. Fear Avoidance Beliefs Questionnaire (FABQ) scores for the 2 programmes in the short and long trial during follow-up. Data are estimated
means with 95% confidence intervals for: (a) FABQ work in the short trial, (b) FABQ work in the long trial, (c) FABQ physical activity in the short
trial, and (d) FABQ physical activity in the long trial. Analyses performed with linear mixed-effects models.
J Rehabil Med 51, 2019