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Abstract

Project Summary

This experiment aims to use multiple Fear Avoidance Belief Questionnaires (FABQs) for post-surgical female spinal patients for a more comprehensive therapy experience. FABQs are given to quantify and assess the fears and avoidant behavior a patient may have due to their beliefs about movement that may cause pain. The avoidant behaviors could range from the patient unnecessarily limiting their daily activities to refusing the physical therapists recommendations for exercise during their session. It is standard practice in clinics to use a singular FABQ during the initial evaluation for physical therapy. High levels of fear have been known to cause chronic pain and a less successful treatment in therapy. The FABQ are a useful tool but are usually overlooked. FABQs are many times briefly considered, put in the patient’s medical chart, and never looked at again. This is common practice despite research that validates the accuracy of FABQs. This experiment aims to use FABQs four times throughout the post-operation (PO) and physical therapy processes, instead of just once, to assemble a more thorough program.

The questionnaires will be given immediately before discharge from the surgical center, at the initial evaluation of physical therapy, and week 2 of physical therapy (PT), and at week 6 of PT. These four scores would differ from the usual protocol of administering only one questionnaire during the initial physical therapy evaluation. The scores, ranging from high to low quantitatively, indicate how much the patient is avoiding behaviors that they believe could increase their pain. The scores would be categorized for each measurement for each patient as high, medium, or low. The progress of each patient will be tracked and a series of standard discharge test will be performed at the end of a 12-week physical therapy program. The landmark discharge tests look to ensure that the patient is equipped with the strength and proper technique to go about their daily lives with minimal risk to reinjure themselves. The results of this experiment will be used to see if high fear avoidance beliefs during a certain point in physical therapy, such as week 2 or week 6, would indicate a significantly decreased ability to pass the standard landmark discharge tests performed at the end of a 12 week program. These landmark tests are used in physical therapy to determine whether or not a patient has progressed enough to no longer need care and is able to handle everyday tasks without the risk of reinjuring themselves. From there, further research into preventative measures could be explored to best equip the patients with the therapy, both physical and psychological, needed for their comprehensive and prompt recovery. These measures could include additional counseling for patients with high avoidance beliefs, scheduling a longer session that includes more one-on-one time with the therapist and aides, or adjusting the length of the program to address patient’s fears before reentering their usual routines.

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