Avoidance-Endurance Model in Older Black Men with Low Back Pain: Exploring Relationships

J Racial Ethn Health Disparities. 2023 Jun;10(3):1310-1318. doi: 10.1007/s40615-022-01316-4. Epub 2022 May 2.

Abstract

Objective: The objective of the study was to investigate functional performance and pain intensity outcomes for associations with negative cognitive orientations, avoidance behaviors, and fear of pain in older Black men with low back pain (LBP).

Methods: Sixty Black men aged 60 and older (70 years[Formula: see text]) with LBP completed the Short Physical Performance Battery (SPPB), the 400-m walk test, and subjective measures of avoidance behaviors, back performance, pain intensity, and pain catastrophizing (i.e., rumination, magnification, and helplessness). Multiple regression models were used to examine associations.

Results: Higher helplessness scores were associated with worse back performance (ß = 0.55, p = 0.02), slower walking speed (ß = 0.30, p = 0.02), and higher average pain intensity (ß = 0.22, [Formula: see text] p = 0.03). Higher rumination scores were associated with better back performance (ß = - 0.36, p = 0.04). Avoidance behaviors, fear of pain, and magnification were not significantly associated with any of the variables included in the tested models.

Conclusion: Negative cognitive internalization is associated with limitations in functional performance in older Black men with LBP. Additional research is needed to further examine the cognitive orientations for understanding experienced pain and function in this population. Such research may inform the development of interventions for improving functional performance outcomes of older Black men with LBP.

Keywords: Avoidance-Endurance Model; Black men; Functional performance; Helplessness; Low back pain.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Disability Evaluation
  • Emotions
  • Fear / psychology
  • Humans
  • Low Back Pain* / psychology
  • Male
  • Middle Aged
  • Surveys and Questionnaires