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OP0082-HPR Fear-Avoidance Beliefs of Physical Activity in Adults with Rheumatoid Arthritis
  1. H. Lööf1,2,
  2. I. Demmelmaier3,
  3. E. Welin Henriksson4,5,
  4. S. Lindblad6,
  5. B. Nordgren3,
  6. C.H. Opava3,4,
  7. U.-B. Johansson1,2
  1. 1Sophiahemmet University, Sophiahemmet University
  2. 2Department of Clinical Sciences Danderyd Hospital
  3. 3Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Karolinska Institutet
  4. 4Department of Rheumatology, Karolinska University Hospital
  5. 5Department of Neurobiology, Care Sciences and Society, Division of Nursing
  6. 6Department of Learning Informatics Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm, Sweden


Background A minority of people with RA perform maintained health enhancing physical activity (HEPA). Psychosocial factors seem to be the most salient and consistent factors to explain HEPA variation [1]. Furthermore, avoidance of physical activity could result in negative physical consequences and in psychological changes [2]. The Fear-Avoidance Belief Questionnaire (FABQ) seems to be the best available instrument to measure the concept of fear and avoidance behaviors of physical activity [3].

Objectives The objective of this study was to describe fear-avoidance beliefs of physical activity and explore how they correlate to socio-demographic, disease-specific and psychosocial factors in adults with RA.

Methods This cross-sectional study is a part of a study focusing physical activity (the PARA 2010 study). The present study included 2351 patients from six rheumatology clinics. The participants answered the modified version of the FABQ and questionnaires on socio-demographic, disease-related, and psychosocial factors. The statistical analysis, performed in two steps, was aimed to evaluate factors associated with fear-avoidance beliefs. The model fit was estimated using Nagelkerkés R2.

Results High level of pain (OR 1.99 95%, CI 1.40 - 2.84) and poor health (OR 1.59, 95% CI 1.10 - 2.29) were the two disease-specific factors most indicative of high mFABQ. Being male (OR 1.55, 95% CI 1.26–1.91) and having a below average income (OR 1.35, 95% CI 1.12–1.63) were associated with an increased risk of high fear-avoidance beliefs. Regarding psychosocial factors, low health related quality of life, HRQoL (OR 0.44, 95% CI 0.35–0.55) and low exercise self-efficacy, ESES (OR 0.66, 95% CI 0.52–0.82) were significantly associated with high fear-avoidance beliefs (Nagelkerkés R2 0.27).

Conclusions High fear-avoidance beliefs in patients with RA were associated with being male, below average income, high level of pain, poor health, low health related quality of life and low exercise self-efficacy. The present findings indicate that such beliefs about physical activity are complex and multidimensional.


  1. Demmelmaier I, Bergman P, Nordgren B, Jensen I, Opava CH. Current and maintained health-enhancing physical activity in rheumatoid arthritis: a cross-sectional study. Arthritis Care Res (Hoboken). 2013;65:1166-76.

  2. Turk DC, Monarch ES. Biopsychosocial perspective on chronic pain. In: Turk DC, Gatchel RJ, editors. Psychological approaches to pain management: a practitioner's handbook. New York: Guilford; 2002.

  3. Lundberg M, Grimby-Ekman, A, Verbunt, J, Simmonds MJ. Pain-related fear: a critical review of the related measures. Pain Research and Treatment 2011; 494196. doi: 10.1155/2011/494196.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.1244

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