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Context
The fear-avoidance model was developed in an attempt to explain the process by which “pain experience” and “pain behavior” become dissociated from the actual pain sensation in individuals who manifest the phenomenon of exaggerated pain perception. High levels of fear avoidance can lead to chronic pain and disability and have successfully predicted rehabilitation time in the work-related–injury population. Existing fear-avoidance questionnaires have all been developed for the general population, but these questionnaires may not be specific enough to fully assess fear avoidance in an athletic population that copes with pain differently than the general population.Objective
To develop and validate the Athlete Fear Avoidance Questionnaire (AFAQ).Design
Qualitative research to develop the AFAQ and a cross-sectional study to validate the scale.Patients or Other Participants
For questionnaire development, a total of 8 experts in the fields of athletic therapy, sport psychology, and fear avoidance were called upon to generate and rate items for the AFAQ. For determining concurrent validity, 99 varsity athletes from various sports participated.Data Collection and Analysis
A total of 99 varsity athletes completed the AFAQ, the Fear-Avoidance Beliefs Questionnaire, and the Pain Catastrophizing Scale. We used Pearson correlations to establish concurrent validity.Results
Concurrent validity was established with significant correlations between the AFAQ and the Fear Avoidance Beliefs Questionnaire-Physical Activity (r = 0.352, P > .001) as well as with the Pain Catastrophizing Scale (r = 0.587, P > .001). High internal consistency of our questionnaire was established with a Cronbach α coefficient of 0.805. The final version of the questionnaire includes 10 items with good internal validity (P < .05).Conclusions
We developed a questionnaire with good internal and external validity. The AFAQ is a scale that measures sport-injury–related fear avoidance in athletes and could be used to identify potential psychological barriers to rehabilitation.Key Words: fear-avoidance model, scale, sports, athletic injuries, rehabilitation, psychologyKey Points
- We developed and validated the Athlete Fear Avoidance Questionnaire to assess pain-related fear in athletes.
- Pain-related fear or fear avoidance plays a critical role in the rehabilitation of patients with low back pain and work-related injuries. High levels of fear avoidance in athletes may affect rehabilitation times.
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Methods: A four-year old boy with PTHS participated in a 12-week intervention comprising five one-hour long walking sessions per week at a local daycare. Walking sessions used the Upsee mobility device (Firefly by Leckey Ltd., Ireland). Outcome measures included Goal Attainment Scaling and the Mobility Ability Participation Assessment.
Results: Parental and caregiver goals for social interaction, physical activity and physical health surpassed expectations by post-testing. Gains were not sustained at three months follow-up. The participant’s ability and mobility may have increased following the intervention.
Conclusions: Participants with PTHS may benefit from regular physical activity and early intervention. The Upsee mobility device is a feasible and fun way to promote inclusive community-based physical activity and social engagement in a young child with PTHS. Further research into the health benefits of physical activity and the Upsee for children with PTHS may be warranted.
- Implications for Rehabilitation
Physical activity may be beneficial for a child with Pitt Hopkins syndrome, a rare genetic disorder.
New design, implementation of mobility intervention for a child with neurodevelopmental disabilities.
The Upsee mobility device may offer physical benefits for a child with a neurodevelopmental disability.
The Upsee mobility device may offer social benefits for a child with a neurodevelopmental disability.