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Originalia

Depressivität, Bewegungsangst-Kognitionen und körperliche Aktivität bei Patienten mit Rückenschmerz

Published Online:March 06, 2015https://doi.org/10.1026/1612-5010.14.1.29

Abstract

Zusammenfassung. Ziel der Arbeit war die Untersuchung der Rolle von Depression und Bewegungsangst-Kognitionen (“fear-avoidance beliefs”) für die Bereitschaft zur Aufnahme und zur Beibehaltung körperlicher Aktivität bei Patienten mit Rückenschmerz. In die Sekundäranalyse einer randomisierten, kontrollierten Interventionsstudie gingen Daten von N = 1378 Patienten mit vorwiegend akuten Rückenschmerzen ein (58 % weiblich, mittleres Alter 49 Jahre). Personen mit hoher Depressivität und gleichzeitig starken “fear-avoidance beliefs” zeigten den niedrigsten Aktivitätsumsatz zur Baseline (kcal/Woche). Bedeutsamster Prädiktor für den Aktivitätsumsatz nach sechs bzw. 12 Monaten war neben der Baseline-Aktivität eine hohe Selbstwirksamkeitserwartung zur Baseline; Rückfälle in Inaktivität wurden v.a. durch geringe Selbstwirksamkeit und geringe wahrgenommene Vorteile von Bewegung vorhergesagt. Weder Depressivität noch Bewegungsangst erwiesen sich als bedeutsame Prädiktoren für körperliche Aktivität bzw. Rückfall in Inaktivität nach sechs bzw. 12 Monaten. Vergleichsweise stabile Konstrukte wie Depressivität oder Bewegungsangst-Kognitionen sind offenbar wenig geeignet, die Bereitschaft zur Aktivität oder tatsächliche Aktivität vorherzusagen. Es wird angeregt, verstärkt die Bedeutung von kognitiven und affektiven Aspekten situativer Entscheidungsprozesse für die Ausübung körperlicher Aktivität zu thematisieren.


Depression, fear-avoidance beliefs, and physical activity in patients with low back pain

Abstract. The goal of this study was to evaluate the impact of depression and fear-avoidance beliefs on the willingness to commence and continue physical activity in patients with low back pain. Data from a controlled, randomized intervention study of 1,378 German patients in primary care settings (58 % female, mean age 49 years) suffering predominantly from acute back pain were subjected to a secondary analysis. Results showed that patients with high scores on both depression and fear-avoidance beliefs reported the lowest physical activity (kcal/week). The most important predictors for physical activity after 6 and 12 months were baseline activity and expected self-efficacy. Important predictors for relapse into inactivity were low self-efficacy and low perceived benefits of physical activity. Neither depression nor fear-avoidance beliefs were significant predictors of physical activity or relapse after 6 or 12 months. It is concluded that relatively stable constructs such as depression or fear-avoidance beliefs do not seem to be suitable for explaining either actual or intended physical activity in low back pain patients. Future research should focus more strongly on the impact of cognitive and affective aspects of situational decision-making processes on physical activity in everyday situations.

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