Brazilian Journal of Pain
Brazilian Journal of Pain
Original Article

Kinesiophobia and functionality perception in postmenopausal women with chronic low back pain

Cinesiofobia e percepção de funcionalidade em mulheres na pós-menopausa portadoras de lombalgia crônica

Giullio César Pereira Salustiano Mallen da Silva; Juliana Brandão Pinto de Castro; Andressa Oliveira Barros dos Santos; João Gabriel Miranda de Oliveira; Rodrigo Gomes de Souza Vale; Vicente Pinheiro Lima

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BACKGROUND AND OBJECTIVES: Low back pain is the main cause of global disability and is prevalent in women, tending to increase after menopause. The present study aimed to analyze the correlation between body mass index, muscle strength, kinesiophobia, estradiol, functional disability, and low back pain perception in postmenopausal women with chronic low back pain.

METHODS: Twenty-two postmenopausal women with chronic low back pain were evaluated. Abdominal and lower back strength were assessed using isometric tests. Basal serum estradiol levels were analyzed using the chemiluminescence method. Kinesiophobia, low back pain perception, and low back functional disability were determined using the Tampa Scale for Kinesiophobia, the visual analog scale, and the Roland Morris Questionnaire, respectively.

RESULTS: The Spearman correlation test showed correlations between the levels of kinesiophobia and the value of body mass (rho= -0.513; p=0.015) and the levels of kinesiophobia and the values of body mass index (rho= -0.576; p=0.005). There was correlation between the levels of kinesiophobia and perception of lumbar functional disability (rho= 0.434; p=0.043). No significant correlations were found between the variables of muscle strength, estradiol, and low back pain perception.

CONCLUSION: Postmenopausal women with low back pain who have higher body mass and body mass index values tend to present lower levels of kinesiophobia. There is a direct relationship between the fear of moving or maintaining a specific position and the perception of the functionality and safety of the lumbar spine.


Body mass index, Low back pain, Muscle strength, Postmenopause, Spine


JUSTIFICATIVA E OBJETIVOS: A dor lombar é a principal causa de incapacidade global e possui prevalência em mulheres, tendendo a aumentar após a menopausa. O presente estudo objetivou analisar as associações entre índice de massa corporal, força muscular, cinesiofobia, estradiol, incapacidade funcional e percepção de dor lombar em mulheres na pós-menopausa com dor lombar crônica.

MÉTODOS: Foram avaliadas 22 mulheres na pós-menopausa diagnosticadas com dor lombar crônica. A força abdominal e dos extensores da coluna foi avaliada por meio de testes isométricos. Os níveis séricos basais de estradiol foram analisados pelo método de quimiluminescência. A cinesiofobia, a percepção de dor e a incapacidade funcional lombar foram determinadas pela Tampa Scale for Kinesiophobia, escala analógica visual e Roland Morris Questionnaire, respectivamente.

RESULTADOS: O teste de correlação de Spearman mostrou associações entre os níveis de cinesiofobia e os valores de massa corporal total (rho=-0,513; p=0,015) e os níveis de cinesiofobia e os valores de índice de massa corporal (rho=-0,576; p=0,005). Foi encontrada correlação entre os níveis de cinesiofobia e de percepção de incapacidade funcional lombar (rho=0,434; p=0,043). Não houve correlações significativas entre as variáveis força muscular, estradiol e percepção de dor.

CONCLUSÃO: Mulheres na pós-menopausa com dor lombar crônica que apresentam maiores valores de massa corporal total e índice de massa corporal tendem a apresentar menores níveis de cinesiofobia. Existe relação direta entre o medo de se movimentar ou permanecer em uma posição específica e a percepção de funcionalidade e segurança da coluna lombar.


Coluna vertebral, Dor lombar, Força muscular, Índice de massa corporal, Pós-menopausa


Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67.

Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-47.

Carvalho RC, Maglioni CB, Machado GB, Araújo JE, Silva JR, Silva ML. Prevalence and characteristics of chronic pain in Brazil: a national internet-based survey study. BrJP. 2018;1(4):331-8.

Wáng YXJ, Wáng JQ, Káplár Z. Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg. 2016;6(2):199-206.

Pardhe BD, Pathak S, Bhetwal A, Ghimire S, Shakya S, Khanal PR. Effect of age and estrogen on biochemical markers of bone turnover in postmenopausal women: a population-based study from Nepal. Int J Womens Health. 2017;9:781-8.

Lou C, Chen H, Mei L, Yu W, Zhu K, Liu F. Association between menopause and lumbar disc degeneration: An MRI study of 1,566 women and 1,382 men. Menopause. 2017;24(10):1136-44.

Blümel JE, Lavin P, Vallejo MS, Sarrá S. Menopause or climacteric, just a semantic discussion or has it clinical implications?. Climacteric. 2014;17(3):235-41.

Agostini D, Donati SZ, Lucerttini F, Annibalini G, Gervasi M, Marini CF. Muscle and bone health in postmenopausal women: role of protein and vitamin D supplementation combined with exercise training. Nutrients. 2018;10(8):1103.

Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-83.

Lima VP, Nunes RAM, Silva JB, Paz GA, Jesus M, Castro JBP. Pain perception and low back pain functional disability after a 10-week core and mobility training program: a pilot study. J Back Musculoskelet Rehabil. 2018;31(4):637-43.

Barbosa FM, Vieira EB, Garcia JB. Beliefs and attitudes in patients with chronic low back pain. BrJP. 2018;1(2):116-21.

Altug F, Unal A, Kilavuz G, Kavlak E, Citisli V, Cavlak U. Investigation of the relationship between kinesiophobia, physical activity level and quality of life in patients with chronic low back pain. J Back Musculoskelet Rehabil. 2016;29(3):527-31.

Miller MB, Roumanis MJ, Kakinami L, Dover GC. Chronic pain patients' kinesiophobia and catastrophizing are associated with activity intensity at different times of the day. J Pain Res. 2020;13:273-84.

Ferrari S, Chiarotto A, Pelizzer M, Vanti C, Monticone M. Pain self-efficacy and fear of movement are similarly associated with pain intensity and disability in Italian patients with chronic low back pain. Pain Pract. 2016;16(8):1040-7.

Heller GZ, Manuguerra M, Chow R. How to analyze the visual analogue scale: myths, truths and clinical relevance. Scand J Pain. 2016;13:67-75.

Stanczyk FZ, Clarke NJ. Measurement of estradiol - challenges ahead. J Clin Endocrinol Metab. 2014;99(1):56-8.

Reed MD, Nostran WV. Assessing pain intensity with the visual analog scale: a plea for uniformity. J Clin Pharmacol. 2014;54(3):241-4.

Siqueira FB, Teixeira-Salmela LF, Magalhães LC. Análise das propriedades psicométricas da versão brasileira da escala tampa de cinesiofobia. Acta Ortop Bras. 2007;15(1):19-24.

Aebischer B, Hill JC, Hilfiker R, Karstens S. German translation and cross-cultural adaptation of the start back screening tool. PLoS ONE. 2015;10(7).

Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris. Braz J Med Biol Res. 2001;34(2):203-10.

Marfell-Jones M, Stewart AD, Ridder JH. International standards for anthropometric assessment. 2012.

Castro JBP, Lima VP, Santos AOB, Silva GCPSM, Oliveira JGM, Silva JNL. Correlation analysis between biochemical markers, pain perception, low back functional disability, and muscle strength in postmenopausal women with low back pain. J Phys Educ Sport. 2020;20(1):24-30.

Mukaka MM. Statistics Corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71.

Obesity: preventing and managing the global epidemic: report of a World Health Organization Consultation. 2000.

Zhang TT, Liu Z, Zhao JJ, Liu DW, Tian QB. Obesity as a risk factor for low back pain: a meta-analysis. Clin Spine Surg. 2018;31(1):22-7.

Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010;171(2):135-54.

O'Sullivan K, O'Sullivan PB, O'Keeffe M. The Lancet series on low back pain: reflections and clinical implications. Br J Sports Med. 2019;53(7):392-3.

Comachio J, Magalhães MO, Silva APMCC, Marques AP. A cross-sectional study of associations between kinesiophobia, pain, disability, and quality of life in patients with chronic low back pain. Adv Reumathol. 2018;58(1):8.

Hashmi JA, Baliki MN, Huang L, Baria AT, Torbey S, Hermann KM. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain. 2013;136:2751-68.

Darlow B, Perry M, Stanley J, Mathieson F, Melloh M, Baxter GD. Cross-sectional survey of attitudes and beliefs about back pain in New Zealand. BMJ Open. 2014;4(5).

Vincent HK, Omli MR, Day T, Hodges M, Vincent KR, George SZ. Fear of movement, quality of life, and self-reported disability in obese patients with chronic lumbar pain. Pain Med. 2011;12(1):154-64.

Main CJ, Foster N, Buchbinder R. How important are back pain beliefs and expectations for satisfactory recovery from back pain?. Best Pract Res Clin Rheumatol. 2010;24(2):205-17.

Larsson L, Degens H, Li M, Salviati L, Lee YI, Thompson W. Sarcopenia: aging-related loss of muscle and function. Physiol Rev. 2019;99(1):427-511.

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