Low Back Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association

. Author manuscript; available in PMC: 2016 Jun 6.

Published in final edited form as: J Orthop Sports Phys Ther. 2012 Mar 30;42(4):A1–57. doi: 10.2519/jospt.2012.42.4.A1

FEAR-AVOIDANCE BELIEFS QUESTIONNAIRE
ICF Category	Measurement of impairment of body function – content of thought (mental functions consisting of the ideas that are present in the thinking process and what is being conceptualized); and thought functions, specified as the tendency to elaborate physical symptoms for cognitive/ideational reasons
Description	The Fear-avoidance Beliefs Questionnaire (FABQ) assesses fear- avoidance beliefs associated with low back pain and consists of a 4-item FABQ physical activity scale (FABQ-PA), potentially ranging from 0 to 24 – when only summing responses to items 2 through 5, and a 7-item FABQ work scale (FABQ-W), potentially ranging from 0 to 42 – when only summing responses to items 6, 7, 9, 10, 11, 12 & 15, with higher scores indicating higher levels of fear-avoidance beliefs for both FABQ scales.³⁰² Patients rate their agreement with statements related to either physical activity or work on a 7-point Likert scale (0 = “completely disagree,” 6 = “completely agree”).³⁰²
Measurement method	Self-report
Nature of variable	Continuous
Units of measurement	Individual items: 7-point Likert scale (0 = “completely disagree,” 6 = “completely agree”)
Measurement properties	The FABQ scales have been found to have acceptable reliability.^{161, 230, 274, 302} Test-retest reliability has been reported for the FABQ-PA (Pearson r = 0.84 to 0.88) and FABQ-W (Pearson r = 0.91 to 0.88).^{274, 302} Cronbach’s alpha estimates for the FABQ-PA (ranging from .70 to .83) and FABQ-W (ranging from .71 to .88) scores suggest both scales demonstrate internal consistency.^{180, 274, 285, 286, 302} The FABQ-W has demonstrated predictive validity for disability and work loss in patients with LBP.^{108, 109, 118, 274} A suggested FABQ-W cutoff score of >29 has been suggested as an indicator of return to work status in patients receiving physical therapy for acute occupational LBP¹⁰⁸ and a cutoff score of >22 has been suggested in non-working populations.¹¹⁹ An FABQ-PA cutoff score of >14, based on a median-split of the FABQ has been suggested as an indicator of treatment outcomes in LBP patients seeking care from primary care or osteopathic physicians.³⁷ Data from 2 separate physical therapy intervention clinical trials indicated that the FABQ-W cutoff score (>29) was a better predictor of self-reported disability at 6-months in comparison to the FABQ-PA cutoff score (>14).¹¹⁹ Another psychometric analysis indicated that single items of the FABQ-PA and FABQ-W were able to accurately identify those with elevated (above median) or not elevated (below median) total FABQ-PA and FABQ-W scores.¹³⁷