• Kenneth Jay, Mikkel Brandt, Markus Due Jakobsen, Emil Sundstrup, Kasper Gymoese Berthelsen, Mc Schraefel, Gisela Sjøgaard, and Lars L Andersen.
• National Research Centre for the Working Environment, Lersø Parkallé, Copenhagen Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark Electronics and Computer Science University of Southampton, United Kingdom Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Aalborg University, Denmark Department of Abdominal- & ENT-Anaesthesia, Aalborg University, Denmark The Carrick Institute-Clinical Neuroscience and Rehabilitation Cape Canaveral, FL.
• Medicine (Baltimore). 2016 Aug 1; 95 (34): e3945e3945.

AbstractPeople with chronic musculoskeletal pain often experience pain-related fear of movement and avoidance behavior. The Fear-Avoidance model proposes a possible mechanism at least partly explaining the development and maintenance of chronic pain. People who interpret pain during movement as being potentially harmful to the organism may initiate a vicious behavioral cycle by generating pain-related fear of movement accompanied by avoidance behavior and hyper-vigilance.This study investigates whether an individually adapted multifactorial approach comprised of biopsychosocial elements, with a focus on physical exercise, mindfulness, and education on pain and behavior, can decrease work-related fear-avoidance beliefs.As part of a large scale 10-week worksite randomized controlled intervention trial focusing on company initiatives to combat work-related musculoskeletal pain and stress, we evaluated fear-avoidance behavior in 112 female laboratory technicians with chronic neck, shoulder, upper back, lower back, elbow, and hand/wrist pain using the Fear-Avoidance Beliefs Questionnaire at baseline, before group allocation, and again at the post intervention follow-up 10 weeks later.A significant group by time interaction was observed (P < 0.05) for work-related fear-avoidance beliefs. The between-group difference at follow-up was -2.2 (-4.0 to -0.5), corresponding to a small to medium effect size (Cohen's d = 0.30).Our study shows that work-related, but not leisure time activity-related, fear-avoidance beliefs, as assessed by the Fear-avoidance Beliefs Questionnaire, can be significantly reduced by 10 weeks of physical-cognitive-mindfulness training in female laboratory technicians with chronic pain.

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