An overview of the treatment interventions and assessment of fear-avoidance for chronic musculoskeletal pain in adults: A scoping review protocol

TL;DR

This paper outlines a scoping review protocol to explore treatment interventions for fear-avoidance in chronic musculoskeletal pain, considering all relevant components and synonyms.

Contribution

The study introduces a comprehensive approach to assess interventions targeting all fear-avoidance components and their synonyms.

Findings

Current reviews focus mainly on kinesiophobia, neglecting other fear-avoidance components.

The review will include diverse study designs and outcome measures to provide a broader overview of interventions.

Patient and Public Involvement will be used to develop and reflect on the findings.

Abstract

The Fear-Avoidance (FA) model aims to explain how an acute pain experience can develop into a persistent state. The FA model considers five core components: kinesiophobia, pain-related fear, catastrophisation, victimisation, and interpersonal social environment. Amongst these, kinesiophobia, tends to dominate the literature on chronic musculoskeletal pain. As a result, current reviews have not considered the other core components of the FA model when exploring its interventions. Moreover, several synonyms of the term kinesiophobia is not reflected in their search strategies. Coupled with the preference of particular study designs and outcome measures, this scoping review aims to provide and characterise an overview of treatment interventions that consider all study designs, relevant outcome measures, FA components, and FA component synonyms.

Eligible studies will be in English or with an available English translation from 1970 onwards. Databases to be searched include Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, The Allied and Complementary Database (AMED), PEDro, Web of Science, and grey literature. We will include studies involving participants ≥18 years old with chronic musculoskeletal pain, and interventions targeting FA and/or its components. Three review authors will independently screen papers using preestablished eligibility criteria and conduct assessments of risk of bias, with a fourth independent researcher employed to resolve disagreements where found. Qualitative synthesis techniques will be used to characterise the interventions. Patient and Public Involvement (PPI) has been utilised to develop this protocol and will be conducted following completion of the systematic review to discuss and reflect on the findings.

This systematic review does not require ethical approval as existing data will be used and the PPI to be conducted is an involvement activity rather than study data. The results will be disseminated through a peer-reviewed journal and via national and international conferences.

This protocol is registered on Open Science Framework:
https://doi.org/10.17605/OSF.IO/NR37A

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