Avoidance-Endurance Model in Older Black Men with Low Back Pain: Exploring Relationships

Objective The objective of the study was to investigate functional performance and pain intensity outcomes for associations with negative cognitive orientations, avoidance behaviors, and fear of pain in older Black men with low back pain (LBP). Methods Sixty Black men aged 60 and older (70 years ± 6 ) with LBP completed the Short Physical Performance Battery (SPPB), the 400-m walk test, and subjective measures of avoidance behaviors, back performance, pain intensity, and pain catastrophizing (i.e., rumination, magnification, and helplessness). Multiple regression models were used to examine associations. Results Higher helplessness scores were associated with worse back performance ( ß = 0.55, p = 0.02), slower walking speed ( ß = 0.30, p = 0.02), and higher average pain intensity ( ß = 0.22, API , p = 0.03). Higher rumination scores were associated with better back performance ( ß = − 0.36, p = 0.04). Avoidance behaviors, fear of pain, and magnification were not significantly associated with any of the variables included in the tested models. Conclusion Negative cognitive internalization is associated with limitations in functional performance in older Black men with LBP. Additional research is needed to further examine the cognitive orientations for understanding experienced pain and function in this population. Such research may inform the development of interventions for improving functional performance outcomes of older Black men with LBP.