Validierung der deutschen Version des Fear-Avoidance Beliefs Questionnaire (FABQ-D) für Patient*innen mit Schulterbeschwerden

Validation of the German version of the Fear-Avoidance Beliefs
Questionnaire (FABQ-D) for shoulder disorders
Background: With a prevalence of up to 30%, shoulder disorders form the third largest group of musculoskeletal complaints worldwide. Their formation and development are influenced by psychosocial factors such as movement-related fear. One of the internationally most common measurements for quantifying fear of movement is the Fear-Avoidance Beliefs Questionnaire (FABQ).
Objectives: To investigate the reliability (internal consistency) and validity (structural validity, construct validity, predictive validity) of the FABQ-D in a shoulder pain population.
Materials and methods: Subjects with shoulder pain were included in a multicenter cross-sectional study. In addition to fear-avoidance beliefs, pain intensity, subjective impairment in daily life and kinesiophobia were recorded. To this end, the FABQ-D, numeric rating scale (NRS), Shoulder and Pain Disability Index (SPADI) and the Tampa Scale for Kinesiophobia (TSK-GV) were used.
Results: A total of 49 subjects (24 women and 25 men) with a mean age of 41.8 years (SD = 12.8) were included. The descriptive evaluation at item level showed good internal consistency of the FABQ-D (Cronbach’s α = 0.88). The homogeneity factor differs significantly between the subscales (Loevinger’s H = 0.66–0.9). The correlation analyses did not show any clear convergence of the FABQ-D with the TSK-GV (r = 0.3501; p = 0.0137). A divergence to the constructs of the NRS (r = 0.1818; p = 0.2112) and SPADI (r = 0.4415; p = 0.0015) were confirmed. The hypothesis testing resulted in 42.87% of the assumed hypotheses and therefore a low construct validity. The FABQ-D and the TSK-GV showed a significant influence on the duration of the complaints (R2 = 0.3652; p ≤ 0.0001). It was also shown that the greatest factors for a high FABQ-D value were functional impairment (SPADI) and duration of symptoms (R2 = 0.3066; p = 0.0002). The subgroup analysis showed a significantly higher FABQ-D value in older subjects (40–65 years; t = 3.8084/df = 47, p = 0.0002).
Conclusion: The FABQ-D is a reliable measurement tool. The construct validity should be further investigated in future studies. This study reproduced results from previous studies in other populations. The FABQ-D appears to be an adequate measurement tool for quantifying fear of movement in patients with shoulder disorders.