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Pinheiro CAB, Bassi-Dibai D, Pontes-Silva A, Pereira FHF, Pinheiro JS, Fidelis-de-Paula-Gomes CA, Dibai-Filho AV. Measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in individuals with chronic pain. BMC Public Health 2024; 24:1776. [PMID: 38961346 PMCID: PMC11223431 DOI: 10.1186/s12889-024-19297-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE To examine the measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in Brazilians with chronic pain. METHODS Cross-sectional and longitudinal design (washout period for reliability). The study was conducted in two Brazilian states, Maranhão and São Paulo, and included Brazilian adults, irregular exercisers, former exercisers or non-exercise practitioners, aged 18 to 59 years and with chronic pain. The instruments used in this study were: the REPEAS, the Numerical Pain Rating Scale (NPRS), the Baecke Habitual Physical Activity Questionnaire (BHPAQ), the Pain Self-Efficacy Questionnaire (PSEQ), and the Roland-Morris Disability Questionnaire for general pain (RMDQ-g). The evaluation focused on structural validity, construct validity, reliability (with standard error of measurement and minimum detectable change), internal consistency, and floor and ceiling effects. RESULTS The two-dimensional structure was tested through confirmatory factor analysis, which resulted in adequate fit indeces: chi-square values/degrees of freedom = 1.541, Tucker-Lewis Index = 0.966, comparative fit index = 0.974, root mean square error of approximation = 0.074, and standardized root mean square residual = 0.068. Additionally, satisfactory factor loadings (> 0.40) were obtained. Test-retest reliability and internal consistency were adequate for the environmental factors domain (intraclass correlation coefficient [ICC] = 0.79, Cronbach's alpha = 0.88) and the personal factors domain (ICC = 0.97, Cronbach's alpha = 0.93). In hypothesis testing for construct validity, we observed a significant correlation with magnitude below 0.30 of the environmental factors domain of the REPEAS with RMDQ-g, PSEQ and sport domain of the BHPAQ. For the personal factors domain, we observed a significant correlation with a magnitude of 0.30 to 0.50 with RMDQ-g, PSEQ, and sport domain of the BHPAQ, and below 0.30 with leisure domain of the BHPAQ. No floor or ceiling effects were found for the REPEAS domains. CONCLUSION The REPEAS is a valid instrument with a two-dimensional internal structure consisting of 12 items. It has a reliable construct and is suitable for use in the clinical and epidemiological context for adults with chronic pain in Brazil.
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Affiliation(s)
| | - Daniela Bassi-Dibai
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, MA, Brazil
| | - André Pontes-Silva
- Postgraduate Program in Physical Therapy, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
| | | | - Jocassia Silva Pinheiro
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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do Nascimento Freitas DW, Dibai-Filho AV, Pontes-Silva A, Araujo GGC, de Oliveira AR, da Cunha Leal P, Gabel CP, Fidelis-de-Paula-Gomes CA, Cabido CET. Translation, cross-cultural adaptation, and validation of the 10-item spine functional index (SFI-10) in the Brazilians with musculoskeletal spine disorders. BMC Musculoskelet Disord 2024; 25:266. [PMID: 38575902 PMCID: PMC10996142 DOI: 10.1186/s12891-024-07406-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
PURPOSE To translate and cross-culturally adapt the Spine Functional Index (SFI) into Brazilian Portuguese (SFI-Br) in individuals with musculoskeletal spine disorders. METHODS Participants (n=194) answered the Numerical Pain Rating Scale (NPRS), 36-item Short-Form Health Survey (SF-36), Roland-Morris Disability Questionnaire for General Pain (RMDQ-g), and SFI-25 incorporating the SFI-10. Structural validity, from confirmatory factor analysis (CFA), used comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). The best structure was considered from the lower values of the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Construct and criterion validity used Spearman's correlation coefficient (rho). Internal consistency used Cronbach's alpha, reliability used intraclass correlation coefficient (ICC2,1), with ceiling and floor effects determined. Error used the standard error of the measurement (SEM) and minimal detectable change, 90% level (MDC90). RESULTS Adequate fit indices demonstrated an unequivocal one-factor structure only for the SFI-10 (chi-square/DF <3.00, CFI and TLI >0.90, RMSEA <0.08). The SFI-10-Br correlation was high with the SFI-Br (rho=0.914, p<0.001), moderate for the RMDQ-g (rho=-0.78), SF-36 functional capacity domain (rho=0.718) and NPRS (rho=-0.526); and adequate for the remaining SF-36 domains (rho>0.30). Test-retest reliability (ICC2,1=0.826) and internal consistency (alpha=0.864) were high. No ceiling or floor effects were observed, and error was satisfactory (SEM=9.08%, MDC90=25.15%). CONCLUSION The SFI Brazilian version was successfully produced with the 10-item version showing an unequivocal one-factor structure, high construct and criterion validity, reliability, internal consistency, and satisfactory error. Further research on responsiveness is required.
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Affiliation(s)
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - André Pontes-Silva
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
| | | | | | - Plinio da Cunha Leal
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
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Mendes LP, Fidelis-de-Paula-Gomes CA, Pontes-Silva A, Barreto FS, Pinheiro JS, da Silva ACB, de Oliveira Pires F, da Cunha Leal P, Avila MA, Dibai-Filho AV. Tampa Scale for Kinesiophobia in chronic neck pain patients (TSK-neck): structural and construct validity and reliability in a Brazilian population. BMC Musculoskelet Disord 2024; 25:151. [PMID: 38368337 PMCID: PMC10874046 DOI: 10.1186/s12891-024-07268-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/08/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND To date, there are no studies in the literature that define the internal structure of the Tampa Scale for Kinesiophobia (TSK) in patients with chronic neck pain based on factorial analysis. As such, we aimed to verify and identify the best structure of the Brazilian version of the TSK in patients with chronic neck pain. METHODS We included Brazilian participants aged ≥18 years, both sexes, with self-reported neck pain for more than 3 months and pain intensity ≥3 on the Numerical Pain Rating Scale (NPRS). Dimensionality and number of TSK items were assessed using confirmatory factor analysis (CFA). We tested the following internal structures: structure 1 (1 domain and 17 items), structure 2 (1 domain and 11 items), structure 3 (2 domains and 11 items), and structure 4 (2 domains and 9 items). We used the Pain-Related Catastrophizing Thoughts Scale (PCTS) and the NPRS for construct validity. In addition, we assessed test-retest reliability for the seven-day interval using intraclass correlation coefficient (ICC2,1), Cronbach's alpha to assess internal consistency, and ceiling and floor effects. RESULTS The study sample included of 335 patients. Most were women (77.6%), young adults (~ 34 years), single (48.4%), with complete primary education (57.3%), physically inactive (66.6%), with a mean pain duration of 46 months and a mean pain intensity of ~ 5 points on the NPRS. Redundancy was found in the following items: item 1 with item 2 (modification indices = 21.419) and item 13 with item 15 (modification indices = 13.641). Subsequently, based on these paired analyses, the items with the lowest factor loadings (items 2 and 15) were excluded. As such, TSK structure 4 was composed of two domains ("somatic focus" and "activity avoidance") and 9 items, which showed adequate fit indices and lower AIC and SABIC values. We observed significant values (p < 0.05) with a correlation magnitude greater than 0.142 to 0.657 between the two domains of the TSK-neck and the other instruments (PCTS and NPRS). We found excellent reliability (ICC2,1 ≥ 0.96) and adequate internal consistency (Cronbach's alpha ≥0.98) of the TSK-neck. Finally, ceiling and floor effects were not observed. CONCLUSION The TSK-neck structure with two domains (somatic focus and activity avoidance) and nine items is the most appropriate for patients with chronic neck pain.
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Affiliation(s)
| | | | - André Pontes-Silva
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil.
| | - Felipe Souza Barreto
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
- Sarah Network of Rehabilitation Hospitals, São Luís, Brazil
| | - Jocassia Silva Pinheiro
- Postgraduate in Rehabilitation and Functional Performance, Faculdade de Medicina de Ribeirão Preto, Universidade São Paulo, Ribeirão Preto, Brazil
| | | | - Flávio de Oliveira Pires
- Department of Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
| | - Plinio da Cunha Leal
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
| | - Mariana Arias Avila
- Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Almir Vieira Dibai-Filho
- Department of Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
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Penha LMB, Pontes-Silva A, Santos-de-Araújo AD, Camargo PF, Pires FDO, Fidelis-de-Paula-Gomes CA, Mostarda CT, Bassi-Dibai D, Dibai-Filho AV. Reliability of the Heart Rate Variability Registered Through Polar Cardio Frequency Meter in Individuals With Chronic Low Back Pain. J Chiropr Med 2023; 22:180-188. [PMID: 37644996 PMCID: PMC10461136 DOI: 10.1016/j.jcm.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 08/31/2023] Open
Abstract
Objective The purpose of this study was to analyze the intra- and inter-examiner reliability of the analysis of heart rate variability (HRV) captured by a Polar cardio frequency meter in individuals with chronic nonspecific low back pain. Methods The study included 35 individuals with nonspecific low back pain, both sexes, aged 18 to 45. We used a Polar V800 cardio frequency meter to capture HRV in individuals in different positions, and we calculated the reliability through the intraclass correlation coefficient (ICC). Results Regarding intra-examiner reliability, we found excellent reliability of HRV analysis in the supine position (ICC ranging from 0.89 to 1.00) and in the standing position (ICC ranging from 0.95 to 0.99). In addition, for inter-examiner reliability, we found substantial to excellent reliability of the HRV analysis in the supine position (ICC ranging from 0.76 to 0.98) and moderate to excellent reliability in the standing position (ICC ranging from 0.73 to 0.99). Conclusion The HRV analysis captured by a Polar cardio frequency meter presented adequate reliability when considering different times and different examiners.
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Affiliation(s)
| | - André Pontes-Silva
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Patrícia Faria Camargo
- Postgraduate Program in Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | | | | | - Daniela Bassi-Dibai
- Postgraduate Program in Programs Management and Health Services, Ceuma University, São Luís, Maranhão, Brazil
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Pontes-Silva A. Letter to the editor regarding "A novel physical functioning test to complement subjective questionnaires in chronic low back pain assessments" by Sutanto et al. Spine J 2023; 23:1096-1097. [PMID: 37349005 DOI: 10.1016/j.spinee.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/15/2023] [Indexed: 06/24/2023]
Affiliation(s)
- André Pontes-Silva
- Physical Therapy Post-Graduate Program (PPGFT), Physical Therapy Department (DFisio), Federal University of São Carlos (UFSCar), Rod. Washington Luis, Km 235, CEP 13565-905, São Carlos, SP, Brazil.
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de Jesus SFC, Bassi-Dibai D, Pontes-Silva A, da Silva de Araujo A, de Freitas Faria Silva S, Veneroso CE, de Paula Gomes CAF, Dibai-Filho AV. Construct validity and reliability of the 2-Minute Step Test (2MST) in individuals with low back pain. BMC Musculoskelet Disord 2022; 23:1062. [PMID: 36471309 PMCID: PMC9721032 DOI: 10.1186/s12891-022-06050-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/01/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Functional tests are important clinical tools, since they are non-invasive methods, with simple applicability, and low cost. However, there are few tests adapted for individuals with chronic low back pain. Thus, our objective was to evaluate the test-retest and inter-rater reliability of the 2-Minute Step Test in individuals with chronic low back pain and to correlate the test score with measures of pain and physical activity. METHODS We included patients aged between 18 and 45 years, of both sexes, and with low back pain. The interval between the test and retest was 7 days. We analyzed the data via intra-class correlation coefficient (ICC), confidence interval at 95%, standard error of measurement, and minimum detectable change for reliability. We used the Spearman's correlation coefficient to verify the correlation between 2-Minute Step Test and measures of pain and physical activity (Numerical Pain Scale, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Baecke Habitual Physical Activity Questionnaire). RESULTS Sample is composed of 37 individuals, most of them female, with overweight and low back pain > 60 months. 2-Minute Step Test showed excellent test-retest (ICC = 0.903) and inter-rater (ICC = 0.925) reliability. Sport domain of the Baecke showed a significant correlation with the 2-Minute Step Test (rho = 0.444). CONCLUSION 2-Minute Step Test is a reliable measure to measure the functional capacity of patients with chronic low back pain considering different times and examiners, as well as being positively correlated with sports practice.
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Affiliation(s)
- Sulamizia Filomena Costa de Jesus
- grid.411204.20000 0001 2165 7632Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA Brazil ,Specialized Center for Rehabilitation and Health Promotion, São Luís, MA Brazil
| | - Daniela Bassi-Dibai
- grid.442152.40000 0004 0414 7982Postgraduate Program in Environment, Universidade Ceuma, São Luís, MA Brazil ,Department of Physical Therapy, Faculdade Santa Terezinha, São Luís, MA Brazil
| | - André Pontes-Silva
- grid.411247.50000 0001 2163 588XPostgraduate Program in Physical Therapy, Department of Physical Therapy, Universidade Federal de São Carlos, Rod. Washington Luís, Km 235, CEP, São Carlos, SP 13565-905 Brazil
| | | | | | - Christiano Eduardo Veneroso
- grid.411204.20000 0001 2165 7632Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA Brazil
| | - Cid André Fidelis de Paula Gomes
- grid.412295.90000 0004 0414 8221Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, SP Brazil
| | - Almir Vieira Dibai-Filho
- grid.411204.20000 0001 2165 7632Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA Brazil
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Pontes-Silva A, Bassi-Dibai D, Fidelis-de-Paula-Gomes CA, Souza CDS, Pires FDO, Mostarda CT, Dibai AV. Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: neck pain versus low back pain. Rev Assoc Med Bras (1992) 2022; 68:1288-1296. [PMID: 36228260 PMCID: PMC9575013 DOI: 10.1590/1806-9282.20220406] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 04/30/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study aims to compare heart rate variability (HRV) between patients with chronic neck pain and patients with chronic low back pain and to correlate the chronic pain variables with heart rate variability indices. METHODS This is a cross-sectional study. We divided the sample into two groups: neck pain (n=30) and low back pain (n=30). We used the Numeric Pain Rating Scale, Neck Disability Index, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Pain Self-Efficacy Questionnaire. For heart rate variability analysis, we used the following indices: mean RR, standard deviation of all RR intervals, mean heart rate, root mean square differences of successive RR intervals, triangular index, triangular interpolation of the interval histogram, low-frequency band in arbitrary units and in absolute values, high-frequency band in arbitrary units and in absolute values, standard deviation of the instantaneous beat-to-beat variability (standard deviation 1), long-term standard deviation of continuous RR intervals (standard deviation 2), and Stress Index. We used Student's t-test for comparisons and Spearman's coefficient for correlations. RESULTS We observe insignificant values in the differences between the groups. Disability and self-efficacy were correlated with heart rate variability only in patients with chronic neck pain, whereas catastrophizing and kinesiophobia showed greater correlations with heart rate variability in patients with chronic low back pain. CONCLUSIONS Autonomic dysfunction of individuals with chronic neck pain, when compared to patients with chronic low back pain, does present insignificant differences.
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Affiliation(s)
- André Pontes-Silva
- Universidade Federal do Maranhão, Postgraduate Program in Adult Health – São Luís (MA), Brazil.,Corresponding author:
| | - Daniela Bassi-Dibai
- Universidade Ceuma, Postgraduate Program in Programs Management and Health Services – São Luís (MA), Brazil
| | | | | | | | | | - Almir Vieira Dibai
- Universidade Federal do Maranhão, Postgraduate Program in Adult Health – São Luís (MA), Brazil
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The internal structure of Brazilian versions of disability questionnaires in patients with chronic low back pain: A cross-sectional study. Musculoskelet Sci Pract 2022; 60:102587. [PMID: 35605463 DOI: 10.1016/j.msksp.2022.102587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Structural validity refers to the degree to which the scores of a questionnaire or scale are an adequate reflection of the construct to be measured. The aim of this study was to perform the analysis of the structural validity of the Roland-Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), Quebec Back Pain Disability Scale (QBPDS), and Bournemouth Questionnaire (BQ) in Brazilian respondents with chronic low back pain. METHODS A cross-sectional study was conducted. The sample was composed by respondents with non-specific chronic low back pain (score ≥3 points on the 11-point Numerical Pain Rating Scale). The internal structure (number of domains and items) of the Brazilian versions of the RMDQ, the ODI, the QBPDS, and the BQ were analyzed by the confirmatory factor analysis. RESULTS Two hundred and twenty-two patients were included. Most of the sample consisted of women and overweight. The RMDQ and ODI have a one-dimensional structure and acceptable values for all confirmatory factor analysis fit indices. The QBPDS with 4 domains and 20 items showed the best values of the fit indices. In addition, we did not identify an internal structure for the BQ supported by the confirmatory factor analysis. CONCLUSION The ODI and RMDQ present valid internal structure with 1 domain (disability). The QBPDS has a valid internal structure with 4 domains (rest, prolonged postures, ambulation/reach, and bending/carrying). The BQ does not have a well-defined internal structure.
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