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Budzisz A, Jung A, Adamczyk WM, Szikszay TM, Carvalho GF, Bąbel P, Luedtke K. Body Image Measured via the Fremantle Awareness Questionnaire in Individuals With and Without Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2024; 25:104530. [PMID: 38599266 DOI: 10.1016/j.jpain.2024.104530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
Research suggests that pain negatively affects body image, and body image may also influence reported pain levels. This review aims to summarize the literature on differences in body image distortion between individuals with pain compared to pain-free individuals. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement and an a priori preregistered protocol. The literature was searched using 5 electronic databases. Studies assessing body image with the Fremantle Awareness Questionnaire (FAQ) in individuals with and without pain were eligible for inclusion. Screening and selection of eligible studies were performed by independent reviewers. Methodological quality was assessed with the Joanna Briggs Institute critical appraisal tool. Meta-analyses, meta-correlations, and metamean analyses were performed using random-effect models. The primary outcome was the FAQ score; secondary outcomes were reported pain variables. Data from individuals with pain (n = 2277) and without pain (n = 615) were summarized. Significant body image distortions were found in individuals with pain compared to individuals without pain. Compared to pain-free individuals, the pain group rated significantly higher in the FAQ when experiencing back pain (standardized mean differences=1.33, 95% confidence interval=.88-1.77) or other body parts (standardized mean differences=1.25, 95% confidence interval=.51-1.99). The results of meta-correlation analyses confirmed the positive relationship between body image distortion and pain intensity (r = .31), pain at rest (r = .31), or pain during movement (r = .36), but not for pain duration. A difference in mean FAQ results was observed between individuals with pain in different areas (knee and back). PERSPECTIVE: This review confirms differences in body image distortion between pain and pain-free individuals. Pain intensity was correlated with altered body perception, but not pain duration. A moderate correlation was observed between body image distortion and reported pain variables. Body image was more impaired by knee pain than back pain. REGISTERED PROTOCOL AT PROSPERO: CRD42022309937; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022309937.
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Affiliation(s)
- Aleksandra Budzisz
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland.
| | - Andres Jung
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Waclaw M Adamczyk
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tibor M Szikszay
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Luebeck, Germany
| | - Gabriela F Carvalho
- Department of Physiotherapy, Faculty of Health, Safety and Society, Furtwangen University, Furtwangen, Germany
| | - Przemysław Bąbel
- Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Kerstin Luedtke
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Luebeck, Germany
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Gabrys L, Schaller A, Peters S, Barzel A, Berrisch-Rahmel S, Dreinhöfer KE, Eckert K, Göhner W, Geidl W, Krupp S, Lange M, Nebel R, Pfeifer K, Reusch A, Schmidt-Ohlemann M, Sewerin P, Steindorf K, Ströhle A, Sudeck G, Wäsche H, Wolf S, Wollesen B, Thiel C. [DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research]. DAS GESUNDHEITSWESEN 2024. [PMID: 39047784 DOI: 10.1055/a-2340-1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
The DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research summarizes, for the first time, the highly interdisciplinary and interprofessional field of physical activity-based health care in the German healthcare system. In addition to providing a conceptual framework and definition of key measures and concepts in physical activity-related health care research, existing research gaps and needs are identified, and methods for advancing this relatively young field of research are described. A particular focus of this study is the relevant outcome parameters and their standardized assessment using established and valid measurement tools. The memorandum aims to establish a general understanding of the complex subject of promoting physical activity and sports therapy in the context of healthcare, to give an impulse to new research initiatives, and to integrate the currently available strong evidence on the effectiveness of physical activity and exercise into healthcare.
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Affiliation(s)
- Lars Gabrys
- ESAB Fachhochschule für Sport und Management Potsdam, Gesundheitssport und Prävention, Potsdam, Germany
| | - Andrea Schaller
- Universität der Bundeswehr München, Institut für Sportwissenschaft, Arbeitsbereich Gesundheit, Betriebliche Gesundheitsförderung und Prävention, München, Germany
| | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Hürth-Efferen, Germany
- Universität der Bundeswehr, Institut für Sportwissenschaft, Arbeitsbereich Gesundheit, Betriebliche Gesundheitsförderung und Prävention, München, Germany
| | - Anne Barzel
- Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Germany
| | - Susanne Berrisch-Rahmel
- Projektgruppe PG 05 Prävention der Deutschen Gesellschaft für Kardiologie, Herz- und Kreislaufforschung e.V., Sprecherin der AG Sport und Prävention des Bundesverband niedergelassener Kardiologen e.V., Düsseldorf, Germany
| | - Karsten E Dreinhöfer
- Medical Park AG, Orthopädie und Unfallchirurgie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Eckert
- IST-Hochschule für Management GmbH, Gesundheitsmanagement & Public Health, Düsseldorf, Germany
| | - Wiebke Göhner
- Katholische Hochschule Freiburg, Bereich Gesundheitspsychologie, Freiburg, Germany
| | - Wolfgang Geidl
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Erlangen, Germany
| | - Sonja Krupp
- Forschungsgruppe Geriatrie Lübeck, Krankenhaus Rotes Kreuz Lübeck - Geriatriezentrum, Lübeck, Germany
| | - Martin Lange
- IST-Hochschule für Management GmbH, Fachbereich Fitness & Gesundheit, Düsseldorf, Germany
| | - Roland Nebel
- Deutsche Gesellschaft zur Prävention und Rehabilitation von Herz-Kreislauferkrankungen e.V. (DGPR), Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, Leichlingen, Germany
| | - Klaus Pfeifer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Erlangen, Germany
| | - Andrea Reusch
- Zentrum Patientenschulung und Gesundheitsförderung, (ZePG e.V.), Würzburg, Germany
| | | | - Philipp Sewerin
- Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Bochum, Germany
| | - Karen Steindorf
- Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg, DKFZ, Abteilung für Bewegung, Präventionsforschung und Krebs, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Andreas Ströhle
- Charite Universitatsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie Campus Charité Mitte, Berlin, Germany
| | - Gorden Sudeck
- Eberhard Karls Universität Tübingen, Arbeitsbereich Bildungs- und Gesundheitsforschung im Sport, Institut für Sportwissenschaft, Tübingen, Germany
- Eberhard Karls Universität Tübingen, Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Tübingen, Germany
| | - Hagen Wäsche
- Universität Koblenz-Landau Fachbereich 3 Mathematik/Naturwissenschaften, Institut für Sportwissenschaft, Koblenz, Germany
| | - Sebastian Wolf
- Eberhard Karls Universität Tübingen, Arbeitsbereich Bildungs- und Gesundheitsforschung im Sport, Institut für Sportwissenschaft, Tübingen, Germany
| | - Bettina Wollesen
- Universität Hamburg, Arbeitsbereich Bewegungs- und Trainingswissenschaft, Fakultät für Psychologie und Bewegungswissenschaft, Hamburg, Germany
| | - Christian Thiel
- Hochschule für Gesundheit Bochum, Studienbereich Physiotherapie, Department für Angewandte Gesundheitswissenschaften, Bochum, Germany
- Ruhr-Universität Bochum, und Forschungsbereich Trainingswissenschaft, Fakultät für Sportwissenschaft, Bochum, Germany
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Monticone M, Maurandi C, Porcu E, Arippa F, Wand BM, Corona G. The Fremantle Back Awareness Questionnaire: cross-cultural adaptation, reliability, and validity of the Italian version in people with chronic low back pain. BMC Musculoskelet Disord 2024; 25:279. [PMID: 38605331 PMCID: PMC11007946 DOI: 10.1186/s12891-024-07420-2] [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: 11/07/2023] [Accepted: 04/05/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND AND AIM There is evidence to suggest that assessing back-specific altered self-perception may be useful when seeking to understand and manage low back pain (LBP). The Fremantle Back Awareness Questionnaire (FreBAQ) is a patient-reported measure of back-specific body perception that has never been adapted and psychometrically analysed in Italian. Hence, the objectives of this research were to cross-culturally adapt and validate the Italian version of this outcome measure (namely, the FreBAQ-I), to make it available for use with Italians suffering from chronic LBP. METHODS The FreBAQ-I was developed by forward and backward translation, review by a committee skilled in patient-reported measures and test of the pre-final version to assess its clarity, acceptability, and relevance. The statistical analyses examined: structural validity based on Rasch analysis; hypotheses testing by investigating correlations of the FreBAQ-I with the Roland Morris Disability Questionnaire (RMDQ), a pain intensity numerical rating scale (PI-NRS), the Pain Catastrophising Scale (PCS), and the Tampa Scale of Kinesiophobia (TSK) (Pearson's correlations); reliability by internal consistency (Cronbach's alpha) and test-retest repeatability (intraclass correlation coefficient, ICC (2,1)); and measurement error by determining the minimum detectable change (MDC). After the development of a consensus-based translation of the FreBAQ-I, the new outcome measure was delivered to 100 people with chronic LBP. RESULTS Rasch analysis confirmed the substantial unidimensionality and the structural validity of the FreBAQ-I. Hypothesis testing was considered good as at least 75% of the hypotheses were confirmed; correlations: RMDQ (r = 0.35), PI-NRS (r = 0.25), PCS (r = 0.41) and TSK (r = 0.38). Internal consistency was acceptable (alpha = 0.82) and test-retest repeatability was excellent (ICC (2,1) = 0.88, 95% CI: 0.83, 0.92). The MDC95 corresponded to 6.7 scale points. CONCLUSION The FreBAQ-I was found to be a unidimensional, valid, and reliable outcome measure in Italians with chronic LBP. Its application is advised for clinical and research use within the Italian speaking community.
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Affiliation(s)
- Marco Monticone
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Elisa Porcu
- Rehabilitation Medicine and Neurorehabilitation, P.O. San Martino, Oristano, Italy
| | - Federico Arippa
- Department of Mechanical, Chemical, and Materials Engineering, University of Cagliari, Cagliari, Italy.
| | - Benedict M Wand
- The Faculty of Medicine, Nursing & Midwifery and Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
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García-Dopico N, De La Torre-Luque A, Wand BM, Velasco-Roldán O, Sitges C. The cross-cultural adaptation, validity, and reliability of the Spanish version of the Fremantle Back Awareness Questionnaire. Front Psychol 2023; 14:1070411. [PMID: 36935999 PMCID: PMC10017493 DOI: 10.3389/fpsyg.2023.1070411] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/26/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction In chronic low back pain (CLBP), disturbed body image has been highlighted as a contributor to the condition and a potential target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) allows its assessment. Following international guidelines for the cross-cultural translation of questionnaires, we aimed to translate the FreBAQ into Spanish (FreBAQ-S) and validate the new questionnaire in a sample of Spanish-speaking people with CLBP. Methods Two hundred and sixty-four adults with CLBP (91 males) and 128 healthy controls (34 males) completed an online form including the FreBAQ-S and questionnaires related to the pain experience. All participants were Spanish and no gender identities differing from biological sex were reported. A week later, 113 CLBP participants and 45 healthy controls (41 and 13 males, respectively), re-answered the FreBAQ-S to evaluate test-retest reliability. Confirmatory factor and multigroup analysis assessed the scale consistency on the patient sample. Discriminant and convergent validity were explored by between-group differences and the relationship with clinical characteristics. Reliability relied on Cronbach's alpha estimates and test-retest (intraclass correlation coefficient, standard error of measurement, minimal detectable change). Results and discussion Confirmatory factor analysis showed a one-factor structure of the questionnaire, without supporting evidence for item deletion (CFI = 0.97; TLI = 0.96; RMSEA = 0.06; SRMR = 0.07; SRMRu = 0.064). Multigroup analyses do not support mean invariance between groups regarding health condition or sex. The FreBAQ-S demonstrated good discriminant and convergent validity, internal consistency (α = 0.82), and test-retest reliability (ICC = 0.78; SE = 3.41; MDC = 5.12). The FreBAQ-S is a valid and reliable tool to assess back awareness in clinical and non-clinical samples.
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Affiliation(s)
- Nuria García-Dopico
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
- *Correspondence: Nuria García-Dopico,
| | - Alejandro De La Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Benedict Martin Wand
- Faculty of Medicine, Nursing and Midwifery and Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Olga Velasco-Roldán
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain
| | - Carolina Sitges
- University of the Balearic Islands (UIB), Research Institute of Health Sciences (IUNICS) and Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department and Faculty of Psychology, University of the Balearic Islands (UIB), Palma, Spain
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Cross-cultural adaptation and validation of the simplified chinese version of the fremantle back awareness questionnaire in patients with low back Pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:935-942. [PMID: 35039964 DOI: 10.1007/s00586-021-07085-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 11/04/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The Fremantle back awareness questionnaire (FreBAQ) was recently developed as simple and quick tool to assess back-specific body perception in Low back pain (LBP) patients. The aim of the present study was to translate and cross-culturally adapt the Fremantle back awareness questionnaire (FreBAQ) into a Simplified Chinese version (FreBAQ-C), and evaluate the reliability and validity of the FreBAQ-C in patients with non-specific Chronic Low back pain (CLBP). METHODS The FreBAQ was translated into Chinese according to established methods. Internal consistency was assessed according to Cronbach's alpha. Test-retest reliability was estimated by Intraclass correlation coefficient (ICC). Construct validity was evaluated by correlations between the FreBAQ-C and Visual analogue scale (VAS), Roland-Morris disability questionnaire (RDQ), Pain catastrophizing scale (PCS), Tampa scale for kinesiophobia (TSK) as well as Hospital anxiety and depression scale (HADS). RESULTS A total of 105 participants (38 males and 67 females) were included in this study with the mean age of 54.1 ± 15.6 years, mean duration of LBP of 6.8 ± 4.6 years. The FreBAQ-C total scores were well distributed, with no floor or ceiling effects. Internal consistency was excellent (Cronbach's alpha = 0.833). ICC of test-retest reliability was good (0.897, 95% confidence interval: 0.852-0.929). The limits of agreement (LOA) ranged from - 5.8 to 6.3. The Standard error of measurement (SEM) and Minimum detectable change (MDC) were 2.16 and 5.99. Construct validity was confirmed by significant correlation of The FreBAQ-C and VAS during motion (r = 0.274, p = 0.005) and rest (r = 0.243, p = 0.012), RDQ (r = 0.377, p < 0.001), PCS (r = 0.439, p < 0.001), and TSK(r = 0.311, p = 0.001). CONCLUSIONS The FreBAQ-C was demonstrated to have acceptable reliability and validity for patients with non-specific CLBP in Chinese mainland. It will allow evaluating body preception of the back in the Chinese population with CLBP.
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Hedayati R, Amjadian F, Ebadi A, Ehsani F. Cross-cultural adaptation, validity and reliability of the Persian version of Fremantle Knee Awareness Questionnaire. J Bodyw Mov Ther 2022; 29:257-263. [DOI: 10.1016/j.jbmt.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/12/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022]
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García-Dopico N, de la Torre-Luque A, Sitges C, Velasco-Roldán O. Proprioceptive acuity is core for back awareness in chronic low back pain: Further analysis of the content validity of the Spanish version of the Fremantle Back Awareness Questionnaire. Front Hum Neurosci 2022; 16:1070402. [PMID: 36875741 PMCID: PMC9983349 DOI: 10.3389/fnhum.2022.1070402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/28/2022] [Indexed: 02/19/2023] Open
Abstract
Treatments aimed at increasing self-perception may improve chronic low back pain (CLBP) symptomatology and present novel management approaches. Consequently, it is important to have valid, complete, and reliable tools for its assessment, and to understand which variables influence altered back awareness. We aimed to evaluate the face/content validity of the Spanish version of the Fremantle Back Awareness Questionnaire (FreBAQ-S) among people with and without CLBP, and to explore additional variables suggested to be involved in back awareness. A total of 264 individuals with CLBP and 128 healthy controls (HC) answered an online survey, including the FreBAQ-S, and questions regarding the completeness, comprehensibility, time-to-complete adequacy, and time spent completing it. If participants declared a lack of completeness, they had to report which aspects would be incorporated into the questionnaire to explore additional back-awareness-related variables. A statistically significant difference in completeness emerged between groups (p < 0.01). The questionnaire was comprehensible for more than 85% of participants, regardless of the group (p = 0.45). CLBP participants spent significantly more time in completing the questionnaire than controls (p < 0.01), but no differences were found between groups regarding the time-to-complete adequacy (p = 0.49). Regarding the back-awareness-related variables, 77 suggestions from CLBP group and seven from the HC were received. Most of them were related to proprioceptive acuity such as posture, weight, or movement patterns, among others. The FreBAQ-S demonstrated adequate face/content validity, completeness, comprehensibility, and adequate time of response. The feedback provided will help improve currently available assessment tools.
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Affiliation(s)
- Nuria García-Dopico
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, CIBERSAM ISCIII, Complutense University of Madrid (UCM), Madrid, Spain
| | - Carolina Sitges
- Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,Department of Psychology, University of the Balearic Islands (UIB), Palma, Spain
| | - Olga Velasco-Roldán
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Palma, Spain.,Research Institute of Health Sciences (IUNICS), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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Adelt E, Schoettker-Koeniger T, Luedtke K, Hall T, Schäfer A. Lumbar movement control in non-specific chronic low back pain: Evaluation of a direction-specific battery of tests using item response theory. Musculoskelet Sci Pract 2021; 55:102406. [PMID: 34139514 DOI: 10.1016/j.msksp.2021.102406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/10/2021] [Accepted: 06/01/2021] [Indexed: 11/15/2022]
Abstract
QUESTION What tests are most useful to identify poor lumbar movement control (LMC) and what are the dimensional and psychometric properties of these tests? DESIGN Multicenter, cross-sectional cohort study. PARTICIPANTS Adults with non-specific chronic low back pain (NSCLBP). METHODS A literature review was conducted to identify LMC tests with good reliability (κ≥ 0.61) and their dimensionality was examined. Based on item response theory, psychometric properties of individual items and the entire battery of LMC tests were determined. RESULTS 277 participants with NSCLBP were included and tested by 21 physiotherapists in 19 clinics in Germany and Austria. 15 tests for LMC were assessed. The battery of LMC tests showed a direction-specific structure representing extension, flexion and rotation/lateral flexion control, for which unidimensionality and local independence were confirmed (eigenvalue >1; factor loading >0.4, Yen's Q3 <0.2). 4 items for flexion control, 4 items for extension control and 5 items for rotation/lateral flexion control were extracted. The flexion control items were the easiest items (item difficulty: 1.98 to -1.31). The rotation/lateral flexion control items were the most difficult (-1.3 to -0.08). More than 80% of all participants showed at least one incorrect direction of LMC. CONCLUSIONS A battery of LMC tests is proposed as the most appropriate to examine individuals with precise to poor LMC. Each direction of LMC should be examined separately. Tests can be sorted according to test difficulty, so that only three tests are initially required to screen for poor LMC.
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Affiliation(s)
- Elisabeth Adelt
- University of Applied Sciences and Arts Hildesheim, Faculty of Social Work and Health, Germany.
| | | | - Kerstin Luedtke
- University of Luebeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research (P.E.R.L.), Luebeck, Germany; Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
| | - Toby Hall
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
| | - Axel Schäfer
- University of Applied Sciences and Arts Hildesheim, Faculty of Social Work and Health, Germany.
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Meier R, Emch C, Gross-Wolf C, Pfeiffer F, Meichtry A, Schmid A, Luomajoki H. Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study. BMC Musculoskelet Disord 2021; 22:391. [PMID: 33902545 PMCID: PMC8077718 DOI: 10.1186/s12891-021-04269-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. METHODS A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. RESULTS MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. CONCLUSIONS Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. TRIAL REGISTRATION No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015-243.
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Affiliation(s)
- R Meier
- Prodorso, Walchestrasse 15, CH-8006, Zurich, Switzerland
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - C Emch
- Physiotherapie im Schutzengel AG, Allmendstrasse 1, CH-6300, Zug, Switzerland
| | - C Gross-Wolf
- Physiotherapie im Sonnenheim, Sonnenheim 8, CH-6344, Meierskappel, Switzerland
| | - F Pfeiffer
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - A Meichtry
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland
| | - A Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - H Luomajoki
- Zurich University of Applied Sciences (ZHAW), School of Health Professions, Institute of Physiotherapy, Katharina-Sulzer-Platz 9, CH-8400, Winterthur, Switzerland.
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Monticone M, Sconza C, Portoghese I, Nishigami T, Wand BM, Sorrentino G, Lemorini G, Respizzi S, Giordano A, Franchignoni F. Cross-cultural adaptation, reliability and validity of the Fremantle Knee Awareness Questionnaire in Italian subjects with painful knee osteoarthritis. Health Qual Life Outcomes 2021; 19:114. [PMID: 33827594 PMCID: PMC8025485 DOI: 10.1186/s12955-021-01754-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
Background and aim Growing attention is being given to utilising physical function measures to better understand and manage knee osteoarthritis (OA). The Fremantle Knee Awareness Questionnaire (FreKAQ), a self-reported measure of body-perception specific to the knee, has never been validated in Italian patients. The aims of this study were to culturally adapt and validate the Italian version of the FreKAQ (FreKAQ-I), to allow for its use with Italian-speaking patients with painful knee OA. Methods The FreKAQ-I was developed by means of forward–backward translation, a final review by an expert committee and a test of the pre-final version to evaluate its comprehensibility. The psychometric testing included: internal structural validity by Rasch analysis; construct validity by assessing hypotheses of FreKAQ correlations with the knee injury and osteoarthritis outcome score (KOOS), a pain intensity numerical rating scale (PI-NRS), the pain catastrophising scale (PCS), and the Hospital anxiety and depression score (HADS) (Pearson’s correlations); known-group validity by evaluating the ability of FreKAQ scores to discriminate between two groups of participants with different clinical profiles (Mann–Whitney U test); reliability by internal consistency (Cronbach’s alpha) and test–retest reliability (intraclass correlation coefficient, ICC2.1); and measurement error by calculating the minimum detectable change (MDC). Results It took one month to develop a consensus-based version of the FreKAQ-I. The questionnaire was administered to 102 subjects with painful knee OA and was well accepted. Internal structural validity confirmed the substantial unidimensionality of the FreKAQ-I: variance explained was 53.3%, the unexplained variance in the first contrast showed an eigenvalue of 1.8, and no local dependence was detected. Construct validity was good as all of the hypotheses were met; correlations: KOOS (rho = 0.38–0.51), PI-NRS (rho = 0.35–0.37), PCS (rho = 0.47) and HADS (Anxiety rho = 0.36; Depression rho = 0.43). Regarding known-groups validity, FreKAQ scores were significantly different between groups of participants demonstrating high and low levels of pain intensity, pain catastrophising, anxiety, depression and the four KOOS subscales (p ≤ 0.004). Internal consistency was acceptable (α = 0.74) and test–retest reliability was excellent (ICC = 0.92, CI 0.87–0.94). The MDC95 was 5.22 scale points. Conclusion The FreKAQ-I is unidimensional, reliable and valid in Italian patients with painful knee OA. Its use is recommended for clinical and research purposes. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01754-4.
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Affiliation(s)
- Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, G. Brotzu Hospital, Cagliari, Italy
| | - Cristiano Sconza
- Department of Physical and Rehabilitation Medicine, Humanitas Clinical and Research Centre IRCSS, Rozzano, Milan, Italy
| | - Igor Portoghese
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, Strada Statale, 554 - Monserrato, Cagliari, Italy.
| | - Tomohiko Nishigami
- Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara, Hiroshima, Japan
| | - Benedict M Wand
- The School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Gregorio Sorrentino
- Physical Medicine and Rehabilitation School, University of Milano-Bicocca, Milan, Italy
| | - Giulia Lemorini
- Physical Medicine and Rehabilitation School, University of Milan, Milan, Italy
| | - Stefano Respizzi
- Department of Physical and Rehabilitation Medicine, Humanitas Clinical and Research Centre IRCSS, Rozzano, Milan, Italy
| | - Andrea Giordano
- ICS Maugeri, IRCCS, Bioengineering Unit, Institute of Veruno, Veruno, NO, Italy
| | - Franco Franchignoni
- ICS Maugeri, IRCCS, Physical Medicine and Rehabilitation Unit, Institute of Tradate, Tradate, VA, Italy
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11
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Schäfer A, Wand BM, Lüdtke K, Ehrenbrusthoff K, Schöttker-Königer T. Validation and investigation of cross cultural equivalence of the Fremantle back awareness questionnaire - German version (FreBAQ-G). BMC Musculoskelet Disord 2021; 22:323. [PMID: 33794840 PMCID: PMC8017790 DOI: 10.1186/s12891-021-04156-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background Disrupted self-perception of the low back might contribute to chronic non-specific low back pain. The Fremantle back awareness questionnaire is a simple questionnaire to assess back specific self-perception. The questionnaire has recently been translated to German (FreBAQ-G). The aim was to further investigate the psychometric properties of the FreBAQ-G, to evaluate its cross cultural validity in patients with chronic non-specific LBP and to explore potential relationships between body perception, pain, disability and back pain beliefs. Methods In this cross-sectional multicentre study, sample data were merged with data from the validation sample of the original English version to examine cross-cultural validity. Item Response Theory was used to explore psychometric properties and differential item function (DIF) to evaluate cross-cultural validity and item invariance. Correlations and multiple linear regression analyses were used to explore the relationship between altered back specific self- perception and back pain parameters. Results Two hundred seventy-two people with chronic low back pain completed the questionnaires. The FreBAQ-G showed good internal consistency (Cronbach’s alpha = 0.84), good overall reliability (r = 0.84) and weak to moderate scalability (Loevinger Hj between 0.34 and 0.48). The questionnaire showed unidimensional properties with factor loadings between 0.57 and 0.80 and at least moderate correlations (r > 0.35) with pain intensity, pain related disability and fear avoidance beliefs (FABQ total - and subscores). Item and test properties of the FreBAQ-G are given. Only item 7 showed uniform DIF indicating acceptable cross-cultural validity. Conclusions Our results indicate that the FreBAQ-G is a suitable questionnaire to measure back specific self-perception, and has comparable properties to the English-language version. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04156-1.
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Affiliation(s)
- Axel Schäfer
- Faculty of Social Work and Health, University of Applied Sciences and Arts (HAWK), Hildesheim, Germany.
| | - Benedict M Wand
- School of Physiotherapy, University of Notre Dame Australia, Fremantle, Australia
| | - Kerstin Lüdtke
- University of Luebeck, Medical Section, Orthopaedics and Trauma Surgery, Academic Physiotherapy, Pain and Exercise Research (PERL), Luebeck, Germany
| | - Katja Ehrenbrusthoff
- Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
| | - Thomas Schöttker-Königer
- Faculty of Social Work and Health, University of Applied Sciences and Arts (HAWK), Hildesheim, Germany
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12
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Goossens N, Geraerts I, Vandenplas L, Van Veldhoven Z, Asnong A, Janssens L. Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum. BMC Pregnancy Childbirth 2021; 21:219. [PMID: 33736613 PMCID: PMC7977601 DOI: 10.1186/s12884-021-03704-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP. Methods A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum. Results Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p < 0.001) during late pregnancy, and with pain intensity 6 weeks postpartum (σ = 0.403, p = 0.015). A disturbed body perception during late pregnancy nearly significantly predicted having postpartum LPP (Odds Ratio = 1.231, p = 0.052). Conclusions Body perception disturbance was greater in women experiencing LPP during late pregnancy and postpartum compared to pain-free women, and correlated with pain intensity and disability. Though non-significant (p = 0.052), the results of the regression analysis suggest that greater body perception disturbance during late pregnancy might predict having LPP postpartum. However, future studies should follow up on this. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03704-w.
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Affiliation(s)
- Nina Goossens
- REVAL Rehabilitation Research Center, UHasselt - Hasselt University, Agoralaan A, 3590, Diepenbeek, Belgium.
| | - Inge Geraerts
- Department of Rehabilitation Sciences, KU Leuven, ON IV Herestraat 49 - box 1510, 3000, Leuven, Belgium
| | - Lizelotte Vandenplas
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Zahra Van Veldhoven
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Anne Asnong
- Department of Rehabilitation Sciences, KU Leuven, ON IV Herestraat 49 - box 1510, 3000, Leuven, Belgium
| | - Lotte Janssens
- REVAL Rehabilitation Research Center, UHasselt - Hasselt University, Agoralaan A, 3590, Diepenbeek, Belgium
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13
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Adamczyk WM, Szikszay TM, Kung T, Carvalho GF, Luedtke K. Not as "blurred" as expected? Acuity and spatial summation in the pain system. Pain 2021; 162:794-802. [PMID: 32925592 PMCID: PMC7920491 DOI: 10.1097/j.pain.0000000000002069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/27/2022]
Abstract
ABSTRACT Spatial acuity measured by 2-point discrimination (2PD) threshold and spatial summation of pain (SSp) are useful paradigms to probe the pain system in humans. Whether the results of these paradigms are influenced by different stimulus modalities and intensities is unclear. The aim of this study was to test 2PD controlling the stimulus modality and the intensity and to investigate the effect of modality on SSp. Thirty-seven healthy volunteers were tested for 2PDs with 2 stimulus modalities (electrocutaneous and mechanical) and intensity (noxious and innocuous). For each condition, participants received stimuli to either 1 or 2 points on their lower back with different distances (2-14 cm, steps of 2 cm). It was found that 2PDs were significantly smaller for noxious stimuli for both modalities. By contrast, between-modality comparison reproduced previous reports of impaired acuity for noxious stimulation. Higher pain intensities were reported when a larger area was stimulated (SSp), independent of the modality. Furthermore, reported pain intensities were higher when the distance between 2 stimulated areas was increased from 2 to 6 cm (P < 0.001), 8 cm (P < 0.01), and 14 cm (P < 0.01). 2PDs determined by mechanical and electrocutaneous stimuli were significantly correlated within both stimulus intensities, ie, innocuous (r = 0.34, P < 0.05) and noxious (r = 0.35, P < 0.05). The current results show 3 novel findings: (1) the precision of the pain system might be higher than in the innocuous (tactile) system when mechanical and electrocutaneous modalities are used, (2) the pattern of distance-based and area-based SSp seems to be comparable irrespective of the modality applied (mechanical and electrocutaneous), and (3) both modalities are moderately correlated.
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Affiliation(s)
- Wacław M. Adamczyk
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tibor M. Szikszay
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
| | - Tiffany Kung
- BSc Study Program, University of Alberta, Edmonton, AB, Canada
| | | | - Kerstin Luedtke
- Department of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
- Laboratory of Pain Research, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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14
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Yamashita Y, Nishigami T, Mibu A, Tanaka K, Wand BM, Catley MJ, Higashi T. Development and Psychometric Testing of the Japanese Version of the Fremantle Neck Awareness Questionnaire: A Cross-Sectional Study. J Pain Res 2021; 14:311-324. [PMID: 33568938 PMCID: PMC7870290 DOI: 10.2147/jpr.s267930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose Contemporary theories of pain suggest that how the body is perceived is central to the emergence of pain. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body-perception specific to the back in people with chronic low back pain. However, there is no comprehensive measure to quantify self-perception of the painful area in Japanese people with neck pain. This study aimed to develop a Japanese version of a self-perception questionnaire specific to the neck and evaluate the validity and reliability of the scale using Rasch analysis. Materials and Methods The Fremantle Neck Awareness Questionnaire (FreNAQ-J) was developed by modifying the FreBAQ-J. One hundred people with chronic neck pain and fifty-six matched healthy controls completed the questionnaire. Rasch analysis was used to evaluate targeting, category order, unidimensionality, person fit, internal consistency, differential item functioning, and differential test functioning in the neck pain population. Validity was investigated by examining the relationship between the FreNAQ-J and clinical status. Results People with chronic neck pain endorsed FreNAQ-J items with greater frequency than healthy controls. FreNAQ-J did not reject the null hypothesis of fitting the Rasch model, had acceptable internal consistency and good test–retest reliability. Summed FreNAQ-J scores were significantly correlated with pain intensity, disability, pain-related catastrophizing and fear of movement. Conclusion The individual items of the FreNAQ-J can be validly summed to provide a score of self-perception. The FreNAQ-J is the first scale developed for comprehensively evaluating disturbed body perception in Japanese patients with chronic neck pain.
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Affiliation(s)
- Yuh Yamashita
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, 852-8520, Japan.,Department of Rehabilitation, Morinaga Orthopedic Clinic, Saga, 849-0934, Japan
| | - Tomohiko Nishigami
- Department of Physical Therapy, Prefectural University of Hiroshima, Mihara, Hiroshima, 723-0053, Japan
| | - Akira Mibu
- Department of Nursing and Physical Therapy, Konan Women's University, Kobe, Hyogo, 658-0001, Japan
| | | | - Benedict M Wand
- School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, 6959, Australia
| | - Mark J Catley
- School of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia
| | - Toshio Higashi
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, 852-8520, Japan
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15
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Nishigami T, Watanabe A, Maitani T, Shigetoh H, Mibu A, Wand BM, Catley MJ, Stanton TR, Moseley GL. Development and validation of a shoulder-specific body-perception questionnaire in people with persistent shoulder pain. BMC Musculoskelet Disord 2021; 22:98. [PMID: 33478446 PMCID: PMC7819341 DOI: 10.1186/s12891-021-03944-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 01/02/2021] [Indexed: 12/17/2022] Open
Abstract
Background There is evidence that people with persistent shoulder pain exhibit findings consistent with the presence of sensorimotor dysfunction. Sensorimotor impairments can manifest in a variety of ways, and further developing our understanding of sensorimotor dysfunction in shoulder pain may improve current models of care. The Fremantle Back Awareness Questionnaire (FreBAQ) has been developed to assess disturbed body perception specific to the back. The purpose of the present study was to develop a shoulder-specific self-perception questionnaire and evaluate the questionnaire in people with persistent shoulder pain. Methods The Fremantle Shoulder Awareness Questionnaire (FreSHAQ-J) was developed by modifying the FreBAQ. One hundred and twelve consecutive people with persistent shoulder pain completed the FreSHAQ-J. Thirty participants completed the FreSHAQ-J again two-weeks later to assess test-retest reliability. Rasch analysis was used to assess the psychometric properties of the FreSHAQ-J. Associations between FreSHAQ-J total score and clinical status was explored using correlational analysis. Results The FreSHAQ-J has acceptable category order, unidimensionality, no misfitting items, and excellent test-retest reliability. The FreSHAQ-J was moderately correlated with disability and pain catastrophization. Conclusions The FreSHAQ-J fits the Rasch measurement model well and is suitable for use with people with shoulder pain. Given the relationship between the FreSHAQ-J score and clinical status, change in body perception may be worth assessing when managing patients with shoulder pain.
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Affiliation(s)
- Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1, Gakuen-chou, Mihara, Hiroshima, 723-0053, Japan.
| | - Akihisa Watanabe
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan
| | - Toshiki Maitani
- Department of Rehabilitation, Utsumi Orthopaedics Clinic, Kagawa, Japan
| | - Hayato Shigetoh
- Department of Rehabilitation, Miura internal Medicine Michiko Pediatrics Clinic, Kagawa, Japan
| | - Akira Mibu
- Department of Nursing and Physical Therapy, Konan Woman's University, Kobe, Hyogo, Japan
| | - Benedict Martin Wand
- The School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Mark J Catley
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia
| | - Tasha R Stanton
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - G Lorimer Moseley
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
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16
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Mahmoudzadeh A, Abbaszadeh S, Baharlouei H, Karimi A. Translation and Cross-cultural Adaptation of the Fremantle Back Awareness Questionnaire into Persian language and the assessment of reliability and validity in patients with chronic low back pain. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:74. [PMID: 33088311 PMCID: PMC7554415 DOI: 10.4103/jrms.jrms_386_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 11/15/2022]
Abstract
Background: Chronic low back pain (LBP) causes some neuroplastic changes in the brain, which result in body perception impairment. The Fremantle Back Awareness Questionnaire (FreBAQ) is a suggested tool for the diagnosis and evaluation of back perception in people with LBP. The aim of this study is to translate and cross culturally adapt the FreBAQ into Persian language and to assess its reliability and validity in patients with chronic LBP (CLBP). Materials and Methods: Fifty people with CLBP and fifty healthy people participated in this study. To evaluate the discriminant validity, we assessed the ability of the FreBAQ to discriminate between people with and without LBP. After an interval of 1 week, 25 patients with CLBP completed the questionnaire in the retest session. Data obtained from the first test administration were used for internal consistency and data obtained from repeated testing were used for test–retest reliability. Construct validity was assessed by investigating a correlation between the FreBAQ with the Roland–Morris Disability Questionnaire (RDQ), Visual Analog Scale, Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale, and Tampa Scale of Kinesiophobia. In addition, the construct validity of Persian FreBAQ was measured by factor analysis. Results: The test–retest reliability of the questionnaire was confirmed by intraclass correlation coefficient = 0.96. Cronbach's alpha was 0.74 for Persian FreBAQ. The standard error of measurement and minimal detectable change were 0.91 and 2.52, respectively. Construct validity was demonstrated by statistically significant relationship between the Persian FreBAQ and questionnaires of PCS (P < 0.001) and RDQ (P = 0.01). Conclusion: The Persian version of FreBAQ is a valid and reliable measurement tool for evaluating back perception changes in Persian-speaking patients with LBP.
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Affiliation(s)
- Ashraf Mahmoudzadeh
- Musculoskeletal Research Center, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Physical Therapy, Faculty of Rehabilitation Sciences, Tehran University of Medical, Tehran, Iran
| | - Sam Abbaszadeh
- Director of Modern Physiotherapy, Specialist Musculoskeletal Physiotherapist as Awarded by Australian College of Physiotherapist. Lecturer and Faculty Staff of Manual Concepts, Australia
| | - Hamzeh Baharlouei
- Musculoskeletal Research Center, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.,Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abdolkarim Karimi
- Department of Physical Therapy, Musculoskeletal Research Center, Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Viceconti A, Camerone EM, Luzzi D, Pentassuglia D, Pardini M, Ristori D, Rossettini G, Gallace A, Longo MR, Testa M. Explicit and Implicit Own's Body and Space Perception in Painful Musculoskeletal Disorders and Rheumatic Diseases: A Systematic Scoping Review. Front Hum Neurosci 2020; 14:83. [PMID: 32327984 PMCID: PMC7161420 DOI: 10.3389/fnhum.2020.00083] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Pain and body perception are essentially two subjective mutually influencing experiences. However, in the field of musculoskeletal disorders and rheumatic diseases we lack of a comprehensive knowledge about the relationship between body perception dysfunctions and pain or disability. We systematically mapped the literature published about the topics of: (a) somatoperception; (b) body ownership; and (c) perception of space, analysing the relationship with pain and disability. The results were organized around the two main topics of the assessment and treatment of perceptual dysfunctions. Methods: This scoping review followed the six-stage methodology suggested by Arksey and O'Malley. Ten electronic databases and grey literature were systematically searched. The PRISMA Extension for Scoping Reviews was used for reporting results. Two reviewers with different background, independently performed study screening and selection, and one author performed data extraction, that was checked by a second reviewer. Results: Thirty-seven studies fulfilled the eligibility criteria. The majority of studies (68%) concerned the assessment methodology, and the remaining 32% investigated the effects of therapeutic interventions. Research designs, methodologies adopted, and settings varied considerably across studies. Evidence of distorted body experience were found mainly for explicit somatoperception, especially in studies adopting self-administered questionnaire and subjective measures, highlighting in some cases the presence of sub-groups with different perceptual features. Almost half of the intervention studies (42%) provided therapeutic approaches combining more than one perceptual task, or sensory-motor tasks together with perceptual strategies, thus it was difficult to estimate the relative effectiveness of each single therapeutic component. Conclusions: To our knowledge, this is the first attempt to systematically map and summarize this research area in the field of musculoskeletal disorders and rheumatic diseases. Although methodological limitations limit the validity of the evidence obtained, some strategies of assessment tested and therapeutic strategies proposed represent useful starting points for future research. This review highlights preliminary evidence, strengths, and limitations of the literature published about the research questions, identifying key points that remain opened to be addressed, and make suggestions for future research studies. Body representation, as well as pain perception and treatment, can be better understood if an enlarged perspective including body and space perception is considered.
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Affiliation(s)
- Antonello Viceconti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Eleonora Maria Camerone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Deborah Luzzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Debora Pentassuglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy.,Policlinico S. Martino IRCCS, Genova, Italy
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Alberto Gallace
- Neuromi, Università di Milano-Bicocca, Milan, Italy.,Mind and Behavior Technological Center- Mibtec, Università di Milano-Bicocca, Milan, Italy
| | - Matthew R Longo
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
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18
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The Fremantle Neck Awareness Questionnaire in Chronic Neck Pain Patients: Turkish Version, Validity and Reliability Study. Spine (Phila Pa 1976) 2020; 45:E163-E169. [PMID: 31425430 DOI: 10.1097/brs.0000000000003207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-cultural adaptation and psychometric analysis. OBJECTIVE The aim of this study wad to develop "Fremantle Neck Awareness Questionnaire Turkish (FreNAQ-T)" and to investigate the validity, reliability, and psychometric properties of FreNAQ-T in the Turkish population with chronic neck pain (CNP). SUMMARY OF BACKGROUND DATA As the different beliefs about the nature of the problem in chronic pain (CP) and its future consequences lead to mis-stimulated neuroplastic changes, the perceptual level and proprioceptive-awareness should be examined in CP. The perceptual level and propriceptive awareness in individuals with chronic low back pain and in knee osteoarthritis were evaluated, whereas the neck version has not been studied. METHODS The neck version was conducted using forward-backward method to translate the FreBAQ from English to Turkish. The number of the included patients was 111. The FreNAQ-T was applied to 37 patients after 3 days for test-retest reliability. Validity of the FreNAQ-T was assessed using Rasch analysis and Spearman correlation coefficient. Reliability of the FreNAQ-T's internal consistency was tested by Person Separation Index (PSI) and Cronbach Alpha. Test-retest reliability was tested by differential item functioning (DIF) by time. RESULTS All items of FreNAQ-T were found to fit Rasch Model (given Bonferroni adjustment fit level of 0.006 and χ: 6 (df = 9), P = 0.739). Internal construct validity evaluation was good, overall mean item fit residual was 0.141 (SD 1.089), and mean person fit residual was -0.211 (SD 1.173). In reliability evaluation, the PSI was 0.69 (good) and Cronbach alpha was 0.70 (acceptable). When the test-retest was examined via DIF by time, none of the items showed DIF. CONCLUSION The FreNAQ-T is a valid, reliable, unidimensional scale in CNP and suitable for the assessment of neck-specified awareness-perception in Turkish population with CNP. LEVEL OF EVIDENCE 3.
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Yamashita H, Nishigami T, Mibu A, Tanaka K, Manfuku M, Fukuhara H, Yoshino K, Seto Y, Wand BM. Perceived Body Distortion Rather Than Actual Body Distortion Is Associated With Chronic Low Back Pain in Adults With Cerebral Palsy: A Preliminary Investigation. Pain Pract 2019; 19:826-835. [DOI: 10.1111/papr.12815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 12/17/2022]
Affiliation(s)
| | - Tomohiko Nishigami
- Department of Nursing and Physical Therapy Konan Women's University Kobe Japan
| | - Akira Mibu
- Department of Rehabilitation Tanabe Orthopaedics Osaka Japan
| | | | | | - Hikaru Fukuhara
- Day‐care and Rehabilitation Center for Disabled Children “Asashioen” Osaka Japan
| | - Koichi Yoshino
- Department of Orthopaedic Surgery SKY Orthopaedics Clinic Ibaraki Japan
| | - Yoichi Seto
- Department of Orthopaedic Surgery SKY Orthopaedics Clinic Ibaraki Japan
| | - Benedict M. Wand
- The School of Physiotherapy The University of Notre Dame Australia Fremantle Western Australia Australia
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