Chronic Low-back Pain
Conditions
Keywords
Chronic Low Back Pain, Responsiveness, Fear-Avoidance Beliefs, Kinesiophobia, Pain Catastrophizing, Rehabilitation, Minimal Important Change
Brief summary
This study evaluates the responsiveness and minimal important change of the Turkish versions of the Fear-Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia, and Pain Catastrophizing Scale in adults with chronic non-specific low back pain undergoing a 4-week rehabilitation program.
Detailed description
Chronic non-specific low back pain is influenced by biological, psychological, and social factors, including fear-avoidance beliefs, kinesiophobia, and pain catastrophizing. The Fear-Avoidance Beliefs Questionnaire (FABQ), Tampa Scale for Kinesiophobia (TSK), and Pain Catastrophizing Scale (PCS) are commonly used to assess these pain-related psychological constructs. This prospective, single-cohort measurement-property study evaluates the responsiveness of the Turkish versions of the FABQ, TSK, and PCS and examines their correspondence with patient-perceived global improvement. Participants undergo baseline assessment followed by a standardized 4-week rehabilitation program comprising 16 supervised physiotherapy sessions. Outcomes are reassessed after 4 weeks. Responsiveness is evaluated using distribution-based indices and associations with the Global Rating of Change (GRC). Receiver operating characteristic analyses are used to examine discrimination between participants classified as improved and not improved and to estimate GRC-defined minimal important change values where appropriate.
Interventions
OTHERStandardized Rehabilitation Program
Participants completed 16 supervised 60-minute physiotherapy sessions over four weeks. The standardized core program comprised lumbar stabilization and trunk-strengthening exercises, lower-limb flexibility training, postural education, and weekly 45-minute pain-related cognitive education addressing pain neurophysiology, fear, avoidance, and safe movement. Superficial heat, conventional TENS, or therapeutic ultrasound could be added by the treating physiotherapist when clinically indicated.
Sponsors
Acibadem University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-65 years * Chronic non-specific low back pain persisting for more than 12 weeks without a recognizable specific pathoanatomical cause * Ability to read and understand Turkish * Sufficient cognitive ability to complete self-reported questionnaires, defined as a Standardized Mini-Mental Test score ≥24 * Provision of written informed consent
Exclusion criteria
* Radiculopathy * Spinal infection, tumor, osteoporosis, vertebral fracture, recent trauma, or previous lumbar surgery * Recent spinal injection * Systemic disease affecting participation or interpretation * Cognitive impairment * Myocardial infarction or cerebrovascular event within the previous 12 weeks * Previous structured exercise therapy or pain neuroscience education for low back pain * Refusal of treatment * Inability to comply with the rehabilitation program
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fear-Avoidance Beliefs Questionnaire (FABQ) | Baseline and 4 weeks | Fear-Avoidance Beliefs Questionnaire (FABQ) assesses fear-avoidance beliefs related to physical activity and work. The questionnaire consists of 16 items. The Physical Activity subscale includes items 2-5 and ranges from 0 to 24, while the Work subscale includes items 6, 7, 9-12, and 15 and ranges from 0 to 42. Higher scores indicate greater fear-avoidance beliefs. |
| Tampa Scale for Kinesiophobia (TSK) | Baseline and 4 weeks | Tampa Scale for Kinesiophobia (TSK) assesses fear of movement or reinjury. The scale consists of 17 items scored on a 4-point Likert scale. After reverse scoring of the relevant items, total scores range from 17 to 68, with higher scores indicating greater kinesiophobia. |
| Pain Catastrophizing Scale (PCS) | Baseline and 4 weeks | Pain Catastrophizing Scale (PCS) assesses catastrophic thinking related to pain. The scale consists of 13 items scored on a 0-4 Likert scale and provides Rumination, Magnification, Helplessness, and Total scores. Higher scores indicate greater pain catastrophizing. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity - Visual Analog Scale (VAS) | Baseline and 4 weeks | Visual Analog Scale (VAS) was used to assess pain intensity at rest and during activity. Pain intensity was recorded on a 10-cm scale, with higher scores indicating greater pain intensity. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORElif E Bayraktar, asst. prof.
Acibadem University
STUDY_CHAIRIrmak Çavuşoğlu, asst. prof.
Kırklareli University
STUDY_DIRECTORNuray Alaca, assoc. prof.
Acibadem University
STUDY_CHAIRYağmur İldeniz, MSc
Acibadem University
STUDY_CHAIRAsiye Koçak
Avicenna Ataşehir Hospital
Outcome results
None listed