Abstract
BackgroundThe World Health Organization reports that one of the main incapacitating conditions in older adults is osteomusculoskeletal disorders, and among these is low back pain. There are few instruments translated and transculturally adapted with psychometric properties evaluated for older adults with this health condition in Brazil. The Pain Response to Activity and Positioning (PRAP) questionnaire enables classification of older adults through functional performance. The objective of this study was to perform a cross-cultural adaptation and verify the reliability of the PRAP for older Brazilian people with chronic low back pain.MethodsA cross-sectional methodological study from the international study “Back Complaints in the Elders”. We included individuals aged ≥60 years, with chronic lumbar pain complaints lasting ≥3 months. The transcultural translation and adaptation process followed the criteria proposed by Beaton and Guilhemeim, 1993. Reliability was tested using an unweighted Cohen’s Kappa.ResultsThirty-six (36) older adults participated in the study (71.15 ± 7.23 years, 94.4% female). The intra-rater reliability for Low Back Pain (LBP) was between 0.50–1.00 and 0.23–0.84 for lower limbs, while the inter-rater reliability for LBP was between 0.25–0.63 and between 0.18–0.53 for lower limbs. The criteria for low back pain diagnosis showed intra and inter-rater agreement of 0.52 and 0.47, respectively.ConclusionThe Brazilian version of the instrument showed adequate reliability and ability to classify older adults in the diagnosis of LBP by reporting the performance of daily activities, and is indicated for use in the context of research and clinical practice.Trial registrationThere is no trial registration. This is a methodological study.
Highlights
With aging in Brazil being similar to the world population, the country is presenting a period of demographic and epidemiological transition [1], in which chronic musculoskeletal degenerative diseases are prevalent and incapacitating [2, 3]
Unlike specific low back pain in which there is a cause and a certain pathological process, non-specific low back pain is characterized by the absence of structural alteration, i.e. there is no compression of nerve roots, bone or joint injury which can lead to pain in the spine; in this case, the justification for the cause of the pain symptoms occurs due to the mechanical imbalance between the functional load, which is the effort required for certain activities, and the capacity, which is the potential for execution [9]
There is a gap in the literature on low back pain in older adults, as most of the studies involving older adults are excluded due to cognitive changes or with the justification that they are not inserted in work activities
Summary
With aging in Brazil being similar to the world population, the country is presenting a period of demographic and epidemiological transition [1], in which chronic musculoskeletal degenerative diseases are prevalent and incapacitating [2, 3]. According to the World Health Organization (WHO), one of the main incapacitating conditions in the older population is musculoskeletal disorders, including. The anatomical bases for explaining LBP in older adults are different from those of young adults; osteoarthritis, osteoporosis, fractures, tumors, stenoses, associated comorbidities and polypharmacy are more prevalent in this age group. Outcomes such as falls, hospitalization and loss of functional independence are not reported in studies with young adults [10]. The World Health Organization reports that one of the main incapacitating conditions in older adults is osteomusculoskeletal disorders, and among these is low back pain. The objective of this study was to perform a cross-cultural adaptation and verify the reliability of the PRAP for older Brazilian people with chronic low back pain
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