Abstract
Objectives To examine the interrater and intrarater reliability and construct validity of the Pain Behaviour Scale during standard physical performance tests in people with chronic low back pain and to confirm the test-retest reliability of the physical performance tests in this population. The Pain Behaviour Scale (PaBS) is an observational scale that was recently designed to uniquely measure both the presence and severity of observed pain behaviours. Methods Twenty-two participants with chronic low back pain were observed during performance of five physical performance tests by two raters. Pain behaviours were assessed using the Pain Behaviour Scale. The Visual Analogue Scale and Modified Oswestry Disability Index were used to measure pain and disability, respectively. Descriptive statistics were used to report demographic features of participants. Reliability was analyzed using ICCs. Rater agreement was analyzed using the weighted Cohen's kappa. Correlations between PaBS, self-reported measures, and physical performance tests were calculated using Pearson's product-moment correlations. Results The PaBS demonstrated excellent interrater (ICC2,1 = 1.0, 95% CI: 0.9 to 1.0) and intrarater (ICC3,1 = 0.9, 95% CI: 0.8 to 1.0) reliability. Component physical performance tests (i.e., time and distance) demonstrated good test-retest (0.6–1.0) reliability. Perfect agreement in the reporting of pain behaviours was found (95–100%). Correlations between pain behaviour severity and pain intensity (r = 0.6) and disability (r = 0.6) were moderate. Moderate correlations were found between pain behaviours and physical performance tests in sit to stand (r = 0.5), trunk flexion (r = 0.4), timed up and go (r = 0.4), and 50-foot walk (r = 0.4). Conclusion The Pain Behaviour Scale is a valid and reliable tool for measuring the presence and severity of pain behaviour, and the physical performance tests are reliable tests.
Highlights
Chronic low back pain (CLBP) is one of the leading causes of disability that is often described as nonspecific and is recognized as having multiple contributing factors [1, 2]
Pain Research and Management certain aberrant behaviours, with visible or audible responses indicative of discomfort or suffering such as grimacing and sighing [8, 9]. Such pain-related behaviours are commonly seen in musculoskeletal clinical practice in people with conditions such as osteoarthritis [10] and CLBP [11, 12]. erefore, reporting perceived pain intensity on a Visual Analogue Scale and demonstrating pain-related behaviours are two different ways in which people may communicate their suffering in a clinical setting [6]
A summary of the participants’ component physical performance tests, Pain Behaviour Scale (PaBS) total score, and PaBS scores for each physical performance test are presented in Table 1. ere were no significant differences in the component physical performance tests or PaBS scores between first and second sessions
Summary
Chronic low back pain (CLBP) is one of the leading causes of disability that is often described as nonspecific and is recognized as having multiple contributing factors [1, 2] It affects most people at some point in their lives with recurrent episodes common [3]. Pain Research and Management certain aberrant behaviours, with visible or audible responses indicative of discomfort or suffering such as grimacing and sighing [8, 9] Such pain-related behaviours are commonly seen in musculoskeletal clinical practice in people with conditions such as osteoarthritis [10] and CLBP [11, 12]. A number of studies have shown a positive association between pain behaviour and disability among people with low back pain (LBP). erefore, quantification of pain behaviour should be considered during clinical assessment [15,16,17,18]
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