Cross-Cultural Adaptation, Validity, and Reliability Study of the Turkish Version of the Back Pain Functional Scale

STUDY DESIGN: Prospective study. PURPOSE: To investigate the cross-cultural adaptation, validity, and reliability of the Turkish version of the Back Pain Functional Scale (BPFS). OVERVIEW OF LITERATURE: Low back pain is a common disorder in the population that negatively affects the patient’s daily, professional, and social life. Self-report questionnaires are important to precisely evaluate back pain and making better and appropriate treatment decisions. Currently, there are several questionnaires for investigating mobility in patients with low back pain. METHODS: We recruited 360 patients with chronic low back pain. For assessing the reliability of the scale, we performed test–retest and internal consistency analyses. Test–retest analysis was performed using intraclass correlation coefficient (ICC). Internal consistency was analyzed by calculating Cronbach’s alpha value. Construct validity of the questionnaire was evaluated by comparing total scores on the BPFS with those on Roland Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) using Pearson’s correlation coefficient analysis. RESULTS: Cronbach’s alpha value was 0.910, indicating high internal consistency. The test–retest reliability was excellent (ICC, 0.958; 95% confidence interval, 0.710–0.908). No floor or ceiling effects were observed. Factor analysis indicated that the scale had a single-factor structure. Pearson correlation coefficient was −0.669 when BPFS was compared with RMDQ and −0.701 when compared with ODI. These values indicate a significant correlation of BPFS with RMDQ and ODI. CONCLUSIONS: These data indicate the validity and reliability of the Turkish version of the BPFS.

Single-injection femoral nerve block. Effects on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty

To investigate the efficacy of single injection femoral nerve block [FNB] on the independence level in functional activities in the early postoperative period in patients with total knee arthroplasty [TKA]. We conducted this prospective, randomized, blinded trial in the Department of Orthopedics and Traumatology, Hacettepe University Hospital Ankara, Turkey, between June 2003 and April 2004. Twenty-three patients scheduled for elective TKA were randomly divided into 3 groups. Group I received preemptive single injection FNB, group II received postoperative single injection FNB, and group III served as a control group. Intravenous morphine patient controlled analgesia [PCA] was used following surgery in all groups. Morphine dose and pain score defined by the visual analog scale [VAS] were recorded postoperatively at the 15th minute, 30th minute, 1st, 4th, 6th, 12th, 24th, and 48th hours. A standard rehabilitation protocol was applied for all patients. The independence level in functional activities was assessed during the first 2 postoperative days and at discharge with the Iowa Level of Assistance Scale [ILAS] and the Iowa Ambulation Speed Scale [IASS]. Physical therapists that enrolled in the study were blinded to the groups. Pain scores were significantly different between the groups [p<0.05]. The preemptive and postoperative FNB group's VAS scores were both significantly lower than the control group [p<0.05]. However, there was no significant difference in VAS scores between preemptive and postoperative FNB groups [p>0.05]. There was no statistically significant difference between the groups in any of the functional scores in the first 2 postoperative days, and at discharge [p>0.05]. Single injection FNB provided effective analgesia in patients undergoing TKA. However, the independence level in functional activities in the early postoperative period was not influenced by the analgesia method