Task-Specific Sensitivity in Physical Function Testing Predicts Outcome in Patients With Low Back Pain.

OBJECTIVE: To investigate the prognostic value of task-specific sensitivity in patients with low back pain by exploring whether task-specific sensitivity during physical function testing was associated with self-reported change in pain and disability. DESIGN: Prospective cohort study nested in a randomized controlled trial. METHODS: The study included 260 patients with low back pain, referred for evaluation in a secondary care setting. All patients completed questionnaires and underwent clinical examination by a physical therapist. Patients rated their pain intensity before and after completing a test battery measuring physical function and were classified into 4 categories-worse, unchanged, better, or no pain-depending on their pain response. At 3-month follow-up, outcomes were obtained by a postal questionnaire. RESULTS: Task-specific sensitivity significantly predicted pain, after adjusting for known prognostic factors. Patients in the no pain, better, and unchanged groups improved their pain score significantly more than patients in the worse pain group. Patients in the no pain group also improved their disability score significantly more compared to patients in the worse pain group, after adjusting for known prognostic factors. CONCLUSION: Task-specific sensitivity predicted pain intensity after 3 months in patients with low back pain. The prognostic value appears limited with respect to disability. J Orthop Sports Phys Ther 2020;50(4):206-213. Epub 30 Oct 2019. doi:10.2519/jospt.2020.8953.

Measurement properties of the Fear-Avoidance Belief Questionnaire for physical activity in patients with shoulder impingement syndrome.

BACKGROUND: The Fear-Avoidance Belief Questionnaire for physical activity (FABQ-PA) was originally developed for patients with low-back pain. Whether the FABQ-PA is suitable for use among patients with other musculoskeletal disorders has been sparsely evaluated. PURPOSE: To evaluate test-retest reliability, measurement error, construct validity, and responsiveness of the FABQ-PA in patients with shoulder impingement syndrome (SIS). METHODS: This prospective cohort study included 45 patients with SIS. Data were collected with questionnaires at baseline, after 2-4 days, and at 3 months, which included the Danish versions of the FABQ-PA and the Oxford Shoulder Score (OSS). Test-retest reliability was assessed by intraclass correlation, and standard error of measurement was estimated and converted into the minimal detectable change (MDC). Construct validity was investigated by analyzing the correlation between the baseline scores of the FABQ-PA and the OSS. Responsiveness was investigated from longitudinal construct validity using a correlation analysis reflecting changes over time. RESULTS: Test-retest reliability showed an intraclass correlation of 0.80, and examination of the measurement error showed no systematic differences and a MDC of 7.95 (95% CI 6.57-10.07). Construct validity showed a correlation of -0.60 (95% CI -0.76 to -0.37) between the FABQ-PA and OSS at baseline. A weaker correlation between FABQ-PA- and OSS-change scores was observed (-0.43, 95% CI -0.67 to -0.12). CONCLUSION: The Danish version of the FABQ-PA is suitable for assessing fear-avoidance beliefs in groups of patients with SIS, but its ability to evaluate individual patients and changes over time may be more limited.