The aim of this study was to translate and culturally adapt the Pain Behaviour Scale (PaBS) into Turkish and to evaluate its psychometric properties in adults with chronic nonspecific low back pain. Specifically, the study examined interrater reliability, intrarater reliability, agreement, measurement error, and construct validity of the Turkish version of the PaBS during standardized functional performance tasks.
The Pain Behaviour Scale (PaBS) is a clinician-rated observational measure designed to assess the presence and severity of pain behaviors during functional movement in individuals with chronic low back pain. Before its use in Turkish-speaking populations, translation, cross-cultural adaptation, and psychometric evaluation were required. In this cross-cultural adaptation and psychometric validation study, the PaBS was translated into Turkish, back-translated, reviewed by an expert panel, and pilot-tested before the main psychometric evaluation. The prefinal Turkish version was pilot-tested in 20 adults with chronic nonspecific low back pain, and the pilot data were not included in the main analyses. The main study included adults aged 18-55 years with chronic nonspecific low back pain lasting more than three months. Participants completed self-reported measures of pain, disability, and fear-avoidance beliefs and performed standardized physical performance tests. During the first testing session, two independent physiotherapists simultaneously rated pain behaviors using the Turkish PaBS. One rater repeated the PaBS assessment approximately one week later. The psychometric evaluation included interrater and intrarater reliability, agreement, measurement error, and construct validity.
Study Type
OBSERVATIONAL
Enrollment
102
Participants completed self-report measures of pain intensity and characteristics, disability, and fear-avoidance beliefs and performed five standardized physical performance tests: repeated trunk flexion, repeated sit-to-stand, Timed Up and Go, loaded reach, and 50-foot walk. During the first testing session, two independent physiotherapists simultaneously assessed the presence and severity of pain behaviors using the Turkish Pain Behaviour Scale (PaBS). For intrarater reliability, one rater repeated the PaBS assessment during a second testing session approximately one week later. No therapeutic intervention was administered as part of the study assessments.
Acıbadem Health Group
Istanbul, None Selected, Turkey (Türkiye)
Turkish Pain Behaviour Scale (PaBS)
The Turkish Pain Behaviour Scale (PaBS) is a clinician-rated observational measure used to assess the presence and severity of pain behaviors during five standardized physical performance tests. Observed behaviors include sighing, breath-holding, grimacing, guarding, rubbing, and antalgic gait. For each physical performance test, the presence or absence of individual behaviors is recorded and the overall severity of observed pain behavior is rated from 0 to 3. The total PaBS severity score ranges from 0 to 15, with higher scores indicating greater severity of observed pain behaviors. Interrater reliability was evaluated using ratings from two independent raters during the first testing session, and intrarater reliability was evaluated using ratings from the same rater across two testing sessions.
Time frame: Baseline and approximately 1 week
Oswestry Disability Index (ODI)
Low back pain-related disability was assessed using the Oswestry Disability Index (ODI). The total score is expressed as a percentage, with higher scores indicating greater disability.
Time frame: Baseline and approximately 1 week
Fear-Avoidance Beliefs Questionnaire (FABQ)
Fear-avoidance beliefs were assessed using the Fear-Avoidance Beliefs Questionnaire (FABQ), including the physical activity and work subscales and the total score. Higher scores indicate greater fear-avoidance beliefs.
Time frame: Baseline and approximately 1 week
Short-Form McGill Pain Questionnaire (SF-MPQ)
Pain characteristics were assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ), including sensory and affective pain descriptors. Sensory, affective, and total scores were recorded, with higher scores indicating greater pain-related symptom burden.
Time frame: Baseline and approximately 1 week
MPQ-VAS Pain Intensity
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Pain intensity was assessed using the visual analog scale component of the Short-Form McGill Pain Questionnaire (MPQ-VAS). Higher scores indicate greater pain intensity.
Time frame: Baseline and approximately 1 week