This study evaluates the responsiveness and minimal important change of the Turkish versions of the Fear-Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia, and Pain Catastrophizing Scale in adults with chronic non-specific low back pain undergoing a 4-week rehabilitation program.
Chronic non-specific low back pain is influenced by biological, psychological, and social factors, including fear-avoidance beliefs, kinesiophobia, and pain catastrophizing. The Fear-Avoidance Beliefs Questionnaire (FABQ), Tampa Scale for Kinesiophobia (TSK), and Pain Catastrophizing Scale (PCS) are commonly used to assess these pain-related psychological constructs. This prospective, single-cohort measurement-property study evaluates the responsiveness of the Turkish versions of the FABQ, TSK, and PCS and examines their correspondence with patient-perceived global improvement. Participants undergo baseline assessment followed by a standardized 4-week rehabilitation program comprising 16 supervised physiotherapy sessions. Outcomes are reassessed after 4 weeks. Responsiveness is evaluated using distribution-based indices and associations with the Global Rating of Change (GRC). Receiver operating characteristic analyses are used to examine discrimination between participants classified as improved and not improved and to estimate GRC-defined minimal important change values where appropriate.
Study Type
OBSERVATIONAL
Enrollment
124
Participants completed 16 supervised 60-minute physiotherapy sessions over four weeks. The standardized core program comprised lumbar stabilization and trunk-strengthening exercises, lower-limb flexibility training, postural education, and weekly 45-minute pain-related cognitive education addressing pain neurophysiology, fear, avoidance, and safe movement. Superficial heat, conventional TENS, or therapeutic ultrasound could be added by the treating physiotherapist when clinically indicated.
Avicenna Ataşehir Hospital
Istanbul, None Selected, Turkey (Türkiye)
Fear-Avoidance Beliefs Questionnaire (FABQ)
Fear-Avoidance Beliefs Questionnaire (FABQ) assesses fear-avoidance beliefs related to physical activity and work. The questionnaire consists of 16 items. The Physical Activity subscale includes items 2-5 and ranges from 0 to 24, while the Work subscale includes items 6, 7, 9-12, and 15 and ranges from 0 to 42. Higher scores indicate greater fear-avoidance beliefs.
Time frame: Baseline and 4 weeks
Tampa Scale for Kinesiophobia (TSK)
Tampa Scale for Kinesiophobia (TSK) assesses fear of movement or reinjury. The scale consists of 17 items scored on a 4-point Likert scale. After reverse scoring of the relevant items, total scores range from 17 to 68, with higher scores indicating greater kinesiophobia.
Time frame: Baseline and 4 weeks
Pain Catastrophizing Scale (PCS)
Pain Catastrophizing Scale (PCS) assesses catastrophic thinking related to pain. The scale consists of 13 items scored on a 0-4 Likert scale and provides Rumination, Magnification, Helplessness, and Total scores. Higher scores indicate greater pain catastrophizing.
Time frame: Baseline and 4 weeks
Pain Intensity - Visual Analog Scale (VAS)
Visual Analog Scale (VAS) was used to assess pain intensity at rest and during activity. Pain intensity was recorded on a 10-cm scale, with higher scores indicating greater pain intensity.
Time frame: Baseline and 4 weeks
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