The Danish version for the Back Pain Attitudes Questionnaire - Translation and cross-cultural adaptation.

BACKGROUND: Beliefs and attitudes about back pain are relevant factors in relation to developing back pain. A Danish version of the Back Pain Attitudes Questionnaire (Back-PAQ) could be a way of assuring a more systematic examination of attitudes about back pain within patients with back pain, laypeople and healthcare professionals in Denmark. OBJECTIVES: The aim of this study was to develop a Danish version of the Back-PAQ and assess its psychometric properties. STUDY DESIGN: Study of diagnostic accuracy/assessment scale. METHOD: The adaptation was performed in several steps following the dual-panel method. The psychometric analyses included testing the reliability and validity. RESULTS: Thirty-seven individuals participated in the translation process, and the main findings were that the translated version was considered to reflect the original version and that it was considered relevant to address beliefs related to back pain. Five hundred and thirteen patients were included in principal component analysis and sixty were included in the test-retest analysis. The analysis on the 10-item version revealed a structure that was similar to the original questionnaire and explained 82% of the variance in the dataset. The test-retest analysis showed an ICC of 0.80 (95% CI 0.67-0.88) and SDC ranged from 0.78 to 2.35 with a mean of 1.61. CONCLUSION: The Back-PAQ was successfully translated and cross-culturally adapted into Danish. Its psychometrics properties showed that the Danish version of the questionnaire is valid and reliable for assessment of beliefs and attitudes regarding back pain, and may prove useful in both clinical settings and research in Denmark.

Pressure-induced referred pain areas are more expansive in individuals with a recovered fracture.

Musculoskeletal trauma and pain can sensitize central pain mechanisms, but whether these normalize on recovery is unknown. This study compared the extent of pain referral in individuals recovered from a musculoskeletal trauma and healthy controls. Twenty pain-free participants recovered from a shoulder fracture and 20 age-/sex-matched controls participated in 2 experimental sessions (day-0 and day-1) separated by 24 hours. On both days, pressure pain thresholds were measured bilaterally at infraspinatus, supraspinatus, trapezius, and gastrocnemius muscles. Referred pain towards the shoulder region was induced by a 60-second pressure stimulation (pressure pain threshold + 20%) at the infraspinatus muscle and recorded on an electronic body chart. After day-0 assessments, delayed onset muscle soreness (DOMS) was induced to challenge the pain systems by exercising the external rotators of the recovered/dominant shoulder. The size of pressure-induced pain referral on day-0 did not differ between groups, although there was a tendency for a smaller referred pain area in recovered group. Pressure pain thresholds at the infraspinatus muscle on the DOMS side were reduced on day-1 in both groups (P = 0.03). An expansion of pressure-induced pain referral was found in both groups following the DOMS protocol on day-1 (P = 0.05) with a relatively larger expansion (P = 0.05) and higher frequency of pain in the shoulder (P = 0.04) in the recovered pain group. After complete recovery and absence of pain symptoms after a fracture, central pain mechanisms seem to normalize in the region of the trauma after recovery but when sensitized a heightened response can emerge. Such mechanisms could be important for recurrence of pain conditions.