Body awareness disturbances in patients with low back pain: a systematic review.

BACKGROUND: The pain-neuroscience literature has recently emphasized body perception or awareness. Impaired body perception results have been reported in many different chronic pain problems. Studies have reported that individuals with low back pain (LBP) also have body perception disturbances related to the lumbar spine. OBJECTIVES: This review aimed to determine the evidence that body awareness alterations in individuals with LBP. DESIGN: Systematic review. METHOD: Studies were searched in PubMed, Cochrane Library, and Pedro databases up to January 2021. Each database was searched independently, according to a specific iteration research string. The protocol record of the systematic review was entered into the PROSPERO system. RESULTS: Nine studies were included in this research. We found evidence to support more perceptual impairments in patients with LBP than healthy counterparts. In addition, the results of the studies showed an association between disrupted body awareness and pain severity, pain catastrophizing, and disability. CONCLUSIONS: Body perception disturbances in LBP seem to be a promising path that needs to be further explored, with the ultimate goal of developing treatment contents targeting body awareness as a more comprehensive and valid evaluation and therapeutic method. TRIAL REGISTRATION: The registration number was CRD42021235934.

Reliability and validity of the Turkish version of the Health Care Satisfaction Questionnaire in patients with spinal pain.

BACKGROUND: The concept of satisfaction is an important concept because of the information it provides about both the quality of health services and the patients' utilization of the health services they receive. The aim of this study was to test the validity and reliability of the Turkish version of the Health Care Satisfaction Questionnaire (HCSQ). METHODS: The study sample consisted of 148 patients who received exercise therapy for spinal pain. Psychometric evaluations were analyzed using the Turkish version of the HCSQ (confirmatory factor analysis, convergent validity, test-retest reliability). Convergent validity was determined by examining the relationship between the scale and the Numeric Rating Scale (NRS), Patient Satisfaction Scale for Physiotherapy Outpatient Clinics (PSSPOC) , and the Patient Satisfaction Scale in Physiotherapy (PSSP). RESULTS: The HCSQ showed excellent internal consistency (Cronbach's a = 0.96) and excellent test-retest reliability (intraclass correlation coefficient = 0.944). The HCSQ showed high correlation with NRS, PSSPOC , and PSSP. CONCLUSION: The HCSQ is a valid and reliable tool for assessing satisfaction with health care services in the Turkish population with spinal pain.

Investigation of masticatory muscle thickness and mechanosensitivity of cervical and masticatory muscles in myofascial temporomandibular disorder patients with bruxism: A cross-sectional study.

OBJECTIVE: Bruxism is a common problem associated with temporomandibular disorders (TMD). The aim of this study was to compare a patient group with Myofascial TMD and bruxism and a healthy control group in terms of masseter and temporal muscle thickness (clenching and resting), mechanosensitivity of neck and jaw muscles, craniofacial pain, and disability and emotional stress status. METHODS: The study included 31 patients with myofascial TMD and bruxism (19 females, 12 males) with a mean age of 29.96 ± 8.12 years (range, 18-45 years), and a control group of 31 healthy subjects (19 females, 12 males) with a mean age of 27.58 ± 9.39 years years (range, 18-45 years). Masseter and temporal muscle thicknesses were evaluated with a mobile ultrasound device both at rest and when clenching the jaw. The mechanosensitivity values between the upper trapezius, obliquus capitis inferior, masseter and temporal muscles were measured with a digital algometer device. Craniofacial pain and disability level were evaluated with the Craniofacial Pain and Disability Index (CFPDI), and emotional stress levels with the Perceived Stress Scale-14 (PSS-14). RESULTS: No difference was determined between the two groups in respect of the clenching and resting ratios of muscle thickness in any muscle (p > 0.05). The mechanosensitivity values in all muscles were lower in the myofascial TMD group than in the healthy group (p < 0.05). The CFPDI and PSS-14 scores were higher in the myofascial TMD group (p < 0.05). There was a moderate positive correlation between CFPDI, PSS-14 and Bruxism Frequency Score (p < 0.05). CONCLUSION: The difference in mechanosensitivity and CFPDI values between the myofascial TMD patients with bruxism and the healthy control group indicates that the problem in this patient group has effects in the craniocervical and cervical regions. In addition, the correlation between CFPDI, PSS-14 and Bruxism Frequency Score in myofascial TMD patients suggests that this problem may be affected by the interaction of different parameters.

Cross-cultural adaptation, reliability and validity of the Turkish version of the Henry Ford Hospital Headache Disability Inventory (HDI/T) in patients with cervicogenic headache.

PURPOSE: Cultural adaptation to Henry Ford Hospital Headache Disability Inventory (HDI) and investigating the validity and reliability of this inventory. METHODS: International standards were followed in conducting the cultural adaption of Henry Ford Hospital Headache Disability Inventory Turkish version (HDI-T). Test-Retest reliability (intraclass correlation coefficient, ICC) and internal consistency (Cronbach's alpha) were included in the psychometric assessments; Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess the structural validity; and construct validity was performed by examining relationship the HDI-T between the Headache Impact Test-6 (HIT- 6), Neck Disability Index (NDI), Perceived Stress Scale-14 (PSS-14), and Nottingham Health Profile (NHP). RESULTS: HDI-T showed excellent test-retest reliability (ICC =0.901), excellent internal consistency (Cronbach's a = 0.935), and low to high correlation with Headache Impact Test-6 (HIT-6), Neck Disability Index (NDI), Perceived Stress Scale-14 (PSS-14) and Nottingham Health Profile (NHP). Following EFA, two factors (emotional and functional) were extracted, accounting for 50.734% of the total variation. The dimensional structure of the HDI-T obtained in the EFA was confirmed by CFA. CONCLUSION: The HDI-T is a reliable and valid instrument to determine the symptoms and disability in the Turkish population with cervicogenic headaches.Implications for RehabilitationHenry Ford Hospital Headache Disability Inventory Turkish version (HDI-T) is an outcome measure with high validity and reliability to obtain objective data in the determination of disability due to cervicogenic headache.HDI-T is recommended for all rehabilitation professionals to evaluate both the disability levels before rehabilitation and the changes during the rehabilitation process in patients with cervicogenic headaches in the Turkish population.Physiotherapists, orthopedists and neurosurgeons can also use HDI-T to objectively evaluate the secondary effects of their treatment for neck problems.

The Effects of Yoga and Stabilization Exercises in Patients With Chronic Low Back Pain: A Randomized Crossover Study.

This study aimed to assess the effectiveness of yoga and stabilization exercises in patients with chronic low back pain. Thirty-five female patients were randomly assigned to the stabilization exercise group or the yoga group. Outcome measures were the visual analog scale (VAS), Oswestry Disability Index (ODI) and Back Performance Scale (BPS), 6-minute walk test (6MWT), Fear-Avoidance Beliefs Questionnaire (FABQ), and Pittsburgh Sleep Quality Index (PSQI). The scores of the VAS, ODI, BPS, 6MWT, and PSQI improved significantly after both interventions (P < .05). Improvements in the stabilization program were higher on the transversus abdominis activation (P < .05). Both interventions had no effect on kinesiophobia (P > .05). Both exercise approaches were found to be similarly effective on pain, function, metabolic capacity, and sleep quality.

Tele-Assessment of Functional Capacity: Validity, Intra- and Inter-rater Reliability.

BACKGROUND: Functional capacity evaluation is a standardized tool that assesses work-related skills. Although there are different test batteries, the most frequently used one is Work Well Systems. This study aims to determine the validity and inter- and intra-rater reliability of remote implementation of functional capacity tests (repetitive reaching, lifting object overhead, and working overhead) in asymptomatic individuals. METHODS: A total of 51 asymptomatic individuals were included in the study. Participants completed all tests both face-to-face and remotely. Remote assessment videos were rewatched by the same researcher and different researchers for intra- and inter-rater reliability. All processes were scored by two independent researchers. RESULTS: Remotely performing repetitive reaching (intraclass correlation coefficient [ICC]: 0.85-0.92, p < .001), lifting object overhead (ICC: 0.98, p < .001), and working overhead (ICC: 0.88 p < .001) tests are valid and reliable. DISCUSSION: Repetitive reaching, lifting an object overhead, and sustained overhead work tests in the Work Well Systems-Functional Capacity Evaluation test battery can be performed remotely through videoconferencing. Remotely evaluating these tests, which are especially important in work-related situations, may be important in pandemic conditions and hybrid working conitions.

SUPER rehabilitation of hamstring strain injuries in soccer players: Delphi consensus study.

INTRODUCTION: Hamstring strain injuries (HSI) are one of the most common injuries for soccer players and there is a need for new clinical-based studies on the rehabilitation of these injuries. OBJECTIVE: This study aimed to create a consensus on physiotherapy and rehabilitation approaches used in HSI by physiotherapists with super league experience in Turkey. METHODS: Twenty-six male physiotherapists (duration of experience in professional life, on athlete health, and in the super league: 12.84 ± 6.04 years, 12.19 ± 5.96 years, 8.71 ± 5.31 years, respectively) from different institutions participated in the study. The research was carried out in three rounds using the Delphi method. RESULTS: Data collected using LimeSurvey and Google Forms were analyzed using the Microsoft Excel and SPSS 22 software. The response rates over the three rounds were 100%, 96%, and 96%, respectively. The 10 main items that were agreed upon in Round 1 were divided into 93 sub-items. Their numbers in the second and third Rounds were 60 and 53, respectively. At the end of Round 3, the highest consensus was on eccentric exercise, dynamic stretching, interval running, and movement-enhancing field training. All sub-items at this round were classified as SUPER (S: Soft tissue restoration techniques; U: Using supportive approaches; P: Physical fitness exercises; E: Electro-hydro-thermal methods; and R: Return to sport activities). CONCLUSION: SUPER rehabilitation provides a new conceptual framework in terms of approaches used by clinicians in rehabilitation for athletes with HSI. Recognizing the lack of evidence for the various approaches involved, clinicians can modify their practice and researchers can explore whether these approaches are scientifically correct.

Effects of spinal stabilization exercises delivered using telerehabilitation on outcomes in patients with chronic neck pain: a randomized controlled trial.

BACKGROUND: When spinal stabilization exercises (SSE) are performed regularly, may provide benefits on outcome measures in chronic nonspecific neck pain (CNNP) patients. The pandemic has made it difficult for CNNP patients to access regular physiotherapy-exercise services. This study aims to compare telerehabilitation (TR) with face-to-face rehabilitation in CNNP. METHODS: Neck Functional Capacity Evaluation Test (NFCET) results were the primary outcomes. Pain intensity (PI), disability, awareness, neck muscles architecture, andexercise satisfaction were the secondary outcomes. Patients were randomized into the TR group (TRG) (n = 15) and the control group (CG) (n = 16). Patients performed SSE 3 days a week, for 8 weeks. The TRG was instructed remotely while the CG was instructed in the clinic. RESULTS: After 8 weeks in both groups, NFCET values and neck awareness increased (p < 0.05), PI and disability decreased (p < 0.05).      Muscle architecture improved in both groups (p < 0.05), except for the Right Sternocleidomastoideus in both groups and the Right Upper-Trapezius in TRG (p > 0.05). There was no difference between the groups for all variables and exercise satisfaction(p > 0.05). CONCLUSION: SSE for CNNP, whether supervised by therapists in the clinic or by telerehabilitation, was equally effective. THE CLINICAL TRIAL NUMBER: NCT04691024.

Multimedia Instructions for Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain.

BACKGROUND: Low back pain (LBP) is one of the top 3 diseases that may lead to disability. Current treatment guidelines define exercise as a first-line treatment for nonspecific LBP (NSLBP). There are various evidence-based exercise approaches for treating NSLBP, and many of them include motor control principles. Motor control exercises (MCEs) are better than general exercises that do not include motor control principles. Many patients find learning these exercises complex and challenging, in that MCE exercises have no standard teaching method. The researchers of this study developed multimedia instructions for an MCE program to make teaching MCE easier; thus, more effective. METHODS: The participants were randomized into multimedia or standard (face-to-face) instruction groups. We applied the same treatments to both groups at the same dosage. The only differences between groups were the exercise instruction methods. The multimedia group learned MCE from multimedia videos; the control group learned MCE from a physiotherapist with face-to-face instructions. Treatment lasted 8 weeks. We evaluated patients' exercise adherence with Exercise Adherence Rating Scale (EARS), pain with the Visual Analog Scale, and disability with Oswestry Disability Index. Evaluations were made before and after treatment. Follow-up evaluations were carried out 4 weeks after the end of treatment. RESULTS: There was no statistically significant interaction between the group and time on pain, F2,56 = 0.068, P = .935, partial η2 = .002 and Oswestry Disability Index scores, F2,56 = 0.951, P = .393, partial η2 = .033. Also, there was no statistically significant interaction between the group and time on Exercise Adherence Rating Scale total scores F1,20 = 2.343, P = .142, partial η2 = .105. CONCLUSIONS: This study showed that multimedia instructions for MCE have similar effects to standard (face-to-face) instructions on pain, disability, and exercise adherence in patients with NSLBP. To our knowledge, with these results, the developed multimedia instructions became the first free, evidence-based instructions that have objective progression criteria and a Creative Commons license.

Determination of cognitive status and influencing variables in patients with chronic neck pain: A cross-sectional study.

OBJECTIVES: This study aimed to evaluate cognitive function in individuals with chronic neck pain (CNP) and investigate the effects of different variables on cognition. METHODS: The sociodemographic characteristics of the individuals who participated in this study were recorded. Pain intensity of the individuals was evaluated using the Visual Analog Scale, pain-related disability was evaluated with the Neck Disability Index and cognitive function was evaluated using Montreal Cognitive Assessment (MoCA). RESULTS: For this study, 95 patients with CNP were recruited. The mean age was 45.61 ± 11.14, and the median MoCA score was 24 (20-26), and 64.2% of the patients scored below the original cutoff (<26/30 points). The regression analysis showed that higher age and lower education levels were associated with lower MoCA scores. Education appeared to be the most influential variable. Younger participants (18-45) performed systematically better on naming, attention and language domains than their older counterparts (over 45). CONCLUSIONS: The findings suggest that age and education play an important role in MoCA total and domain scores in these patients. While treating these patients, assessment of cognitive function can be useful for effective pain management.

Investigation of Joint Position Sense and Balance in Individuals With Chronic Idiopathic Neck Pain: A Cross-Sectional Study.

OBJECTIVE: The aim of this study was to determine the relationship between joint position sense and static and dynamic balance in female patients with chronic neck pain compared with healthy controls. METHODS: The study sample comprised 25 female patients with chronic neck pain and 25 healthy (asymptomatic) female controls. Pain severity with the visual analog scale, joint position sense with the laser pointer method, static balance with the Single-Leg Balance Test, and dynamic balance with the Y Balance Test were assessed. RESULTS: The deviation in cervical joint position sense was greater in extension (P < .001), right rotation (P < .001), and left lateral rotation (P < .05) in the patients with chronic neck pain compared with the healthy controls. The results of the patients with chronic neck pain were worse than the healthy controls in the Single-Leg Balance Test with both eyes open (P < .05) and eyes closed (P < .05). The patients with chronic neck pain had worse dynamic balance only in the anterior direction reach of the left leg (P < .05). CONCLUSION: Cervical joint position sense and static balance were worse in female patients with chronic idiopathic neck pain when compared with asymptomatic controls. Dynamic balance in all other directions except for the anterior direction was not negatively affected in individuals with chronic idiopathic neck pain.

Education level is a strong determinant of cognitive function as measured by MoCA in people with chronic low back pain.

BACKGROUND: Over recent years there has been increasing clinical interest in the relationship between chronic pain and cognitive function. There are very few studies on individuals with low back pain (LBP) in the literature, which has remained under-researched. OBJECTIVES: This study aimed to evaluate cognitive function in individuals with chronic back pain and investigate the effects of different variables on cognition. DESIGN: Cross-sectional study. METHODS: In this study, 115 individuals with chronic low back pain (CLBP) participated. The sociodemographic characteristics of the individuals who participated were recorded, including age, sex, weight, height, education and pain duration. Pain intensity of the individuals was evaluated using the Visual Analog Scale, functional status was evaluated with the Oswestry Disability Index, and cognitive function was evaluated using Montreal Cognitive Assessment (MoCA). RESULTS: One hundred fifteen individuals with CLBP were recruited. The mean age was 48.4±11.8, and the mean MoCA score was 22.9±4.4. MoCA scores were associated with education, age, gender and pain intensity. CONCLUSIONS: The findings obtained in the current study showed that individuals with CLBP had low MoCA scores and cognitive function was affected. In individuals with CLBP, cognitive function was affected depending on education level, age and intensity of pain. Assessment of the cognitive function in pain management can be useful for clinicians interested in LBP.

Family and personal factors associated with the participation of children with special needs in leisure activities: A Turkish perspective.

OBJECTIVE: The primary aims of the current study were to describe the participation patterns in leisure activities of children between the ages of 6 and 15 years with special needs and to analyze family behavior and personal factors that affect participation. MATERIAL AND METHODS: Overall, 112 children with special needs aged 6-15 years and their families participated in the present study. Children's sociodemographic characteristics, participation patterns in leisure activities, family behavior, and quality of life were evaluated. RESULTS: In this study, it was observed that children participated in recreational activities the most and in physical activities the least. Most of the families reported that they did not have an influence on determining the activity. The findings showed correlations between leisure activities and age, gender, and socioeconomic status (p < 0.05). CONCLUSION: The findings suggest that (a) children's participation in activities outside the home and (b) family guidance are insufficient. Thus, rehabilitation professionals can inform families about activities appropriate for children, positive family behavior, and social support programs.

Body image disturbance, psychosocial adjustment and quality of life in adolescents with amputation.

BACKGROUND: Physical and emotional situations experienced by amputees can affect body image and quality of life (QoL). Although adolescence is a time when appearance becomes more important, there are insufficient studies in literature examining the effect of body image disturbance (BID) on QoL and psychosocial adjustment in adolescents with amputation. OBJECTIVE: To investigate the BID, psychosocial adjustment and QOL in adolescents with amputation. METHODS: This cross-sectional study included individuals aged 11-18 years with amputation. The Amputee Body Image Scale was used to determine BID, the psychosocial adjustment subscale of Trinity Amputation and Prosthesis Experience Scale was used to investigate the psychosocial adjustment to amputation, and the Pediatric Quality of Life Inventory was used to determine the QoL. RESULTS: Evaluation was made of 42 adolescents (26 boys, 16 girls) with a mean age of 14.24 ± 2.25 years. Significant correlations were found between BID and age of fitting of the first prosthesis, psychosocial adjustment and QoL (p < 0.05). 38% of the variance of QoL was predicted by perceived body image and income of the family. 34% of the variance of psychosocial adjustment was predicted by perceived body image (p < 0.05). Adolescents suffering phantom limb pain were seen to have lower QoL scores (p < 0.05). CONCLUSION: BID is an important predictor of psychosocial adjustment and QoL in adolescent amputees. Therefore, a prosthesis that ensures the integrity of the body image should be fitted at an as early age as possible before the onset of body image disorder.

Investigating the Relationship between Body Mass Index and Pain in the Spine in Children or Adolescents: A Systematic Review.

Background: Neck pain (NP), back pain (BP), and low back pain (LBP) are generally defined as "pain in the spine." With the increasing prevalence of childhood obesity, secondary problems such as pain in the spine have arisen. The purpose of this review was to investigate the relationship between body mass index (BMI) and pain in the spine in children or adolescents. Methods: Publications were searched in PubMed, Web of Science, Scopus, and Google Scholar databases up to December 12, 2020. The search strategy in the database consisted of free text words and MeSH terms. Results: Twelve studies were reviewed. It was determined that different methods were used in all 12 studies to evaluate pain. In the evaluation of overweight/obesity, these studies performed BMI assessment by dividing body weight in kilograms by height squared. Five studies showed a relationship between LBP and BMI, two studies showed a relationship between BP and BMI, and two studies showed a relationship between NP and BMI. Conclusions: The review shows that there is a relationship between BMI and pain in the spine, especially LBP. There may be factors affecting this condition such as mechanical loading and hormonal metabolic activity in childhood and adolescence. Different methods are used in the studies in literature for the assessment pain in the spine and BMI, overweight, and obesity.

An evaluation of the knowledge and attitudes of school staff related to diabetes care at school: The 10th year of the "diabetes program at school" in Turkey.

The aim of this study was to measure the knowledge and attitudes of school staff regarding care in school for children with type 1 diabetes and to evaluate the contribution of the "Diabetes Program at School"(DPS). The data were collected through an online survey consisting of 55 questions, which included 39 knowledge and 16 attitude questions. The survey was delivered to the participating school staff via a link. A total of 55,677 people who completed 100% of the survey were included. Of the participants, 76% were teachers, 23% were school administrators and 0.1% were school nurses. 73% (40732) of the participants stated that they had heard about the "DPS". Of the participants who were aware of the DPS 75%, 50%, and 41% stated an increase in their knowledge level, self-confidence, and awareness respectively. Both scores were positively associated with being female and school nurse, having students with diabetes in the school, having been trained in childhood diabetes, being familiar with the program and being from the Western region of Turkey. The DPS is well known among school staff including teachers, school administrators, and school nurses. However, there are clear regional differences in the knowledge and attitude of school staff regarding diabetes care at school. Therefore, regional differences should be taken into account when planning the necessary interventions to prevent any further increase in the current inequalities. In addition, increasing the number of school nurses, together with strengthening the knowledge and attitude of school staff, can improve the level of diabetes care at school.

The Acute Effects of Cognitive-Based Neuromuscular Training and Game-Based Training on the Dynamic Balance and Speed Performance of Healthy Young Soccer Players: A Randomized Controlled Trial.

Objective: The aim of this study was to investigate the acute effects of cognitive and game-based trainings (GBT) on dynamic balance (DB) and speed performance (SP) in healthy young soccer players. Materials and Methods: Forty-nine male soccer players were divided into three groups: cognitive-based neuromuscular training (CBNT; n = 16; age = 16.93 ± 1.18 years; body mass index [BMI] = 21.37 ± 1.57 kg/m2) group, GBT (n = 17; age = 17.05 ± 1.39 years; BMI = 21.10 ± 0.97 kg/m2) group, and control group (n = 16; age = 16.75 ± 1.12 years; BMI = 21.95 ± 1.36 kg/m2). The athletes in CBNT and GBT groups took part in one session lasting 1 hour. The Star Excursion Balance Test and the Speed Dribbling Test were used to evaluate DB and SP, respectively. The measurements were taken just before and after the trainings. Statistical analysis of the study was performed using SPSS 22.0 software (Statistical Package for Social Sciences, Inc., Chicago, IL). The Paired Student's t-test and Wilcoxon test were used. For in-group evaluation the ANOVA test was used for comparisons between the three groups. The Tukey's test was used for post hoc analysis. Results: DB significantly improved in all directions in the GBT group (P < 0.05). Also, significant improvements were observed in DB in all directions except anterior, anterolateral, and anteromedial in the CBNT group, and except anterior, medial, and anteromedial directons in the control group (P < 0.05). SP significantly developed just in the CBNT and GBT groups (P = 0.001, P = 0.003, respectively). CBNT and GBT improved the DB of soccer players by 9.6% and 9.5%, respectively. Also, trainings improved the SP by 3.1% and 2.6%, respectively. Conclusion: CBNT and GBT are promising trainings that can improve DB and SP of healthy young soccer players. Trial number: NCT03739658 (ClinicalTrials.gov Identifier).

Is cervical region tightness related to vagal function and stomach symptoms?

The vagal nerve is a cranial nerve that carries mainly parasympathetic fibers (average 75%) with both sensory and motor functions. The vagal nerve contains a complex neuro-endocrine-immune network. The majority, at least 66%, of the gastric myenteric neurons receive direct cholinergic excitatory stimulation from the pre-enteric vagal nerve. Changes in vagal function may cause stomach problems, although the mechanisms that change the vagal function have not yet been fully illuminated. Considering the course of the vagal nerve in the cervical region, it is thought that conditions such as stiffness, tightness and decreased elasticity in this region may compress the vagal nerve andmay affect vagal function. According to this hypothesis, neuroinflammation and hyperalgesia may occur in the vagal nerve under mechanical pressure, resulting in increased complaints of pain and burning in the stomach increases. However, as the vagal nerve has various effects on the motility of the stomach and vagal dysfunction affects the motor function of the stomach, relaxation techniques applied to the soft tissues of the cervical region will provide mechanical relief in the nerve. Thus, the vagal nerve will be decompressed and be able to function optimally. According to our clinical observations, in patients whose soft tissues in the cervical region are relaxed, gastric symptoms are decreased. Based on research results and clinical experience, cervical region tightness can be considered to cause stomach problems through the vagal nerve, and soft tissue relaxation of the cervical region can be a promising treatment method for stomach symptoms.

Body awareness and chronic low back pain: validity and reliability study of Turkish version of body awareness rating scale

Background/aim: Previous studies reported that patients with chronic low back pain (CLBP) had trouble describing senses or body functions. A questionnaire, the body awareness rating questionnaire (BARQ), was recently developed for assessing body awareness. The aim of the study was to develop a Turkish version of the BARQ and investigate the validity and reliability in patients with CLBP. Materials and methods: BARQ translated to Turkish with forward-backward method. Ninety-nine patients with CLBP and 101 healthy controls (HC) completed the BARQ-T. Fifty-one of patients with CLBP and HC repeated BARQ-T 3 days later. In addition to BARQ-T, Oswestry disability index (ODI), pain severity, short form 36 (SF-36) and Toronto alexithymia scale (TAS) were administered. Results: The current study found good-excellent Cronbach's alpha values for patients with CLBP (α: between 0.883­0.967) and acceptable-good Cronbach's alpha values for HC (α: between 0.649­0.825) in factors of BARQ-T. ICC values for test-retest validity were found to be good-excellent for patients with CLBP in all factors. BARQ-T was positively correlated with SF-36 and negatively correlated with ODI and TAS (P < 0.05). Conclusion: The study confirmed that the BARQ-T has acceptable validation and reliability in terms of pain perception and pain assessment in the Turkish CLBP community.

The Fremantle Neck Awareness Questionnaire in Chronic Neck Pain Patients: Turkish Version, Validity and Reliability Study.

STUDY DESIGN: Cross-cultural adaptation and psychometric analysis. OBJECTIVE: The aim of this study wad to develop "Fremantle Neck Awareness Questionnaire Turkish (FreNAQ-T)" and to investigate the validity, reliability, and psychometric properties of FreNAQ-T in the Turkish population with chronic neck pain (CNP). SUMMARY OF BACKGROUND DATA: As the different beliefs about the nature of the problem in chronic pain (CP) and its future consequences lead to mis-stimulated neuroplastic changes, the perceptual level and proprioceptive-awareness should be examined in CP. The perceptual level and propriceptive awareness in individuals with chronic low back pain and in knee osteoarthritis were evaluated, whereas the neck version has not been studied. METHODS: The neck version was conducted using forward-backward method to translate the FreBAQ from English to Turkish. The number of the included patients was 111. The FreNAQ-T was applied to 37 patients after 3 days for test-retest reliability. Validity of the FreNAQ-T was assessed using Rasch analysis and Spearman correlation coefficient. Reliability of the FreNAQ-T's internal consistency was tested by Person Separation Index (PSI) and Cronbach Alpha. Test-retest reliability was tested by differential item functioning (DIF) by time. RESULTS: All items of FreNAQ-T were found to fit Rasch Model (given Bonferroni adjustment fit level of 0.006 and χ: 6 (df = 9), P = 0.739). Internal construct validity evaluation was good, overall mean item fit residual was 0.141 (SD 1.089), and mean person fit residual was -0.211 (SD 1.173). In reliability evaluation, the PSI was 0.69 (good) and Cronbach alpha was 0.70 (acceptable). When the test-retest was examined via DIF by time, none of the items showed DIF. CONCLUSION: The FreNAQ-T is a valid, reliable, unidimensional scale in CNP and suitable for the assessment of neck-specified awareness-perception in Turkish population with CNP. LEVEL OF EVIDENCE: 3.