Correction: The Hausa Back Beliefs Questionnaire: Translation, cross-cultural adaptation and psychometric assessment in mixed urban and rural Nigerian populations with chronic low back pain.

[This corrects the article DOI: 10.1371/journal.pone.0249370.].

The Hausa Back Beliefs Questionnaire: Translation, cross-cultural adaptation and psychometric assessment in mixed urban and rural Nigerian populations with chronic low back pain.

INTRODUCTION: Negative attitudes and beliefs about low back pain (LBP) can lead to reduced function and activity and consequently disability. One self-report measure that can be used to assess these negative attitudes and beliefs and to determine their predictive nature is the Back Beliefs Questionnaire (BBQ). This study aimed to translate and cross-culturally adapt the BBQ into Hausa and assess its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP. METHODS: The BBQ was translated and cross-culturally adapted into Hausa (Hausa-BBQ) according to established guidelines. To assess psychometric properties, a consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the questionnaire along with measures of fear-avoidance beliefs, pain catastrophizing, functional disability, physical and mental health, and pain. One hundred of the 200 patients completed the questionnaire twice at an interval of 7-14 days to assess test-retest reliability. Internal construct validity was assessed using exploratory factor analysis, and external construct validity was assessed by examining convergent, divergent, and known-groups validity. Reliability was assessed by calculating internal consistency (Cronbach's α), intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC95), and limits of agreement using Bland-Altman plots. Reliability (ICC, SEM and MDC95) was also assessed separately for rural and urban subgroups. RESULTS: The factor analysis revealed a four-factor solution explaining 58.9% of the total variance with the first factor explaining 27.1%. The nine scoring items loaded on the first factor hence supporting a unidimensional scale. The convergent and divergent validity were supported as 85% (6:7) of the predefined hypotheses were confirmed. Known-groups comparison showed that the questionnaire discriminated well for those who differed in education (p < 0.05), but not in age (p > 0.05). The internal consistency and ICC (α = 0.79; ICC = 0.91) were adequate, with minimal SEM and MDC95 (1.9 and 5.2, respectively). The limits of agreements were -5.11 to 5.71. The ICC, SEM and MDC95 for the urban and rural subgroups were comparable to those obtained for the overall population. CONCLUSIONS: The Hausa-BBQ was successfully adapted and psychometrically sound in terms of internal and external construct validity, internal consistency, and test-retest reliability in mixed urban and rural Hausa-speaking populations with chronic LBP. The questionnaire can be used to detect and categorize specific attitudes and beliefs about back pain in Hausa culture to prevent or reduce potential disability due to LBP.

The Hausa 12-item short-form health survey (SF-12): Translation, cross-cultural adaptation and validation in mixed urban and rural Nigerian populations with chronic low back pain.

INTRODUCTION: Measuring health-related quality of life (HRQOL) in patients with chronic low back pain (LBP) is crucial to monitor and improve the patients' health status through effective rehabilitation. While the 12-item short-form health survey (SF-12) was developed as a shorter alternative to the 36-item short-form health survey for assessing HRQOL in large-scale studies, to date, no cross-culturally adapted and validated Hausa version exists. This study aimed to translate and cross-culturally adapt the SF-12 into Hausa language, and test its psychometric properties in mixed urban and rural Nigerian populations with chronic LBP. METHODS: The Hausa version of the SF-12 was developed following the guidelines of the International Quality of Life Assessment project. Fifteen patients with chronic LBP recruited from urban and rural communities of Nigeria pre-tested the Hausa SF-12. A consecutive sample of 200 patients with chronic LBP recruited from urban and rural clinics of Nigeria completed the instrument, among which 100 respondents re-tested the instrument after two weeks. Factorial structure and invariance were assessed using confirmatory factor analysis (CFA) and multi-group CFA respectively. Multi-trait scaling analysis (for convergent and divergent validity) and known-groups validity were performed to assess construct validity. Composite reliability (CR), internal consistency (Cronbach's α), intraclass correlation coefficients (ICC), and Bland-Altman plots were computed to assess reliability. RESULTS: After the CFA of the original conceptual SF-12 model, 2 redundant items were removed and 4 error terms were allowed to covary, thus providing adequate fit to the sample. The refined model demonstrated good fit and evidence of factorial invariance in three demographic groups (age, gender, and habitation). Convergent (11:12; 91% success rate) and divergent (10:12; 83% success rate) validity were satisfactory. Known-groups comparison showed that the instrument discriminated well for those who differed in age (p < 0.05) but in gender and habitation (p > 0.05). The physical component summary and the mental component summary demonstrated acceptable CR (0.69 and 0.79 respectively), internal consistency (α = 0.73 and 0.78 respectively), test-rest reliability (ICC = 0.79 and 0.85 respectively), and good agreement between test-retest values. CONCLUSIONS: The Hausa SF-12 was successfully developed and showed evidence of factorial invariance across age, gender, and habitation. The instrument demonstrated satisfactory construct validity, internal consistency, and test-retest reliability. However, stronger psychometric properties need to be established in general population and other patients groups in future studies. The instrument can be used clinically and for research in Hausa-speaking patients with chronic LBP.

Effects of acupuncture, core-stability exercises, and treadmill walking exercises in treating a patient with postsurgical lumbar disc herniation: a clinical case report.

The objective of this study is to investigate the effects of acupuncture, core-stability exercises, and treadmill 12-minute walking exercises in treating patients with postsurgical lumbar disc herniation. A 34-year-old woman with a history lumbar disc prolapse who had undergone lumbar disc surgery on two different occasions was treated using acupuncture, core-stability exercises, and treadmill walking exercises three times per week for 12 weeks. The outcome measures used in this study were pain intensity, spinal range of movement, and general health. After 12 weeks of treatment, the patient had made improvement in terms of pain, which was reduced from 9/10 to 1/10. In a similar vein, the patient's general health showed improvement of >100% after 12 weeks of treatment. Pre-treatment scores of spinal flexion and left-side flexion, which measured 20 cm and 12 cm, respectively, increased to 25 cm and 16 cm after 12 weeks of treatment. This study showed that acupuncture, core-stability exercises, and treadmill walking exercises were useful in relieving pain, increasing spinal range of movement, and improving the health of a patient with postsurgical lumbar disc herniation.

Experiences of individuals with chronic low back pain during and after their participation in a spinal stabilisation exercise programme - a pilot qualitative study.

Spinal stabilisation exercises are commonly used in the management of low back pain (LBP). There is limited evidence relating to patients' experiences of their involvement in such programmes. The aim of this study was to explore the experiences of a sample of individuals with chronic LBP who participated in a randomised controlled trial (RCT) investigating the most efficacious dosage and frequency of spinal stabilisation exercises. The qualitative study involved nine participants who took part in focus group discussions. The data were analysed using thematic content analysis and provided insights into the experiences of the participants. Four themes emerged: Physical dimensions of the LBP experience, emotional and psychological dimensions of the LBP experience and perceived effects of the programme and lastly, the impact of the treatment programme on participants' knowledge, understanding and adherence. In conclusion participants' experiences were not limited to the positive effects of stabilisation exercises on pain, functional disability and quality of life, but also reflected increases in confidence, the formulation of self help strategies and the ability to exert better control over their LBP. The findings highlight the importance of well planned associated educational support packages in the treatment of LBP paving the way for future qualitative research.

Factors contributing to possession of walking aids among persons with osteoarthritis of the knee.

OBJECTIVES: To investigate the possession and use of walking aids among patients with knee osteoarthritis (OA), and to identify factors contributing to possession and actual use of these aids METHODS: A random sample of 90 patients with OA was derived from a database of 3,500 registered patients. A total of 80 (88.8%) patients with OA completed a questionnaire on possession and use of walking aids. Demographics, disease-related characteristics, and information about possession and use were assessed. Logistic regression analyses were used to determine which factors are associated with the possession and use of walking aids. RESULTS: Sixty (75%) of the OA patients owned a walking aid. Canes, forearm crutches and walkers were most frequently possessed. Age, frequency of pain, and disability were associated with possessing a walking aid. Of the sixty patients that possess walking aid 25 (41.7%) of them are active walking aid users while the remaining 58.3% are non users. Factors associated with the actual use of an aid included higher age, a high intensity of pain, more disability, decrease in morning stiffness by the aid, and a positive evaluation of the aid CONCLUSION: More than half of the patients with OA possess a walking aid. Disability, pain, and age-related impairments seem to determine the need for a walking aid. Nonuse is associated with less need, negative outcome, and negative evaluation of the walking

Changes in plasma concentration of serotonin in response to spinal stabilisation exercises in chronic low back pain patient.

BACKGROUND: Currently, there is evidence demonstrating the efficacy of stabilisation exercises in the management of acute and chronic low back disorders. However, the main facilitation techniques behind the efficacy of this exercise still remain uncertain. OBJECTIVE: The purpose of the study was to investigate the changes in the plasma levels of serotonin in response to spinal stabilisation exercises in participants with chronic low back pain. METHODS: Twenty-two participants (11 males, 11 females) with chronic low back pain volunteered to the take part in this study. The main outcome measures used in this study were plasma levels of serotonin measured with Enzyme linked immuno absorbent assay (ELISA) technique. Participants were randomly allocated either to the stabilisation exercise groups, where they carried out stabilisation exercise training or the control (no exercise) group. RESULTS: The results showed significant increase in plasma serotonin level by 17.8% in the exercise groups immediately following active exercise, which was not noticed in the control group. CONCLUSION: It could also be that an increase in plasma serotonin levels produced with the use of stabilisation exercise may have a role to play in the positive out come of stabilisation exercise in the management of chronic low back pain.