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      Low Back Pain Functional Disability in Athletes; Conceptualization and Initial Development of a Questionnaire

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          Abstract

          Background:

          Low Back Pain (LBP) is one of the most prevalent causes of disability not only in the general population but also in athletes. Despite a large number of self-reported back specific disability questionnaires, there is no specific, well documented, outcome measure for athletes suffering from back pain.

          Objectives:

          This study aimed to identify the main descriptive themes representing functional disability in athletes due to LBP.

          Patients and Methods:

          We conducted a qualitative study using in-depth interviews to characterize the experiences of athletes with LBP. Twenty athletes with LBP were recruited and the main descriptive elements of their LBP related disability were extracted. Then a preliminary questionnaire using these themes was proposed.

          Results:

          The main disability indicators were pain intensity; stretching exercises, strengthening exercises, sport specific skills, back range of motion (ROM), sitting, walking, sleep patterns, self-care, and recreational activities, fear of pain and avoidance behavior, and changes in sexual activity.

          Conclusions:

          The findings of this study suggest that apart from non-sports items, some sport related items should be included in the assessment of LBP disability levels in athletes. Our results have also been organized as a preliminary LBP disability questionnaire for athletes.

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          Most cited references36

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          Determination and quantification of content validity.

          M Lynn (1986)
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            The rising prevalence of chronic low back pain.

            National or state-level estimates on trends in the prevalence of chronic low back pain (LBP) are lacking. The objective of this study was to determine whether the prevalence of chronic LBP and the demographic, health-related, and health care-seeking characteristics of individuals with the condition have changed over the last 14 years. A cross-sectional, telephone survey of a representative sample of North Carolina households was conducted in 1992 and repeated in 2006. A total of 4437 households were contacted in 1992 and 5357 households in 2006 to identify noninstitutionalized adults 21 years or older with chronic (>3 months), impairing LBP or neck pain that limits daily activities. These individuals were interviewed in more detail about their health and health care seeking. The prevalence of chronic, impairing LBP rose significantly over the 14-year interval, from 3.9% (95% confidence interval [CI], 3.4%-4.4%) in 1992 to 10.2% (95% CI, 9.3%-11.0%) in 2006. Increases were seen for all adult age strata, in men and women, and in white and black races. Symptom severity and general health were similar for both years. The proportion of individuals who sought care from a health care provider in the past year increased from 73.1% (95% CI, 65.2%-79.8%) to 84.0% (95% CI, 80.8%-86.8%), while the mean number of visits to all health care providers were similar (19.5 [1992] vs 19.4 [2006]). The prevalence of chronic, impairing LBP has risen significantly in North Carolina, with continuing high levels of disability and health care use. A substantial portion of the rise in LBP care costs over the past 2 decades may be related to this rising prevalence.
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              Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.

              There is growing evidence for the idea that in back pain patients, pain-related fear (fear of pain/physical activity/(re)injury) may be more disabling than pain itself. A number of questionnaires have been developed to quantify pain-related fears, including the Fear-Avoidance Beliefs Questionnaire (FABQ), the Tampa Scale for Kinesiophobia (TSK), and the Pain Anxiety Symptoms Scale (PASS). A total of 104 patients, presenting to a rehabilitation center or a comprehensive pain clinic with chronic low back pain were studied in three independent studies aimed at (1) replicating that pain-related fear is more disabling than pain itself (2) investigating the association between pain-related fear and poor behavioral performance and (3) investigating whether pain-related fear measures are better predictors of disability and behavioral performance than measures of general negative affect or general negative pain beliefs (e.g. pain catastrophizing). All three studies showed similar results. Highest correlations were found among the pain-related fear measures and measures of self-reported disability and behavioral performance. Even when controlling for sociodemographics, multiple regression analyses revealed that the subscales of the FABQ and the TSK were superior in predicting self-reported disability and poor behavioral performance. The PASS appeared more strongly associated with pain catastrophizing and negative affect, and was less predictive of pain disability and behavioral performance. Implications for chronic back pain assessment, prevention and treatment are discussed.
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                Author and article information

                Journal
                Asian J Sports Med
                Asian J Sports Med
                10.5812/asjsm
                Kowsar
                Asian Journal of Sports Medicine
                Kowsar
                2008-000X
                2008-7209
                10 November 2014
                December 2014
                : 5
                : 4
                : e24281
                Affiliations
                [1 ]Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
                [2 ]Noorafshar Rehabilitation and Sports Medicine Hospital, Tehran, IR Iran
                [3 ]Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
                Author notes
                [* ]Corresponding author: Ramin Kordi, Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188630228, Fax: +98-2188003539, E-mail: ramin_kordi@ 123456Tums.ac.ir
                Article
                10.5812/asjsm.24281
                4335478
                25741417
                85c7eff9-32af-4841-8041-27a887fdccec
                Copyright © 2014, Kowsar Corp.; Published by Kowsar.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                : 30 January 2014
                : 15 March 2014
                : 14 April 2014
                Categories
                Research Article

                Sports medicine
                low back pain,athlete,questionnaire design,disability
                Sports medicine
                low back pain, athlete, questionnaire design, disability

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