Turkish Pain Behaviour Scale in Adults With Chronic Nonspecific Low Back Pain

The Pain Behaviour Scale (PaBS) is a clinician-rated observational measure designed to assess the presence and severity of pain behaviors during functional movement in individuals with chronic low back pain. Before its use in Turkish-speaking populations, translation, cross-cultural adaptation, and psychometric evaluation were required.

In this cross-cultural adaptation and psychometric validation study, the PaBS was translated into Turkish, back-translated, reviewed by an expert panel, and pilot-tested before the main psychometric evaluation. The prefinal Turkish version was pilot-tested in 20 adults with chronic nonspecific low back pain, and the pilot data were not included in the main analyses.

The main study included adults aged 18-55 years with chronic nonspecific low back pain lasting more than three months. Participants completed self-reported measures of pain, disability, and fear-avoidance beliefs and performed standardized physical performance tests. During the first testing session, two independent physiotherapists simultaneously rated pain behaviors using the Turkish PaBS. One rater repeated the PaBS assessment approximately one week later. The psychometric evaluation included interrater and intrarater reliability, agreement, measurement error, and construct validity.

Inclusion criteria

• Adults aged 18-55 years
• Chronic nonspecific low back pain lasting longer than 3 months
• Sufficient cognitive and language ability to understand study instructions, complete questionnaires, and provide informed consent

Exclusion criteria

• Clinical features suggesting serious spinal pathology, including malignancy, infection, fracture, or cauda equina syndrome
• Spinal stenosis
• Signs of radiculopathy, including radiating leg pain, weakness, numbness, or tingling
• Previous fracture or surgery in the relevant spinal region
• History of rheumatic disease
• Pregnancy