Assessment of measurement properties of the Brazilian-Portuguese version of the low back activity confidence scale (LoBACS) in patients with chronic low back pain

PLoS One. 2020 Sep 22;15(9):e0239332. doi: 10.1371/journal.pone.0239332. eCollection 2020.

Abstract

The Low Back Activity Confidence Scale (LoBACS) assesses the self-efficacy to perform activities in individuals with chronic low back pain (CLBP). As self-efficacy appears to directly influence the patient's functional capacity and prognosis, it is important to develop a scale that evaluates this attribute to guide treatment strategy and monitor the clinical course of patients. This study aimed to evaluate the reliability, construct validity, and responsiveness of the Brazilian version of the LoBACS. The scale was applied to 112 male and female patients (age, 18-65 years) with specific and nonspecific CLBP. For evaluating the interobserver reliability, the scale was applied twice on the first evaluation day by two trained evaluators (A and B). Within 48-72 h of the first evaluation, assessor A reapplied the scale to evaluate intraobserver reliability (test-retest), which was analyzed by intraclass correlation coefficient (ICC). The first LoBACS applied in the baseline evaluation was also used to assess the construct validity of the scale by factor analysis. For responsiveness, the scale was applied 5 times at 2-week intervals and the change in scores was analyzed by the repeated measures ANOVA. Although factor analysis indicated three subscales, they did not present acceptable values of convergent and divergent validity. Reliability ranged from good to excellent, with ICC values of .90 (95% CI, .84; .93) and .85 (95% CI, .77; .91) for inter- and intraobserver variability for total score. Moreover, the total score was responsive in all comparisons, with no floor or ceiling effects. Thus, only the total score of the Brazilian version of LoBACS proved to be reliable, valid, and responsive.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Chronic Disease
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Low Back Pain / physiopathology*
  • Low Back Pain / psychology
  • Male
  • Middle Aged
  • Pain Measurement / methods*
  • Reproducibility of Results
  • Self Efficacy
  • Translating
  • Young Adult

Grants and funding

The original study was partially funded by the Foundation for Physical Therapy (American Physical Therapy Association) and the present study by a grant from CNPq (National Council for Scientific and Technological Development – 14/2013), a productivity scholarship for the last author, Araucaria Foundation/PPSUS/SESA-PR/MSDecit/CNPq [grant number # 04/2013], and by the Coordination for the Improvement of Higher Education Personnel (CAPES – Brazil) – [Finance Code 001]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.