Validation of the French version of the Fremantle Back Awareness Questionnaire in patients with chronic low back pain

Abstract

Background: Impaired body perception could contribute to the pain experience and be a possible treatment target. The Fremantle Back Awareness Questionnaire (FreBAQ) is the only self-report questionnaire to assess back-specific self-perception.

Aim: The aim of this study was to develop a French version of the FreBAQ (FreBAQ-FR) and to evaluate its psychometric properties.

Design: Observational study.

Setting: Department of Physical Medicine and Rehabilitation at University Hospital.

Population: One hundred eighteen patients with chronic low back pain (cLBP) and 30 healthy participants were included.

Methods: A forward-backward method was used to translate the FreBAQ into French. Unidimensionality was assessed by exploratory factor analysis, and internal consistency was quantified by Cronbach's alpha coefficient. Known-groups validity was assessed by comparing results between cLBP patients and healthy participants. Temporal stability was assessed in participants who completed the FreBAQ-FR 7 days later using the intraclass correlation coefficient (ICC). Patients' FreBAQ-FR scores were correlated with functional questionnaires and two-point discrimination thresholds (TPD) for tactile acuity.

Results: The FreBAQ-FR showed good internal consistency with a Cronbach's alpha coefficient of 0.78 and can be considered unidimensional. The cLBP group scored significantly higher than the control group (11 [6 ; 17] vs. 0.5 [0 ; 5], P<0.0001). The temporal stability of the FreBAQ-FR was acceptable, with an ICC of 0.84 (95% CI: 0.77 to 0.89) and an estimated bias of -0.71±4.2 (95% CI: -1.61 to 0.18, P=0.12). In the cLBP group, FreBAQ-FR total scores correlated moderately with the Oswestry Disability Index (r=0.53, 95% CI: 0.39 to 0.65) and the Pain Catastrophizing Scale total score (r=0.53, 95% CI: 0.38 to 0.65). TPD results did not correlate with FreBAQ-FR scores (r=0.06, 95% CI: -0.12 to 0.24).

Conclusions: The FreBAQ-FR showed acceptable psychometric properties and is suitable to assess back-specific body perception in the French-speaking population with cLBP.

Clinical rehabilitation impact: This questionnaire may help researchers and clinicians to assess disrupted self-perception of the back, improve our understanding of the multifaceted experience of cLBP, and potentially offer better tailored treatment to patients.