Construct validity of movement-evoked pain operational definitions in older adults with chronic low back pain
Date
2023-03-21
Journal Title
Journal ISSN
Volume Title
Publisher
Pain Medicine
Abstract
Objective:
Movement-evoked pain (MeP) may predispose the geriatric chronic low back pain (LBP) population to health decline. As there are differing operational definitions for MeP, the question remains as to whether these different definitions have similar associations with health outcomes in older adults with chronic LBP.
Design:
Cross-sectional analysis of an observational study.
Setting:
Clinical research laboratory.
Subjects:
226 older adults with chronic LBP.
Methods:
This secondary analysis used baseline data from a prospective cohort study (n = 250). LBP intensity was collected before and after the repeated chair rise test, stair climbing test, and 6-minute walk test; MeP change scores (ie, sum of pretest pain subtracted from posttest pain) and aggregated posttest pain (ie, sum of posttest pain) variables were calculated. LBP-related disability and self-efficacy were measured by the Quebec Back Pain Disability Scale (QBPDS) and Low Back Activity Confidence Scale (LOBACS), respectively. Physical function was measured with the Health ABC Performance Battery. Robust regression with HC3 standard errors was used to evaluate adjusted associations between both MeP variables and disability, self-efficacy, and physical function.
Results:
Greater aggregated posttest MeP was independently associated with worse disability (b = 0.593, t = 2.913, P = .004), self-efficacy (b = –0.870, t = –3.110, P = .002), and physical function (b = –0.017, t = –2.007, P = .039). MeP change scores were not associated with any outcome (all P > .050).
Conclusions:
Aggregate posttest MeP was linked to poorer health outcomes in older adults with chronic LBP, but MeP change scores were not. Future studies should consider that the construct validity of MeP paradigms partially depends on the chosen operational definition.
Description
This is a pre-copyedited, author-produced version of an article accepted for publication in Pain Medicine following peer review. The version of record Patrick J Knox, PT, DPT, Corey B Simon, PT, DPT, PhD, Ryan T Pohlig, PhD, Jenifer M Pugliese, PT, DPT, Peter C Coyle, PT, DPT, PhD, Jaclyn M Sions, PT, DPT, PhD, Gregory E Hicks, PT, PhD, FAPTA, Construct validity of movement-evoked pain operational definitions in older adults with chronic low back pain, Pain Medicine, 2023;, pnad034, https://doi.org/10.1093/pm/pnad034 is available online at: https://doi.org/10.1093/pm/pnad034. This article will be embargoed until 03/21/2024.
Keywords
chronic pain, low back pain, movement-evoked pain, pain measurement, geriatrics
Citation
Patrick J Knox, PT, DPT, Corey B Simon, PT, DPT, PhD, Ryan T Pohlig, PhD, Jenifer M Pugliese, PT, DPT, Peter C Coyle, PT, DPT, PhD, Jaclyn M Sions, PT, DPT, PhD, Gregory E Hicks, PT, PhD, FAPTA, Construct validity of movement-evoked pain operational definitions in older adults with chronic low back pain, Pain Medicine, 2023;, pnad034, https://doi.org/10.1093/pm/pnad034