Disrupted self-perception in people with chronic low back pain: Further evaluation of the fremantle back awareness questionnaire

Abstract

Several lines of evidence suggest that body-perception is altered in people with chronic back pain. Maladaptive perceptual awareness of the back might contribute to the pain experience as well as serve as a target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) is a simple questionnaire recently developed to assess back-specific altered self-perception. The aims of this study were to present the outcomes of a comprehensive evaluation of the questionnaire’s psychometric properties and explore the potential relationships between body-perception, nociceptive sensitivity, distress and beliefs about back pain and the contribution these factors might play in explaining pain and disability. Two-hundred and fifty-one people with chronic back pain completed the questionnaire as well as a battery of clinical tests. The Rasch model was used to explore the questionnaires psychometric properties and correlation and multiple linear regression analyses were used to explore the relationship between altered body-perception and clinical status. The FreBAQ appears unidimensional with no redundant items, has minimal ceiling and floor effects, acceptable internal consistency, was functional on the category rating scale and was not biased by demographic or clinical variables. FreBAQ scores were correlated with sensitivity, distress and beliefs and were uniquely associated with both pain and disability.