Validation of the Brazilian-Portuguese Version of the Gesture Behavior Test for Patients with Non-Specific Chronic Low Back Pain

Abstract

Furtado R, Jones A, Furtado RNV, Jennings F, Natour J. Validation of the brazilian-portuguese version of the gesture behavior test for patients with non-specific chronic low back pain. Clinics. 2009;64:83-90. OBJECTIVE:To develop a Brazilian version of the gesture behavior test (GBT) for patients with chronic low back pain. METHODS: Translation of GBT into Portuguese was performed by a rheumatologist fluent in the language of origin (French) and skilled in the validation of questionnaires. This translated version was back-translated into French by a native-speaking teacher of the language. The two translators then created a final consensual version in Portuguese. Cultural adaptation was carried out by two rheumatologists, one educated patient and the native-speaking French teacher. Thirty patients with chronic low back pain and fifteen healthcare professionals involved in the education of patients with low back pain through back schools (gold-standard) were evaluated. Reproducibility was initially tested by two observers (inter-observer); the procedures were also videotaped for later evaluation by one of the observers (intra-observer). For construct validation, we compared patients' scores against the scores of the healthcare professionals. RESULTS: Modifications were made to the GBT for cultural reasons. The Spearman's correlation coefficient and the intra-class coefficient, which was employed to measure reproducibility, ranged between 0.87 and 0.99 and 0.94 to 0.99, respectively (p < 0.01). With regard to validation, the Mann-Whitney test revealed a significant difference (p < 0.01) between the averages for healthcare professionals (26.60; SD 2.79) and patients (16.30; SD 6.39). There was a positive correlation between the GBT score and the score on the Roland Morris Disability Questionnaire (r= 0.47). CONCLUSIONS: The Brazilian version of the GBT proved to be a reproducible and valid instrument. In addition, according to the questionnaire results, more disabled patients exhibited more protective gesture behavior related to low-back. KEYWORDS: INTRODUCTIONPatient education refers a set of activities designed to improve and/or adapt patient behavior in relation to illness and therefore improve health with long-lasting results.1 Educational groups addressing low back pain that seek information on pain and, above all, behavioral changes have recently emerged. 2Available information indicates that poor gesture behavior is a risk factor for non-specific chronic low back pain.Despite evidence of the progressively harmful effects of biomechanical factors on the lumbar spine, few authors have proposed gesture evaluation in patients with low back pain. A French-language gesture behavior test (GBT) was recently developed for patients with chronic low back pain. The GBT is a valid, reproducible, responsive instrument composed of five tasks: 1) getting out of bed after sleeping; 2) sweeping under the bed; 3) lifting and carrying a trash can; 4) simulating tying laces of a shoe without assistance; and 5) arranging objects...

Back Pain and the Postural and Behavioral Habits of Students in the Municipal School Network of Teotônia, Rio Grande do Sul

“…Students who sleep in the prone position have a higher prevalence of back pain. These results are in accordance with the literature 35 , where it has been reported that it is not advisable to sleep in the prone position, as this position favors increased lumbar lordosis 36 and exposes the neck to the limit of its range of motion, which can cause sprains and cervicalgia 36 . This position, when adopted as a daily postural habit, can also contribute to an anterior projection of the internal organs and stretching of the abdominal muscles 35 .…”

“…This position, when adopted as a daily postural habit, can also contribute to an anterior projection of the internal organs and stretching of the abdominal muscles 35 . Thus, it is recommended that of the three most common sleeping positions (supine, lateral and prone), lateral and supine are the most appropriate positions 36 . A significant relationship was found between the occurrence of back pain and inadequate sitting posture for writing.…”

Effectiveness of the back school program for the performance of activities of daily living in users of a basic health unit in Porto Alegre, Brazil

“…Good postural habits are important for proper functioning of the musculoskeletal system30 ) , and poor postural behaviors may be a risk factor for nonspecific chronic back pain16 ) and postural changes28 ) . The proper use of body mechanics, simulated in the Back School classes, allows for better adjustments of the musculoskeletal system through better balance and distribution of effort required to perform ADL, and can mitigate pain and degenerative processes31 ) ; however, this mitigation depends on complex interactions between biomechanical and neuromuscular functions30 ) .…”

“…The calculation used a confidence level of 95%, a maximum average estimated error of 5% (6.47), and a standard deviation (1.06) of the primary variable (evaluation of dynamic posture in ADL) obtained from the literature16 ) . Thus, it was determined that a minimum of 41 subjects were required to fulfill the purposes of the present study.…”

Reliability, Stability and Validity of the Brazilian Adaptation of the Oliveira Questionnaire on Low Back Pain in Young People

“…5,6,27 However another approach reinforces the importance of identifying the risk factors in young people and adopting primary care, instead of only focusing on policies and treatments during adulthood and in already triggered cases. 6,13,27,30 The OLBPYQ is thus aimed at detecting the problem as soon as the patient mentions low back pain, approaching questions such as occurrence, frequency, intensity and the risk factors which, according to the literature, point in the direction of the outcome. As in other studies, the pain intensity in young people was detected through a visual analogical scale which has been considered valid and reliable.…”