Use of cognitive exercise therapy approach scale in individuals with lowback pain: Reliability, validity and sensitivity study

This study was planned to examine the validity, reliability and sensitivity of the "Bilişsel Egzersiz Terapi Yaklaşımı" (Cognitive Exercise Therapy Approach, BETY) Scale in individuals with low back pain. 150 patients diagnosed with low back pain were included in the study. Test-retest method, intraclass reliability (ICC) coefficient and internal consistency analysis were examined for reliability assessment. To determine BETY Scale's validity was examined the correlation with Oswestry Disability Index (ODI), Short Form-36 (Short Form 36, SF-36), Hospital Anxiety and Depression Scale (HADS), Physical Performance Tests (Physical Performance Tests, FPT) and ROC analysis was performed. To determine the sensitivity, the correlation of the differences between the results of the first evaluation and the evaluation after 1.5 months of 30 individuals was examined. The correlation of the 30 individuals' responses to the BETY Scale at one-week intervals (r=0.876, p<0.001) and the ICC coefficient (0.933, p<0.001) were excellent. The Cronbach's alpha coefficient (0.936) calculated for the internal consistency analysis was found to excellent. The correlation between the BETY Scale and other test/scales was found between r=-448 and r=684 (p<0.001). The cut-off values of the BETY Scale were found to be 40 points with 89% sensitivity and 80% specificity according to the 10 values of ODI that distinguishes minimal-moderate disability and 50 points with 85% sensitivity and 58% specificity according to the 20 value of ODI that distinguishes moderate-severe disability. In the sensitivity analysis, a moderate correlation was found between BETY Scale and ODI, HADS-A, HADS-D, FPT, 5 sub-parameters of SF-36 (between r=-0.433 and r=0.554). As a result of our study, it was concluded that the BETY Scale is a valid, reliable and sensitive scale that can be used in the evaluation of biopsychosocial status in individuals with low back pain.