Validity and reliability the Turkish version of the patterns of activity measure pain

The aim of this study is to determine reliability and validity of the Turkish version of the Patterns of Activity Measure-Pain (POAM-P/T). A total of 252 patients with chronic low back (n=153) and neck pain (n=99) were included in the study. Physical and demographic characteristics of the patients were recorded. Participants physical activity level was assessed by the International Physical Activity Questionnaire-7 (IPAQ-7), and anxiety and depression status by the Hospital Anxiety (HADS-A) Depression Scale (HADS-D). Patients filled out the POAM-P/T, which has subgroups of Avoidance, Overdoing and Pacing, two times a week apart. In addition, a 7-item questionnaire was prepared to predict how participants developed a pattern of behavior in daily living activities with chronic pain in the form and this questionnaire was applied to patients. Internal-external validity and known group validity analyzes for the validity, internal consistency and test-retest analyzes for the reliability were used. The validity of the internal structure of the POAM-P/T by using DWLS (Diagonal Weighted Least Squares) method with Confirmatory Factor Analysis (CFA), the validity of the external structure with Spearman's rho coefficient between the scores of IPAQ-short form, HADS-A and HADS-D scales and avoidance, overdoing and pacing scores of the scale, for the known group validity of the scale's comparison of POAM-P/T scores and answers to 7 items questionnaire that we prepared in the patient evaluation form with the Mann-Whitney U test , internal consistency with Cronbach alpha values and test-retest scores with Wilcoxon test were analyzed and in addition to Intraclass Correlation Coefficient (ICC) for test-retest scores were calculated. Three related factorial structures were defined in CFA. Indexes and factor loads were found to be sufficient. A weak negative relationship was observed between the avoidance score and UFAA-7 (rho: -0.328, p< 0.001), HAD-D (rho: -0.163, p: 0.009), HAD-A (rho: -0.164, p: 0.009). A weak positive relationship was observed between the overdoing score and UFAA-7 (rho: 0.362, p< 0.001), HAD-D (rho: 0.309, p< 0.001), HAD-A (rho: 0.325, p< 0.001). A moderate negative correlation was found between pacing score and HAD-D (rho: -0.507, p< 0.001), HAD-A (rho: -0.509, p< 0.001). A weak negative relationship was observed between the pacing score and UFAA-7 (rho: -0.200, p= 0.001). According to the yes / no answers given to the 7 questions, it was predicted which POAM-P/T sub-group score would be high and sub-group scores were distributed as expected. The cronbach alpha values for avoidance, overdoing, and pacing were obtained as 0.941, 0.917 and 0.940, respectively. ICC for avoidance, overdoing, and pacing was found to be 0.972, 0.973, and 0.972, respectively. There was no significant difference between test-retest scores (p avoidance: 0.996, p overdoing: 0.072, p pacing: 0.054). In conclusion it was concluded that the Turkish version of POAM-P is valid and reliable assessment of pain-related activity patterns in patients with chronic low back and neck pain. Keywords: Patterns of activity measures-pain, validity, reliability, chronic low back pain, chronic neck pain