Background: Excessive fear of movement, restricted physical activity, and cognitive distortions are frequently found with chronic low back pain (CLBP) subjects. The Fear-Avoidance Beliefs Questionnaire (FABQ) is the most well-founded and often used tool to measure fear and avoidance beliefs in CLBP subjects. In India, there is a diversity of culture, educational level, and language. So, there is a need to translate FABQ into the regional language Tamil, which will improve understanding of FABQ and reduce the language barrier of the Tamil population. Objective: To translate, cross-cultural adapt, and investigate the psychometric properties of the Tamil version of FABQ in CLBP subjects. Materials & Methods: The standard translation and adaptation guideline was used to translate FABQ into Tamil version FABQ. CLBP subjects referred to a low back rehabilitation program in an outpatient clinic took part in this study. They completed a FABQ-Tamil questionnaire [includes subscales for Physical Activity (FABQ-PA) and Work (FABQ-W)], pain rating visual analog scale and the Roland- Morris Disability Questionnaire (RMDQ)-Tamil version, on two occasions five days apart. Test-retest reliability, internal consistency and validity were evaluated. Results: Fifty CLBP subjects participated with a mean age of 39.94 (± 15.55) years. Convergent validity analysis displayed a moderate correlation between FABQ-PA and VAS (r = 0.63); FABQ-W and VAS (r = 0.64). Divergent validity analysis demonstrated a moderate correlation between FABQ-PA and RMDQ (r = 0.69) and a good correlation between FABQ-W and RMDQ (r = 0.85). The test-retest reliability was high; the intra-class correlation coefficients of FABQ-PA and FABQ-W were ICC-0.90 and 0.94, respectively. Cronbach's alpha for the FABQ-PA and FABQ-W were 0.87 and 0.92, demonstrating high internal consistency. Conclusion: The findings of this study demonstrated that the FABQ-Tamil version questionnaire is a reliable and valid measure of fear of pain and fear-avoidance beliefs in the Tamil-speaking CLBP subject.

Author Bio(s)

P. Antony Leo Asser is a doctorate in physiotherapy working in the capacity of professor and vice-principal at Sri Ramachandra Faculty of Physiotherapy. He is a certified orthopedic manual therapist and has 18 publications to his credit.

Hasini Dayalan has completed a master's program in physiotherapy at Sri Ramachandra Faculty of Physiotherapy. She has won places for research presentations at the national and international levels.

Soundararajan K has completed a master's program in physiotherapy at Sri Ramachandra Faculty of Physiotherapy. He has won places for research presentations and a junior research fellow in a funded research program.


The authors gratefully acknowledge the late Prof. Gordon Waddell, Orthopaedic surgeon, for permitting us to undertake the study. We sincerely thank the experts and linguistic validators for their untiring contribution to the translation process.




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