Background
Methods
Sample and setting
Measures
Postural awareness scale (PAS)
Body awareness questionnaire (BAQ)
Body responsiveness scale (BRS)
Dresden body image inventory (Dresdner Körperbildfragebogen; DKB)
Conscious Presence and Self Control (CPSC)
Pain visual analog scale (VAS)
Pain perception scale (PPS)
Pain disability index (PDI)
Beck depression inventory (BDI)
Perceived stress scale (PSS)
Statistical analysis
Construct validity
Reliability
Convergent validity
Postural awareness in patients with chronic pain
Responsiveness
Results
Sociodemographic characteristics
Total (N = 512) | Inpatient sample (n = 310) | Outpatient sample (n = 202) | |
---|---|---|---|
Sociodemographic characteristics | |||
Age, in years | 50.3 ± 11.4 | 50.7 ± 12.4 | 49.6 ± 9.7 |
Gender | |||
Female, n (%) | 469 (91.6%) | 282 (91.0%) | 187 (92.6%) |
BMI, in kg/m2 | 26.4 ± 5.6 | 26.9 ± 5.7 | 25.7 ± 5.2 |
Family status, n (%) | |||
Single | 87 (17.0%) | 57 (18.4%) | 30 (14.9%) |
With partner/married | 338 (66.0%) | 193 (62.3%) | 145 (71.8%) |
Divorced, separated, widowed | 81 (15.8%) | 54 (17.4%) | 27 (13.4%) |
Education, n (%) | |||
< High school | 279 (54.5%) | 171 (55.2%) | 108 (53.5%) |
At least high school | 124 (24.2%) | 73 (23.5%) | 51 (25.2%) |
University | 106 (20.7%) | 63 (20.3%) | 43 (21.3%) |
Employment, n (%) | |||
Full-time | 170 (33.2%) | 95 (30.6%) | 75 (37.1%) |
Part-time | 132 (25.8%) | 72 (23.22%) | 60 (29.7%) |
Unemployed | 26 (5.1%) | 20 (6.5%) | 6 (3.0%) |
Home keeper | 32 (6.3%) | 21 (6.8%) | 11 (5.4%) |
Retired | 96 (18.8%) | 68 (21.9%) | 28 (13.9%) |
Sick leave | 48 (9.4%) | 27 (8.7%) | 21 (10.4%) |
In education | 3 (0.6%) | 2 (0.6%) | 1 (0.5%) |
Applied for disability pension, N (%) | 83 (16.2%) | 52 (16.8%) | 31 (15.3%) |
Clinical characteristics | |||
Pain condition, n (%)a | |||
Headache | |||
Migraine | 105 (20.5%) | 39 (12.6%) | 66 (32.7%) |
Tension type headache | 33 (6.4%) | 11 (3.5%) | 22 (10.9%) |
Other headache | 80 (15.6%) | 50 (16.1%) | 30 (14.9%) |
Rheumatic diseases | |||
Fibromyalgia | 114 (22.3%) | 71 (22.9%) | 43 (21.3%) |
Osteoarthritis | 90 (17.6%) | 57 (18.4%) | 33 (16.3%) |
Rheumatoid arthritis | 17 (3.3%) | 10 (3.2%) | 7 (3.5%) |
Spinal/shoulder pain | |||
Low back pain | 150 (29.3%) | 82 (26.5%) | 68 (33.7%) |
Neck pain | 48 (9.4%) | 29 (9.4%) | 19 (9.4%) |
Shoulder pain | 55 (10.7%) | 31 (10.0%) | 24 (11.9%) |
Other pain | 265 (51.8%) | 175 (56.5%) | 90 (44.6%) |
Duration of pain, in years | 12.9 ± 11.9 | 11.0 ± 10.7 | 15.6 ± 13.0 |
Intensity of pain, 0-100 mm VAS | 45.2 ± 26.1 | 48.2 ± 25.2 | 40.7 ± 26.9 |
Descriptive scale characteristics, factor structure and reliability
Factor 1: Ease/Familiarity with Postural Awareness (alpha = 0.81) | Factor 2: Need for Attention Regulation with Postural Awareness (alpha = 0.77) | ||||||||
---|---|---|---|---|---|---|---|---|---|
Item | Mean ± standard deviation | Item difficulty | Factor loading | Alpha if item deleted | Corrected item-total correlation | Factor loading | Alpha if item deleted | Corrected item-total correlation | |
1 | Needs to concentrate for being aware of posturea | 3.6 ± 1.7 | 0.51 | – | – | – | 0.80 | 0.72 | 0.58 |
2 | Awareness of bad posture only by paina | 2.9 ± 1.7 | 0.41 | – | – | – | 0.78 | 0.72 | 0.59 |
3 | Knows how to change posture to relieve painb | 5.0 ± 1.5 | 0.71 | – | – | – | – | – | – |
4 | Slumps down when sittinga | 2.8 ± 1.7 | 0.40 | – | – | – | 0.65 | 0.73 | 0.54 |
5 | Unaware of posture when focuseda | 2.5 ± 1.3 | 0.36 | – | – | – | 0.54 | 0.75 | 0.48 |
6 | Difficulties to consciously adopt a posturea | 3.9 ± 1.9 | 0.56 | – | – | – | 0.72 | 0.73 | 0.54 |
7 | Often checks posture when working | 3.7 ± 1.7 | 0.53 | 0.73 | 0.78 | 0.57 | – | – | – |
8 | Influences her/his own appeal by posture | 4.9 ± 1.6 | 0.70 | 0.56 | 0.81 | 0.40 | – | – | – |
9 | Always aware of sitting or standing posture | 3.4 ± 1.5 | 0.49 | 0.80 | 0.76 | 0.67 | – | – | – |
10 | Often makes her/himself aware of her/his posture | 3.8 ± 1.6 | 0.54 | 0.79 | 0.75 | 0.67 | – | – | – |
11 | Aware of posture even when focused | 2.8 ± 1.5 | 0.40 | 0.77 | 0.77 | 0.62 | – | – | – |
12 | Regulates how she/he feels through posture | 3.6 ± 1.6 | 0.51 | 0.63 | 0.80 | 0.49 | – | – | – |
13 | Needs to concentrate to feel whether a posture benefits her/him or nota | 3.4 ± 1.6 | 0.49 | – | – | – | 0.51 | 0.77 | 0.38 |
Convergent validity
Body Awareness Questionnaire | Body Responsiveness Scale | Dresden Body Image Inventory | Conscious Presence and Self Control | ||||||
---|---|---|---|---|---|---|---|---|---|
Trust in Bodily Sensations | Perceived Connection between Mental and Physical Processes | Vitality | Self-accep-tance | Sexuality | Self-esteem | Physical contact | |||
Total sample | |||||||||
PAS total | 0.23* | 0.41* | 0.26* | 0.26* | 0.32* | 0.22* | 0.25* | 0.24* | 0.38* |
Ease/Familiarity with Postural Awareness | 0.37* | 0.48* | 0.09* | 0.23* | 0.28* | 0.16* | 0.23* | 0.11* | 0.36* |
Need for Attention Regulation with Postural Awareness | 0.01 | 0.17* | 0.32* | 0.19* | 0.24* | 0.19* | 0.18* | 0.11* | 0.25* |
Spinal/shoulder pain | |||||||||
PAS total | 0.29* | 0.46* | 0.12 | 0.34* | 0.30* | 0.20* | 0.20* | 0.17* | 0.41* |
Ease/Familiarity with Postural Awareness | 0.46* | 0.48* | −0.00 | 0.32* | 0.25* | 0.15* | 0.18* | 0.10 | 0.42* |
Need for Attention Regulation with Postural Awareness | 0.02 | 0.29* | 0.20* | 0.24* | 0.25* | 0.19* | 0.14 | 0.18* | 0.28* |
Postural awareness in patients with chronic pain
Total sample (n = 512) | Inpatient sample (n = 310) | Outpatient sample (n = 202) | P | Spinal/ shoulder pain (n = 190) | Other pain (n = 322) |
P
| Men (n = 42) | Women (n = 470) |
P
| |
---|---|---|---|---|---|---|---|---|---|---|
PAS total | 41.2 ± 10.9 | 41.5 ± 10.5 | 40.9 ± 11.6 | 0.54 | 40.8 ± 11.2 | 41.5 ± 10.8 | 0.541 | 42.5 ± 10.6 | 41.1 ± 11.0 | 0.45 |
Ease/Familiarity with Postural Awareness
| 22.2 ± 6.8 | 22.1 ± 6.7 | 22.3 ± 6.9 | 0.76 | 22.0 ± 6.8 | 22.2 ± 6.8 | 0.754 | 22.9 ± 6.5 | 22.1 ± 6.8 | 0.46 |
Need for Attention Regulation with Postural
| 19.1 ± 6.8 | 19.4 ± 6.7 | 18.6 ± 7.0 | 0.20 | 19.2 ± 6.9 | 18.8 ± 6.7 | 0.505 | 19.6 ± 6.3 | 19.0 ± 6.9 | 0.63 |
Pain Intensity | Pain Perception Scale | Pain Duration | Pain Disability Index | Beck Depression Inventory | Perceived Stress Scale | ||
---|---|---|---|---|---|---|---|
Affective pain | Sensory pain | ||||||
Total sample | |||||||
PAS total | −0.14* | −0.08 | −0.02 | 0.06 | −0.12* | −0.23* | −0.29* |
Ease/Familiarity with Postural Awareness | −0.14* | − 0.05 | 0.01 | 0.06 | −0.13* | − 0.14* | − 0.24* |
Need for Attention Regulation with Postural Awareness | − 0.09* | − 0.08 | − 0.05 | 0.04 | − 0.07 | −0.23* | − 0.23* |
Spinal/shoulder pain | |||||||
PAS total | −0.16* | −0.04 | − 0.02 | 0.04 | − 0.21* | −0.12 | − 0.23* |
Ease/Familiarity with Postural Awareness | −0.19* | − 0.07 | 0.06 | − 0.03 | −0.22* | − 0.07 | −0.19* |
Need for Attention Regulation with Postural Awareness | −0.08 | −0.00 | 0.01 | 0.01 | −0.13 | −0.13 | − 0.20* |
Dependent variable | Predictor variable | B ± SE | β |
P
|
---|---|---|---|---|
PAS Total | ||||
Pain intensity | −0.79 ± 0.02 | −0.14 | < 0.001 | |
BAQ | 0.07 ± 0.03 | 0.11 | 0.017 | |
BRS Factor 1 | 0.64 ± 0.11 | 0.27 | < 0.001 | |
BRS Factor 2 | 0.67 ± 0.15 | 0.19 | < 0.001 | |
CPSC | 0.11 ± 0.03 | 0.18 | < 0.001 | |
DKB Vitality | 1.90 ± 0.73 | 0.11 | < 0.001 | |
Constant | 14.34 ± 3.00 | – | < 0.001 | |
Ease/Familiarity with Postural Awareness | ||||
Pain intensity | −0.49 ± 0.01 | −0.15 | < 0.001 | |
BAQ | 0.07 ± 0.03 | 0.18 | 0.017 | |
BRS Factor 1 | 0.46 ± 0.07 | 0.16 | < 0.001 | |
CPSC | 0.45 ± 0.07 | 0.32 | < 0.001 | |
DKB Vitality | 1.26 ± 0.43 | 0.17 | 0.004 | |
Constant | 5.64 ± 1.78 | – | 0.002 | |
Need for Attention Regulation with Postural Awareness | ||||
BDI | −0.10 ± 0.04 | −0.12 | 0.016 | |
BRS Factor 1 | 0.19 ± 0.07 | 0.13 | 0.005 | |
BRS Factor 2 | 0.59 ± 0.09 | 0.28 | < 0.001 | |
CPSC | 0.04 ± 0.02 | 0.11 | 0.026 | |
Constant | 36.85 ± 1.68 | – | 0.002 |
Responsiveness
Week 0 (n = 202) | Week 10 (n = 168) |
P
| |
---|---|---|---|
PAS total | 40.9 ± 11.6 | 46.0 ± 11.4 | < 0.001 |
Ease/Familiarity with Postural Awareness
| 22.3 ± 6.9 | 25.7 ± 6.9 | < 0.001 |
Need for Attention Regulation with Postural Awareness
| 18.6 ± 7.0 | 20.3 ± 7.1 | 0.003 |
Pain intensity | 54.5 ± 19.9 | 35.5 ± 20.5 | < 0.001 |