Validity and Reliability of the Turkish Version of the Revised Bath CRPS Body Perception Disturbance Scale

complex regional pain syndrome

The construct validity of the Turkish version of the Revised Bath Complex Regional Pain Syndrome Body Perception Disturbance Scale (r-B-CRPS-BPDS) will be evaluated in adults with Complex Regional Pain Syndrome. The r-B-CRPS-BPDS assesses disturbances in body perception related to the affected limb, including feelings of ownership, awareness of limb position, emotional feelings toward the limb, perceived differences in size, temperature, pressure, and weight, desire for amputation, and mental representation of the affected limb. The total score ranges from 0 to 47, with higher scores indicating greater body perception disturbance. Construct validity will primarily be examined by assessing the association between the r-B-CRPS-BPDS total score and the Tampa Scale for Kinesiophobia total score. Associations with pain intensity, health-related quality of life, and clinical CRPS severity will also be examined.

The internal consistency of the Turkish r-B-CRPS-BPDS will be evaluated using Cronbach's alpha coefficient and corrected item-total correlations. The analysis will determine the degree to which the items of the Turkish version consistently assess the construct of body perception disturbance in individuals with Complex Regional Pain Syndrome.

Test-retest reliability will be evaluated in clinically stable participants by administering the Turkish r-B-CRPS-BPDS twice, with an interval of 7-10 days. Reliability will be assessed using the intraclass correlation coefficient (ICC), based on a two-way random-effects model, single measurement, and absolute agreement [ICC(2,1)]. Measurement error will additionally be evaluated using the standard error of measurement (SEM) and smallest detectable change (SDC).

The Tampa Scale for Kinesiophobia (TSK) is a 17-item self-report questionnaire used to assess fear of movement and reinjury. Each item is rated on a 4-point Likert scale. Higher total scores indicate greater levels of kinesiophobia. The Turkish version of the scale has demonstrated validity and reliability. The TSK total score will be used primarily to examine the construct validity of the Turkish r-B-CRPS-BPDS.

The EQ-5D-5L will be used to assess health-related quality of life. It evaluates five dimensions of health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, with five response levels for each dimension. Participants will also rate their current overall health using the EQ Visual Analogue Scale (EQ VAS), ranging from 0 to 100, with higher scores representing better self-rated health. EQ-5D-5L outcomes will be examined in relation to body perception disturbance.

Pain intensity will be assessed using an 11-point Numeric Rating Scale (NRS) ranging from 0 to 10. A score of 0 represents no pain, whereas a score of 10 represents the worst imaginable pain. Higher scores indicate greater pain intensity. The NRS score will be examined in relation to the r-B-CRPS-BPDS total score.

Clinical severity of Complex Regional Pain Syndrome will be assessed using the Complex Regional Pain Syndrome Severity Score (CSS). The 17-item score incorporates patient-reported symptoms and signs identified during clinical examination across sensory, vasomotor, sudomotor/edema, motor, and trophic domains. Each item is scored as absent or present, producing a total score ranging from 0 to 17. Higher scores indicate greater clinical severity of Complex Regional Pain Syndrome.