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Chronic Non-Specific Low Back Pain Cohort

Adults with chronic non-specific low back pain who were consecutively recruited from patients referred for physiotherapy. Participants were assessed at baseline and after completion of a four-week physiotherapy program to evaluate the responsiveness and minimal important change of the Turkish versions of the RMDQ, ODI, and QBPDS.

Muut: Standardized Physiotherapy Program

Participants received a standardized physiotherapy program reflecting routine clinical practice, consisting of 16 supervised sessions delivered over four weeks (four sessions per week; approximately 60 minutes per session). The program included lumbar stabilization exercises, trunk strengthening, lower-limb flexibility training, and postural education. Adjunctive electrotherapy was applied when clinically indicated and included superficial heat, conventional transcutaneous electrical nerve stimulation (TENS), and therapeutic ultrasound. All sessions were delivered by licensed physiotherapists according to a standardized treatment protocol. The physiotherapy program served as a change-inducing clinical context for the clinimetric evaluation rather than as an intervention for comparative efficacy testing.

Roland-Morris Disability Questionnaire (RMDQ)

Functional disability related to low back pain was assessed using the Turkish version of the Roland-Morris Disability Questionnaire (RMDQ). The RMDQ consists of 24 dichotomous items scored as 0 or 1, yielding a total score from 0 to 24. Higher scores indicate greater disability. Change scores were calculated as the 4-week follow-up score minus the baseline score, with negative change scores indicating improvement.

Quebec Back Pain Disability Scale (QBPDS)

Functional disability related to low back pain was assessed using the Turkish version of the Quebec Back Pain Disability Scale (QBPDS). The QBPDS consists of 20 items assessing limitations in activities involving spinal movement and load transfer. Each item is rated from 0 to 5, yielding a total score from 0 to 100. Higher scores indicate greater functional disability. Change scores were calculated as the 4-week follow-up score minus the baseline score, with negative change scores indicating improvement.

Oswestry Disability Index (ODI)

Functional disability related to low back pain was assessed using the Turkish version of the Oswestry Disability Index (ODI). The ODI consists of 10 sections assessing pain intensity and limitations in activities such as personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and sexual activity. Each section is scored from 0 to 5, and the total score is expressed as a percentage from 0% to 100%, with higher scores indicating greater disability. Change scores were calculated as the 4-week follow-up score minus the baseline score, with negative change scores indicating improvement.

Visual Analog Scale (VAS) for Pain Intensity

Current pain intensity was assessed using a 10-cm Visual Analog Scale (VAS), anchored by 0 ("no pain") and 10 ("worst imaginable pain"). Participants marked their current pain intensity on the line, and the distance from the 0 anchor was measured in centimeters. Higher scores indicate greater pain intensity.

Global Perceived Effect (GPE) Scale

Perceived change in overall condition was assessed at the 4-week follow-up using a 7-point Global Perceived Effect (GPE) scale ranging from "much worse" to "much improved." The GPE was used as an external anchor for responsiveness and minimal important change analyses. For anchor-based analyses, participants reporting "improved" or "much improved" were classified as improved, and all other participants were classified as not improved. Participants reporting "no change" were considered stable for reliability analyses.