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F224 EFFECTIVENESS OF SPINAL MANIPULATIVE THERAPY ON CHRONIC NONSPECIFIC LOW BACK PAIN
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
36, Beck Ccales, the McGill Pain Questionnaire and the Inability to Rolland-Morris). Results: The average age in the study population was 45±12.46 years. Most were male (66.7%), married (77.8%), with elementary school (72.2%) and low family income (50.0%). Most patients reported maintenance or worsening of pain after surgery (60.0%) and 38.9% were unable to perform their professional activities. The pain was intense and continuous in 50.0% and 61.1% of patients respectively. In the multidimensional assessment, the most affected areas were the affective (76.6%) and evaluative (89.0%). Most of them have moderate to severe depression (50%) and anxiety (55.6%). Low physical function was frequent (61.1%). Quality of life domains especially “role limitations because of physical health problems” and “physical functioning” were predominantly unsatisfactory (94.4% and 83.3%, respectively). Conclusions: The pain, inability to work and impairment quality of life were relevant, reflecting in a high frequency of severe anxiety and depression, demonstrating the importance of clinical monitoring these patients for a long period postoperatively. Disclosure: None declared
F222 CORRELATIONS BETWEEN QUANTITATIVE SENSORY TEST AND INFRARED THERMOGRAPHY IN LOW BACK PAIN PATIENTS – A PILOT STUDY I. Raicher1 , M.L. Brioschi1 , L.T. Yeng1 , R. Galhardoni1 *, H.H.S. Kaziyama1 , C.M. Nishimura2 , J.O. Araujo1 , M.J. Teixeira1 , D.C. Andrade1 . 1 Pain Center Departament of Neurology, Hospital das Clinicas – School of Medicine – University of S˜ ao Paulo, 2 Cancer Institute of the State of S˜ ao Paulo Ot´ avio Frias de Oliveira, Brazil, S˜ ao Paulo, Brazil Background: Infrared Thermography (IT) has been proposed as a potential tool to assess musculoskeletal pain. However, there is a paucity of studies evaluating the correlations between low-back pain, trigger-points (TrP) and thermogram data. Methods: thirty patients with primary low-back pain (average pain VAS >30 mm) and active TrP were included. They filled out the first part of the Brief Pain Inventory and underwent low-back IT and mechanical quantitative sensory testing (mechanical detection, pain and supra-threshold-MDT, MPT, MSupra) of four points marked on the skin: the most intense pain location (MIPL) as pointed by the patient, its mirror area in the contrallateral side (MIPL-mirr); the skin area over the main active trigger point (MATP) and its mirror area (MAPT-mirr). MIPL was central (MIPLA-C) when located +/−1 cm from the midline and lateralized (MIPL-L) when >1 cm. IT: patients were evaluated unclothed, two meters away from the camera in a 22°C room (A320, FLIR, USA). Results: Twenty-eight patients were included (47 years, 22 female; VAS = 51 mm). MIPL-L was lower than MIPL-C [40.0 (12–93) vs. 69.2 (34–90; p = 0.009). MSupra in MIPL-C was more intense than in MIPL-L (81.6±15 vs. 66.0±20.1;p = 0.049). The difference between MIPL and MIPL-mirr MSupra scores correlated to the lwVAS score (rho = 0.51). MIPL and MATP X and Y coordinates showed high correlation (rho = 0.76 and 0.50). Temperature on MIPL and MTPL correlated (rho = 0.83). Conclusions: Centrally located pain was more intense and presented higher mechanical hyperalgesia than lateralized pain. The area of maximal pain was spatially close and presented similar temperature as the area over the MATP. Disclosure: None declared
131
F223 DOES PAIN-RELATED ENDURANCE YIELD A STRESS-REDUCING EFFECT? HPA-AXIS ACTIVITY IN LBP PATIENTS AND HEALTHY CONTROLS 1 T. Mollenberg ¨ *, M.I. Hasenbring1 , R. Willburger2 , B. Fricke3 , 4 H. Klein , K. Schmieder5 , S. Sudhaus1 . 1 Dept. of Medical Psychology and Medical Sociology, Faculty of Medicine, 2 Dept. of Rheumaorthopaedic Surgery, St. Elisabeth Hospital, Orthopaedic University Clinic of Bochum, 3 Dept. of Neuroanatomy and Molecular Brain Research, Faculty of Medicine, 4 Medical Dept. 1, Division of Endocrinology and Metabolism, BG University Hospital Bergmannsheil, Ruhr-University of Bochum, Bochum, 5 Neurosurgery Dept. of the Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany Background and Aims: Preliminary research indicates a heightened cortisol awakening response (CAR) in patients with acute pain compared to pain-free controls. Recently, correlation studies indicated a stress-increasing effect of fear-avoidance responses (FAR) on CAR, versus a stress-reducing effect of endurance responses (ER). The aim of the present study was to examine differences in CAR between subgroups of acute/recurrent LBP patients due to FAR and ER. Methods: 55 acute/recurrent LBP patients, classified into FAR (N = 12), eustress endurance responses (EER, N = 16), distress endurance responses (DER, N = 11) and adaptive pain responses (AR, N = 16) were compared to 14 healthy controls. To measure the CAR, all participants provided 5 saliva samples (0, 15, 30, 45, and 60 minutes after awakening) on two consecutive days, using the two-days mean value. The “area under the curve with respect to ground” (AUCG) was calculated measuring CAR. Psychological pain responses were assessed using the Avoidance-EnduranceQuestionnaire (AEQ), and the Beck Depression Inventory (BDI). Results: Analysis of covariance (age as covariate) revealed a significant group effect (F4 = 5.637, p < 0.01) for AUCG. Single contrasts indicated significant lower AUCG in CG and EER compared to AR and FAR. DER patients showed a CAR level between CG/EER and AR/FAR. Among the LBP group, both ER subgroups showed higher pain intensity than AR patients, FAR scored higher in pain at a trend. Conclusions: Pain itself yielded a stress increasing effect as indicated by the CAR, while the EER pattern seems to enable patients to reducing this increase to a level comparable to healthy controls. Disclosure: None declared
F224 EFFECTIVENESS OF SPINAL MANIPULATIVE THERAPY ON CHRONIC NONSPECIFIC LOW BACK PAIN N. Yagci *, E. Aslan Telci, B. Basakci Calik, U. Cavlak. School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey Background and Aims: Low back pain is one of the most common problems in world wide. Spinal manipulative therapy (SMT) is commonly used to treat low back pain patients. The aim of this study was to determine effect of SMT on pain intensity, trunk muscle endurance, disability level and patient satisfaction in subjects with chronic nonspecific low back pain (CNLBP). Methods: Forty-one patients with CNLBP lasting at least 6 months (mean of pain duration: 62.93 month). The sample recruited among 216 patients suffering from CNLBP, randomly. All enrolled in a physiotherapy program including SMT (i.e., vertebral manipulation, mobilization, facials release technique). Before and after the treatment, the Visual Analogue Scale (VAS) for pain intensity and patient satisfaction, a trunk raising test for flexion endurance, a modified Sorenson test for extension endurance, and the Roland Morris Disability Questionnaire (RMDO) for disability level were
132
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
used. The subjects received 10 sessions (2–3 times a week) for 4 week. Results: The results of this study showed that significant improvements in terms of pain intensity (p = 0.0001), muscle endurance (p = 0.019), and disability level (p = 0.011) were found after the program. Patient satisfaction score obtained after the program was seen to be 8.32/10. There was a significant negative correlation between patient satisfaction and the mean score of RMDO (mean; 15.38) (p < 0.001). Conclusions: This study showed that SMT is effective approach to reduce pain and disability level, and to improve endurance in these patients. Disclosure: None declared
F225 SEE WHAT YOU FEEL BEHIND: LOOKING AT THEIR OWN BACK REDUCES EXPERIMENTAL PAIN INTENSITY IN CHRONIC BACK PAIN PATIENTS 2 M. Diers1 *, W. Zieglgansberger ¨ , P. Yilmaz3 , R. BekraterBodmann3 , J. Foell3 , M. Rance3 , S. Kamping3 , A.M. Drevensek3 , G. Erhardt-Raum3 , J. Trojan3 , H. Flor3 . 1 Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 2 Department of Clinical Neuropharmacology, Max-Planck-Institute for Psychiatry, 3 Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Background and Aims: The body image which is often taken for granted is disrupted in patients with chronic back pain. The back is normally a rather unknown area of the body. Until now nothing is known about the influence of seeing one’s own back during painful stimulation. Methods: We tested 17 patients with chronic back pain and 17 healthy controls by implementing online video feedback of the back compared to feedback of the dorsum of the hand as well as magnified and minified video feedback of the back during pressure pain and subcutaneous electrical stimulation on the musculus trapezius. Pain threshold and pain tolerance were assessed. Pressure pain stimulation intensity was set to 50% above pain threshold. Subcutaneous stimulation intensity was set to 70% above pain threshold. Subjects had to rate pain intensity and unpleasantness after each stimulation block on an 11-point numerical rating scale. Results: Patients with chronic back pain reported significantly higher pain ratings compared to healthy controls. Visual feedback of the back reduced perceived pain intensity compared to feedback of the hand. Conclusion: It is possible that seeing the painful region makes the aversive stimulus less threatening. This finding raises the possibility that training of the body image or visual feedback of the pain region may help patients with chronic pain. Acknowledgement: This research was supported by the PHANTOMMIND advanced grant of the European Research Council (FP7/2007–2013)/ERC Grant Agreement No. 230249 Disclosure: None declared
F226 SOFT TISSUE MOBILIZATION IN THE TREATMENT OF SUBACUTE LOW BACK PAIN: A PILOT STUDY N. Yagci *, E. Aslan Telci, B. Basakci Calik. School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey Background and Aims: Episodes of subacute low back pain are common. The purpose of this study was to evaluate the effect of soft tissue mobilization on the treatment of subacute low back pain. Methods: Twenty-eight subjects (12 women and 16 men; mean age: 50.32±1.16 yr) with sub acute low back pain (mean pain duration: 1.79±0.76 month) were divided in to two groups
randomly: Group I (n = 14; 9 female, 5 male) received soft tissue mobilization three times in a week for 4 weeks. Group II (n = 14; 3 female, 11 male) treated with soft tissue mobilization plus postural training and stretching exercises. The two groups were evaluated using the Visual Analog Scale for pain, the Beck Depression Inventory (BDI) for depressive symptoms and, the Nottingham Health Profile (NHP) before and after treatment. Results: There was a significant improvement in terms of pain severity, depressive symptoms and quality of life in both groups (p < 0.05). However, there were no significant differences between two groups in all parameters (p > 0.05). There was a significant positive correlation between pain duration and pain severity in Group I (p < 0.05). There was a significant negative correlation between body weight and quality of life scores in Group II (p < 0.05). Conclusions: Our study showed that soft tissue mobilization, postural training and stretching exercises are useful to manage subacute low back pain in early term. There was no superiority to each other. Therefore, extra studies needed to show the long term effects of exercises and soft tissue mobilization techniques. Disclosure: None declared
F227 FACTOR STRUCTURE AND VALIDATION OF THE GERMAN VERSION OF THE PAIN ANXIETY SYMPTOMS SCALE (PASS-20) N. Kreddig1 *, D. Hallner1 , S. Held1 , R. Wittenberg2 , M.I. Hasenbring1 . 1 Department of Medical Psychology and Medical Sociology, Ruhr Universit¨ at Bochum, Bochum, 2 Department of Orthopaedics, St. Elisabeth Hospital, Herten, Germany Background and Aims: The PASS-20 (McCracken and Dhingra, 2002) is a 20-item self-report measure of pain anxiety. It represents a shortened version of the original 40-item PASS (Pain Anxiety Symptoms Scale). Our aim was to examine the factor structure and psychometric characteristics of the German PASS-20 in a sample (N = 192) of patients with acute, sub-acute and chronic back and leg pain. Methods: We opted for a principal component analysis with Promax rotation. Reliability was examined with Cronbach’s Alpha, convergent and divergent validity was assessed by correlating the PASS-20’s total score and subscales to measures of depression (BDI), anxiety (TSK), disability (Oswestry, PDI) and avoidance-endurancerelated pain coping (AEQ). Results: We succeeded in replicating the original 4-factor structure proposed for the PASS-20 and also kept the original subscale labels: cognitive anxiety, fear, physiological anxiety and escape/ avoidance. Reliability was satisfactory in all but one subscales, the reliability of the total score was excellent with Alpha = 0.900. Convergent (relation to depression, fear of re/injury, disability, fear-avoidant coping) and divergent validity (relation to positive mood and behavioral endurance) were moderate to high and in the expected directions. The subscales cognitive anxiety and fear showed the highest positive relations to depression, fear of re/injury, helplessness/hopelessness and catastrophizing. Escape/ avoidance showed highest correlations to avoidance of physical and social activities. Conclusions: The German PASS-20 shows satisfactory psychometric characteristics and usefulness in LBP patients. It also seemed to have benefitted from its shortening down to 20 items, which did not impair its characteristics, but instead made it more efficient. Disclosure: None declared
F228 CHARACTERISTICS IN THE FEMALE AND MALE GROUPS OF THE PATIENTS WITH FIBROMYALGIA A.A. Gassol *. Hospital Clinic, Barcelona, Spain Objectives: Of this work are, to know the labor, psychological, and sociodemographic profile of the patients with Fibromialgia so much
36, Beck Ccales, the McGill Pain Questionnaire and the Inability to Rolland-Morris). Results: The average age in the study population was 45±12.46 years. Most were male (66.7%), married (77.8%), with elementary school (72.2%) and low family income (50.0%). Most patients reported maintenance or worsening of pain after surgery (60.0%) and 38.9% were unable to perform their professional activities. The pain was intense and continuous in 50.0% and 61.1% of patients respectively. In the multidimensional assessment, the most affected areas were the affective (76.6%) and evaluative (89.0%). Most of them have moderate to severe depression (50%) and anxiety (55.6%). Low physical function was frequent (61.1%). Quality of life domains especially “role limitations because of physical health problems” and “physical functioning” were predominantly unsatisfactory (94.4% and 83.3%, respectively). Conclusions: The pain, inability to work and impairment quality of life were relevant, reflecting in a high frequency of severe anxiety and depression, demonstrating the importance of clinical monitoring these patients for a long period postoperatively. Disclosure: None declared
F222 CORRELATIONS BETWEEN QUANTITATIVE SENSORY TEST AND INFRARED THERMOGRAPHY IN LOW BACK PAIN PATIENTS – A PILOT STUDY I. Raicher1 , M.L. Brioschi1 , L.T. Yeng1 , R. Galhardoni1 *, H.H.S. Kaziyama1 , C.M. Nishimura2 , J.O. Araujo1 , M.J. Teixeira1 , D.C. Andrade1 . 1 Pain Center Departament of Neurology, Hospital das Clinicas – School of Medicine – University of S˜ ao Paulo, 2 Cancer Institute of the State of S˜ ao Paulo Ot´ avio Frias de Oliveira, Brazil, S˜ ao Paulo, Brazil Background: Infrared Thermography (IT) has been proposed as a potential tool to assess musculoskeletal pain. However, there is a paucity of studies evaluating the correlations between low-back pain, trigger-points (TrP) and thermogram data. Methods: thirty patients with primary low-back pain (average pain VAS >30 mm) and active TrP were included. They filled out the first part of the Brief Pain Inventory and underwent low-back IT and mechanical quantitative sensory testing (mechanical detection, pain and supra-threshold-MDT, MPT, MSupra) of four points marked on the skin: the most intense pain location (MIPL) as pointed by the patient, its mirror area in the contrallateral side (MIPL-mirr); the skin area over the main active trigger point (MATP) and its mirror area (MAPT-mirr). MIPL was central (MIPLA-C) when located +/−1 cm from the midline and lateralized (MIPL-L) when >1 cm. IT: patients were evaluated unclothed, two meters away from the camera in a 22°C room (A320, FLIR, USA). Results: Twenty-eight patients were included (47 years, 22 female; VAS = 51 mm). MIPL-L was lower than MIPL-C [40.0 (12–93) vs. 69.2 (34–90; p = 0.009). MSupra in MIPL-C was more intense than in MIPL-L (81.6±15 vs. 66.0±20.1;p = 0.049). The difference between MIPL and MIPL-mirr MSupra scores correlated to the lwVAS score (rho = 0.51). MIPL and MATP X and Y coordinates showed high correlation (rho = 0.76 and 0.50). Temperature on MIPL and MTPL correlated (rho = 0.83). Conclusions: Centrally located pain was more intense and presented higher mechanical hyperalgesia than lateralized pain. The area of maximal pain was spatially close and presented similar temperature as the area over the MATP. Disclosure: None declared
131
F223 DOES PAIN-RELATED ENDURANCE YIELD A STRESS-REDUCING EFFECT? HPA-AXIS ACTIVITY IN LBP PATIENTS AND HEALTHY CONTROLS 1 T. Mollenberg ¨ *, M.I. Hasenbring1 , R. Willburger2 , B. Fricke3 , 4 H. Klein , K. Schmieder5 , S. Sudhaus1 . 1 Dept. of Medical Psychology and Medical Sociology, Faculty of Medicine, 2 Dept. of Rheumaorthopaedic Surgery, St. Elisabeth Hospital, Orthopaedic University Clinic of Bochum, 3 Dept. of Neuroanatomy and Molecular Brain Research, Faculty of Medicine, 4 Medical Dept. 1, Division of Endocrinology and Metabolism, BG University Hospital Bergmannsheil, Ruhr-University of Bochum, Bochum, 5 Neurosurgery Dept. of the Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany Background and Aims: Preliminary research indicates a heightened cortisol awakening response (CAR) in patients with acute pain compared to pain-free controls. Recently, correlation studies indicated a stress-increasing effect of fear-avoidance responses (FAR) on CAR, versus a stress-reducing effect of endurance responses (ER). The aim of the present study was to examine differences in CAR between subgroups of acute/recurrent LBP patients due to FAR and ER. Methods: 55 acute/recurrent LBP patients, classified into FAR (N = 12), eustress endurance responses (EER, N = 16), distress endurance responses (DER, N = 11) and adaptive pain responses (AR, N = 16) were compared to 14 healthy controls. To measure the CAR, all participants provided 5 saliva samples (0, 15, 30, 45, and 60 minutes after awakening) on two consecutive days, using the two-days mean value. The “area under the curve with respect to ground” (AUCG) was calculated measuring CAR. Psychological pain responses were assessed using the Avoidance-EnduranceQuestionnaire (AEQ), and the Beck Depression Inventory (BDI). Results: Analysis of covariance (age as covariate) revealed a significant group effect (F4 = 5.637, p < 0.01) for AUCG. Single contrasts indicated significant lower AUCG in CG and EER compared to AR and FAR. DER patients showed a CAR level between CG/EER and AR/FAR. Among the LBP group, both ER subgroups showed higher pain intensity than AR patients, FAR scored higher in pain at a trend. Conclusions: Pain itself yielded a stress increasing effect as indicated by the CAR, while the EER pattern seems to enable patients to reducing this increase to a level comparable to healthy controls. Disclosure: None declared
F224 EFFECTIVENESS OF SPINAL MANIPULATIVE THERAPY ON CHRONIC NONSPECIFIC LOW BACK PAIN N. Yagci *, E. Aslan Telci, B. Basakci Calik, U. Cavlak. School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey Background and Aims: Low back pain is one of the most common problems in world wide. Spinal manipulative therapy (SMT) is commonly used to treat low back pain patients. The aim of this study was to determine effect of SMT on pain intensity, trunk muscle endurance, disability level and patient satisfaction in subjects with chronic nonspecific low back pain (CNLBP). Methods: Forty-one patients with CNLBP lasting at least 6 months (mean of pain duration: 62.93 month). The sample recruited among 216 patients suffering from CNLBP, randomly. All enrolled in a physiotherapy program including SMT (i.e., vertebral manipulation, mobilization, facials release technique). Before and after the treatment, the Visual Analogue Scale (VAS) for pain intensity and patient satisfaction, a trunk raising test for flexion endurance, a modified Sorenson test for extension endurance, and the Roland Morris Disability Questionnaire (RMDO) for disability level were
132
POSTER SESSIONS / European Journal of Pain Supplements 5 (2011) 15–295
used. The subjects received 10 sessions (2–3 times a week) for 4 week. Results: The results of this study showed that significant improvements in terms of pain intensity (p = 0.0001), muscle endurance (p = 0.019), and disability level (p = 0.011) were found after the program. Patient satisfaction score obtained after the program was seen to be 8.32/10. There was a significant negative correlation between patient satisfaction and the mean score of RMDO (mean; 15.38) (p < 0.001). Conclusions: This study showed that SMT is effective approach to reduce pain and disability level, and to improve endurance in these patients. Disclosure: None declared
F225 SEE WHAT YOU FEEL BEHIND: LOOKING AT THEIR OWN BACK REDUCES EXPERIMENTAL PAIN INTENSITY IN CHRONIC BACK PAIN PATIENTS 2 M. Diers1 *, W. Zieglgansberger ¨ , P. Yilmaz3 , R. BekraterBodmann3 , J. Foell3 , M. Rance3 , S. Kamping3 , A.M. Drevensek3 , G. Erhardt-Raum3 , J. Trojan3 , H. Flor3 . 1 Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 2 Department of Clinical Neuropharmacology, Max-Planck-Institute for Psychiatry, 3 Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Background and Aims: The body image which is often taken for granted is disrupted in patients with chronic back pain. The back is normally a rather unknown area of the body. Until now nothing is known about the influence of seeing one’s own back during painful stimulation. Methods: We tested 17 patients with chronic back pain and 17 healthy controls by implementing online video feedback of the back compared to feedback of the dorsum of the hand as well as magnified and minified video feedback of the back during pressure pain and subcutaneous electrical stimulation on the musculus trapezius. Pain threshold and pain tolerance were assessed. Pressure pain stimulation intensity was set to 50% above pain threshold. Subcutaneous stimulation intensity was set to 70% above pain threshold. Subjects had to rate pain intensity and unpleasantness after each stimulation block on an 11-point numerical rating scale. Results: Patients with chronic back pain reported significantly higher pain ratings compared to healthy controls. Visual feedback of the back reduced perceived pain intensity compared to feedback of the hand. Conclusion: It is possible that seeing the painful region makes the aversive stimulus less threatening. This finding raises the possibility that training of the body image or visual feedback of the pain region may help patients with chronic pain. Acknowledgement: This research was supported by the PHANTOMMIND advanced grant of the European Research Council (FP7/2007–2013)/ERC Grant Agreement No. 230249 Disclosure: None declared
F226 SOFT TISSUE MOBILIZATION IN THE TREATMENT OF SUBACUTE LOW BACK PAIN: A PILOT STUDY N. Yagci *, E. Aslan Telci, B. Basakci Calik. School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey Background and Aims: Episodes of subacute low back pain are common. The purpose of this study was to evaluate the effect of soft tissue mobilization on the treatment of subacute low back pain. Methods: Twenty-eight subjects (12 women and 16 men; mean age: 50.32±1.16 yr) with sub acute low back pain (mean pain duration: 1.79±0.76 month) were divided in to two groups
randomly: Group I (n = 14; 9 female, 5 male) received soft tissue mobilization three times in a week for 4 weeks. Group II (n = 14; 3 female, 11 male) treated with soft tissue mobilization plus postural training and stretching exercises. The two groups were evaluated using the Visual Analog Scale for pain, the Beck Depression Inventory (BDI) for depressive symptoms and, the Nottingham Health Profile (NHP) before and after treatment. Results: There was a significant improvement in terms of pain severity, depressive symptoms and quality of life in both groups (p < 0.05). However, there were no significant differences between two groups in all parameters (p > 0.05). There was a significant positive correlation between pain duration and pain severity in Group I (p < 0.05). There was a significant negative correlation between body weight and quality of life scores in Group II (p < 0.05). Conclusions: Our study showed that soft tissue mobilization, postural training and stretching exercises are useful to manage subacute low back pain in early term. There was no superiority to each other. Therefore, extra studies needed to show the long term effects of exercises and soft tissue mobilization techniques. Disclosure: None declared
F227 FACTOR STRUCTURE AND VALIDATION OF THE GERMAN VERSION OF THE PAIN ANXIETY SYMPTOMS SCALE (PASS-20) N. Kreddig1 *, D. Hallner1 , S. Held1 , R. Wittenberg2 , M.I. Hasenbring1 . 1 Department of Medical Psychology and Medical Sociology, Ruhr Universit¨ at Bochum, Bochum, 2 Department of Orthopaedics, St. Elisabeth Hospital, Herten, Germany Background and Aims: The PASS-20 (McCracken and Dhingra, 2002) is a 20-item self-report measure of pain anxiety. It represents a shortened version of the original 40-item PASS (Pain Anxiety Symptoms Scale). Our aim was to examine the factor structure and psychometric characteristics of the German PASS-20 in a sample (N = 192) of patients with acute, sub-acute and chronic back and leg pain. Methods: We opted for a principal component analysis with Promax rotation. Reliability was examined with Cronbach’s Alpha, convergent and divergent validity was assessed by correlating the PASS-20’s total score and subscales to measures of depression (BDI), anxiety (TSK), disability (Oswestry, PDI) and avoidance-endurancerelated pain coping (AEQ). Results: We succeeded in replicating the original 4-factor structure proposed for the PASS-20 and also kept the original subscale labels: cognitive anxiety, fear, physiological anxiety and escape/ avoidance. Reliability was satisfactory in all but one subscales, the reliability of the total score was excellent with Alpha = 0.900. Convergent (relation to depression, fear of re/injury, disability, fear-avoidant coping) and divergent validity (relation to positive mood and behavioral endurance) were moderate to high and in the expected directions. The subscales cognitive anxiety and fear showed the highest positive relations to depression, fear of re/injury, helplessness/hopelessness and catastrophizing. Escape/ avoidance showed highest correlations to avoidance of physical and social activities. Conclusions: The German PASS-20 shows satisfactory psychometric characteristics and usefulness in LBP patients. It also seemed to have benefitted from its shortening down to 20 items, which did not impair its characteristics, but instead made it more efficient. Disclosure: None declared
F228 CHARACTERISTICS IN THE FEMALE AND MALE GROUPS OF THE PATIENTS WITH FIBROMYALGIA A.A. Gassol *. Hospital Clinic, Barcelona, Spain Objectives: Of this work are, to know the labor, psychological, and sociodemographic profile of the patients with Fibromialgia so much