Cross-Cultural Adaptation and Psychometric Validation of the Persian Version of the Movement-Specific Reinvestment Scale in Individuals With Chronic Low Back Pain

Abstract

Objectives: Movement-specific reinvestment reflects a tendency to consciously monitor and control movements and may contribute to altered motor behavior in individuals with chronic low back pain (CLBP). This study aimed to translate and culturally adapt the Movement-Specific Reinvestment Scale (MSRS) into Persian and to evaluate the reliability and validity of the Persian version (MSRS-P) in individuals with and without CLBP. Methods: This cross-sectional study included 153 Persian-speaking adults classified into three groups: non-low back pain (non-LBP), CLBP without central sensitization (CS), and CLBP with CS. The MSRS was translated using standardized forward-backward procedures. Internal consistency, test-retest reliability, construct validity, known-groups validity, and factor structure were examined using exploratory and confirmatory factor analyses. Results: The MSRS-P demonstrated acceptable internal consistency (Cronbach’s alpha = 0.83 total score) and good test-retest reliability (ICC[2,1] = 0.81-0.84). Known-groups analyses showed significantly higher MSRS-P scores in participants with CLBP and CS compared with non-LBP controls and CLBP without CS. Moderate correlations between MSRS-P scores and measures of disability and anxiety were observed in individuals with CLBP without CS, whereas these associations were weaker in those with CLBP and CS. Factor analyses supported a two-factor structure reflecting Conscious Motor Processing and Movement Self-Consciousness. Conclusion: The MSRS-P is a reliable and valid instrument for assessing movement-specific reinvestment in Persian-speaking individuals with CLBP. The scale may be useful for identifying patients with heightened conscious motor control tendencies, particularly in those with central sensitization.