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JH Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients: Long-Term Predictive Validity of Pretreatment and Posttreatment Change Scores and Stability of Posttreatment Scores. Please enable scripts and reload this page. The https:// ensures that you are connecting to the Although we contend that the modified Oswestry Disability Questionnaire, the SF-36 Physical Functioning scale, and the Quebec Back Pain Disability Scale appear to be the most useful measures of functional outcome for people with low back pain, there are practical considerations that also influence the choice of questionnaire. (Grade of recommendation: B) [2]The construct validity of the English, French and Dutch versions is good. Besides treating back pain, there is a need for using appropriate and suitable outcome measures in clinical practice. DL G We used the original Roland-Morris Disability Questionnaire,11 the final format of the Quebec Back Pain Disability Scale recommended by the developers,10 the Waddell Disability Index wording from Delitto,2 and the Australian version of the SF-36.32 Characteristics of the 5 questionnaires are shown in Table 1. RD Find it on PubMed, Roland, M. and Morris, R. (1983). The strength of this aforementioned study is that this article has considered the specific outcome measures ('Back pain functional scale', 'Roland-Morris scale, 'Oswestry disability scale', and 'Short form 36 surveys') used to assess physical function and found its correlation to get clear glimpses for evidence-based practice in clinical settings. Correlations of 0.56 and 0.65 were noted between a prognostic rating of change and the RMQ and BPFS, respectively. Candice G. asks how to avoid the aches of working in the garden. Before 2022 Oct 5;13:900308. doi: 10.3389/fneur.2022.900308. We chose the SRM because it is the only distribution-based method for which a method of hypothesis testing has been described.27,37 We believe there is considerable opportunity in the repeated iterations of Liang and colleagues' complex SRM procedure37 for error. (Grade of recommendation: B) [2], External construct/convergent validity: There is a moderate to strong correlation between the Quebec back pain disability scale (QBPDS) and other disability questionnaires (Grade of recommendation: B): - QBPDS and Roland-Morris disability questionnaire: r= 0,77-0,81 - QBPDS and Oswestry disability index: r= 0,80- 0,83 - QBPDS and physical function subscale of SF-36: r=0,67- 0,77 [4], The correlation between the QBPDS and pain (r=0,54- 0,74), psychosocial variables, and direct measures of physical function is weak to moderate. A ceiling effect was noted for 6 patients' RMQ scores compared to 3 patients' BPFS scores. The back pain functional scale: Features and applications A tool often used to assess back pain and functional abilities in athletes is the Micheli Functional Scale (MFS) [48], whereas the Athletes Disability Index [10] is employed to evaluate disability due to LBP. JM Verywell Health's content is for informational and educational purposes only. Measurements obtained with the modified Oswestry Disability Questionnaire, the SF-36 Physical Functioning scale, and the Quebec Back Pain Disability Scale were the most reliable and had sufficient width scale to reliably detect improvement or worsening in most subjects. RA You may search for similar articles that contain these same keywords or you may . Internal consistency for the RMQ and BPFS were 0.87 and 0.93, respectively. come following therapeutic interventions for low back pain (20-28), including older patients (29). Heppner and C.H. Dr. Smith explains how exercising incorrectly can hurt. J Int Med Res. (VAS) and a modified Laitinen's pain questionnaire were carried out four times (before the start of the therapy, in the middle of it . The QBPDS can be completed by patients by using paper and pen, mail, or telephone. Although the ICCs for the subgroup who rated themselves as about the same were somewhat stronger, they were still weak (ICC=.47 and .59), and the lower bound of the CIs approached zero. 1-844-355-ABLE. Scores for the individual questions are summed to provide a single index score for each questionnaire, and higher scores indicate greater activity limitation. eCollection 2022. The BPFS is a competitive functional status measure for patients with low back pain. The reliability of measurements obtained with the Waddell Disability Index was moderate, but the scale appeared to be insufficient to recommend it for clinical application. 2013 Apr 26;14:148. doi: 10.1186/1471-2474-14-148. Test-retest reliability was examined for a group of 47 subjects who were classified as unchanged and a subgroup of 16 subjects who were self-rated as about the same. Responsiveness was compared using standardized response means, receiver operating characteristic curves, and the proportions of subjects who changed by at least as much as the minimum detectable change (MDC) (90% confidence interval [CI] of the standard error for repeated measures). Critical comparison of nine different self-administered questionnaires for the evaluation of disability caused by low back pain. Error estimates in scale points were obtained. Top Contributors - Laura Vander Goten, Berdien De Koster, Uchechukwu Chukwuemeka, Lucinda hampton, Mariam Hashem, WikiSysop, Kim Jackson, Amrita Patro, Nupur Smit Shah, 127.0.0.1 and George Prudden, The Quebec back pain disability scale (QBPDS) is a condition-specific questionnaire developed to measure the level of functional disability for patients with low back pain (LBP) that was designed, developed, and validated by Kopec et al in 1995. This scale asked subjects to rate the extent to which their back problem had changed over the past 6 weeks. The proliferation of responsiveness measures and debate concerning methods for determining responsiveness suggest that the optimal way to quantify this relatively recently conceptualized psychometric property of tests has not been described.27,28,48,50 The validity of scores obtained with a responsiveness index could be demonstrated by testing whether the index is able to discriminate between a test that is known to be responsive and one that is known not to detect change over time in a particular clinical population. Lydick Reliability and validity of the Dutch adaptation of the Quebec Back Pain Disability Scale, Outils de mesure des paramtres fonctionnels dans la lombalgie [Low back pain disability assessment tools], The Quebec Back Pain Disability Scale: conceptualization and development, European guidelines for the diagnosis and treatment of pelvic girdle pain, The joint contribution of physical pathology, pain-related fear and catastrophizing to chronic back pain disability, A comparison of five low back disability questionnaires: reliability and responsiveness, Sensitivity to change of the Quebec Back Pain Disability Scale and the Dallas Pain Questionnaire, http:///index.php?title=Quebec_Back_Pain_Disability_Scale&oldid=322082, Bed/rest items 13, Sitting/standing items 46, Ambulation items 79, Movement items 1012, Bending/stooping items 1316. KM Table 4 shows that for the 47 subjects who were classified as unchanged, there was no difference between initial and follow-up scores on any questionnaire except the SF-36 Bodily Pain scale. Enter your zip code . Philanthropic support truly drives our mission and vision. Samsamshariat S, Sharifi-Sade M, Zoofaghari S, Mehr AM, Sabzghabaee AM. The .gov means its official. By tracking changes in the total score on the Oswestry Disability Index before, during, and after treatment, healthcare providers can better assess whether treatment is effective in improving symptoms. A Comparison of Back Pain Functional Scale With Roland Morris - PubMed "A comparison study of the back pain functional scale and Roland Morris Questionnaire. If this is an emergency, please dial 911. HHS Vulnerability Disclosure, Help [4][2][5], The Quebec back pain disability scale consists of 20 daily activities that can be categorized into 6 types of activities:[1][2], The various components of the questionnaire were selected from a larger pool of items based on test-retest reliability, item-total correlations, and responsiveness of individual items and by using techniques of factor analysis and item response theory. There was a good correlation among the 5 functional outcome measures (correlation r = -0.693 for BPFS/RMQ, r = -0.794 for BPFS/ODI, r = 0.697 for BPFS/SF-36 Physical function and r = 0.540 for BPFS/SF-36 Pain). [9] In addition, the scale is able to recognize small changes in the level of disability over time. They found an ICC of 0,85 ([95% CI] 0,73-0,91). Furthermore, the maximum score obtained indicates the maximum physical abilities of the patients. NK Medtronic has the only MIS+ portfolio that blends AI powered data science, robotics, navigation, spinal access, patient-specific implants and biologics to revolutionize streamlined workflows all under one roof. 2015 Jan-Mar;38(1):33-9. doi: 10.1519/JPT.0000000000000021. The SRM was calculated by dividing the mean change by the standard deviation of change scores.10,20,27,37 We chose the SRM because a method of testing the significance of observed differences in SRMs has been described by Liang et al.37 Confidence intervals were constructed using the jackknife method detailed by Liang et al,37 and a paired t test was used to compare the estimated population SRMs derived by this method.27,37 Rather than compare the SRMs for questionnaires using every possible pair-wise comparison, we limited the number of comparisons by comparing the highest and lowest SRMs until nonsignificant comparisons occurred. This is called the minimum detectable change (MDC) and has been defined by Stratford et al17 as the amount of change required to be 90% confident that an observed change in scores reflects real change in the underlying variable. Shirley Ryan AbilityLab does not provide emergency medical services. (Grade of recommendation: A) [2][4], Content and face validity: The questionnaire contains various domains of activities that patients and care providers deem important. Five questionnaires met these criteria: the modified Oswestry Disability Questionnaire, 8, 9 the Quebec Back Pain Disability Scale, 10 the Roland-Morris Disability Questionnaire, 11 the Waddell Disability Index, 12 and the physical health scales of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Enter your zip code . National Library of Medicine Back Pain Function Scale, comparison, correlation, evaluation, functional status, low back pain, Oswestry Disability Index, Roland Morris questionnaire, self-reported outcome measure, SF-36. You feel no need to seek treatment or medical attention. The SF-36 takes about 10 minutes to complete, and a scoring algorithm is used to calculate scores.32, Characteristics of the Oswestry Disability Questionnaire,8,9 Quebec Back Pain Disability Scale,10 Roland-Morris Disability Questionnaire,11 Waddell Disability Index,12 and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) Physical Functioning, Role Limitations-Physical, and Bodily Pain Scales13,14. A Young Scientist's Journey after a Stroke, Care by the Numbers: Skilled Nursing versus Inpatient Rehabilitation, WSJ: Recognizing Aphasia and Seeking Treatment, Shirley Ryan AbilityLab Ranked No. Roland-Morris Disability Questionnaire | RehabMeasures Database 88 were obtained for the RMQ and BPFS, respectively. , de Vet HCW, Koke AJA. Patient self-ratings, or averages of patient and therapist ratings of overall change, are commonly used as the criterion of change because of the valued perspective of the rater(s) and because the information can be collected easily. The reliable-change method, in our opinion, provides practical information for clinical application in that it answers the question, In what proportion of my patients is this questionnaire likely to detect change beyond the amount that can be attributed to measurement error? The limitation of this method is that the MDC may not be known for many questionnaires and clinical tests. Validation of the Roland Morris Questionnaire in Colombia to Evaluate Disability in Low Back Pain. Arch Orthop Trauma Surg. Spine (Phila Pa 1976). Development and initial validation of the back pain functional scale 2006 Jun 15;31(14):E454-9. When based on the smaller subgroup in our study, the MDC might be as low as 16. JCT Rob Smeets. All scales scored 0100, except Roland-Morris Disability Questionnaire (024) and Waddell Disability Index (09). Chatman A, Neel J, Hyams S, Binkley J, Stratford P, Schomburg A, et al. Kersten RFMR, Fikkers J, Wolterbeek N, ner FC, van Gaalen SM. Yu Z, Yin Y, Wang J, Zhang X, Cai H, Peng F. Int J Environ Res Public Health. Region-specific questionnaires for low back pain are thought to have the advantage of containing only items that are relevant to people with low back problems, whereas generic tools can be used across a wide range of conditions. Abdullahi A, Aliyu K, Hassan AB, Sokunbi GO, Bello B, Saeys W, Truijen S. Front Neurol. People with back problems may find it difficult to perform some of their daily activities. No authors have reported the MDC for the modified Oswestry, Quebec, and Waddell questionnaires or the SF-36 physical health scales. Instructions: page. This result illustrates that the amount of change in questionnaire scores perceived by the client to be meaningful may be smaller than the amount of change required to be statistically 90% confident that score change is not just measurement error (the MDC). A "gold standard" to evaluate disability in low back pain does not exist, but only 4 tools (the Dallas Pain Questionnaire, Roland Disability Questionnaire, Quebec Back Pain Disability Scale and Oswestry Low Back Pain Disability Questionnaire) demonstrated strong qualities (content and construct validity, feasibility, linguistic adaptation and international use). For the Roland-Morris questionnaire, reported reliability estimates ranged from .91 for same-day administration,11 ICC=.93 for 1 to 14 days,10 and ICC=.86 over 3 to 6 weeks.25 No test-retest reliability studies have been reported for the Waddell index, although one research group12 reported interrater reliability (kappa >.60) for each of the 9 questions administered by interview. Only 5 subjects reported any overall worsening of their condition. , Fossel AH, Larson MG. Goldie Functional status and disability questionnaires: what do they assess? Zimmerman I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Because of this and the good measurement properties, the content and face validity is good. Should You Have Disc Replacement Surgery or a Spinal Fusion? We also identified 10 generic tools proposed to assess outcome in low back pain, which are more conceptually linked to perceived health status, quality of life, and pain assessment. There are 36 translations and adaptations available, including minor adaptations for U.S., Canadian and Australian English. However, these scales were designed to evaluate back pain in the general population with low physical and functional activity output (12, 16, 17). (Grade of recommendation: B) [2], The patients and the clinicians both accept the use of the QBPDS. Address correspondence and reprint requests to Meltem Ko, MSc, Mugla Stk Kocman University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, S block Mula 48000, Turkey; E-mail: [emailprotected]. The BPFS is a self-report measure that evaluates a patient's functional status related to back pain. Bookshelf Fairbank We would like to know if you find it difficult to perform any of the . BPFS demonstrated good correlation with RMQ, ODI, SF-36 physical function, and SF-36 pain. , de Vet HCW, Koke AJA, et al. Or Call Toll-Free These are the Numerical rating scale (NRS), Roland-Morris disability questionnaire (RMDQ), Back pain functional score, Oswestry disability index (ODI), Pain self-efficacy Questionnaire (PSEQ) and the patient-specific functional scale (PSFS) in order to assess and treat back pain efficiently. Or Call Toll-Free GR , Maher C. Delitto This margin of detection is lower in chronic low back pain patients compared with acute low back pain patients. The Quebec questionnaire total score was calculated by summing the 20 individual item scores. To reach the aim of this research; Problem-solving Inventory (PSI) developed by P.P. Based on these data, the Physical Functioning scale is the most relevant of the SF-36 physical health scales, and it can be easily hand-scored. Stratford Intraclass correlation coefficients for this group of 37 subjects were identical or similar to those for the group that was classified as unchanged using the global change scale. The ICCs exceeded .80 for the Oswestry and Quebec questionnaires and the SF-36 Physical Functioning scale for the unchanged group of 47 subjects, and the ICCs for these questionnaires were higher than for the Roland-Morris questionnaire or the SF-36 Role LimitationsPhysical or Bodily Pain scale (there was no overlap of 95% CIs for the reliability coefficients). The role of functional status questionnaires for low back pain Reliability coefficients for a group of 37 subjects with back pain of more than 6 months' duration were similar or identical to the coefficients for the group that was classified as unchanged.. JG Liang You may be trying to access this site from a secured browser on the server. Outpatients with low back pain diagnosed with a musculoskeletal origin: (Stratford et al, 1996;n= 60; mean age=41 (12); questionnaires given at initial evaluation and four and six week follow-ups. Coakes , Couper J, Davies JB, O'Brien JP. 2016:5. Pain Self-Efficacy Questionnaire (PSEQ) - Physiopedia , Epstein RS. P Further research is required to know the sensitivity of this scale over time. . The BPFS is a self-report measure that evaluates a patient's functional status related to back pain. D This site needs JavaScript to work properly. Oswestry Disability Index - Physiopedia American Academy of Orthopedic Surgeons. In addition, 67 subjects (32%) who initially agreed to participate failed to return the first set of questionnaires, and it is not known whether this group was different from those who actually participated in the study. Subjects in our study who reported no change but whose Roland-Morris questionnaire scores suggested they had changed, tended to have had their low back problem for more than 6 months. The third method, which calculates the proportion of subjects who change by at least as much as the MDC has not previously been used and can be termed a reliable-change approach. We defined low back pain as pain in the lumbar region with or without referral of pain to the lower extremities. The ICCs for the Role LimitationsPhysical and Bodily Pain scales of the SF-36 in our study were considerably lower than those reported by Patrick et al22 (ICC=.80 and .67). In contrast, we drew our sample from a range of physical therapy outpatient services, and we believe that our subjects were more likely to be more variable and more closely representative of the general clinical population in a health care system where patients may consult a physical therapist with or without referral from a physician. 1 by U.S. News & World Report for 32nd Consecutive Year, Amicous Disorders of Consciousness (DoC) Program, Community-Ready Upper Extremity Interactive Rehabilitation, Dr. Richard Lieber Awarded VAs Highest Honor in Rehabilitation Research, Global Advisory Services Hospital Training & Consulting, Medical Student Education & Residency Program, Bundled Webinars: Spinal Cord Injury (3 Titles), 1 Year Webinar Package - Unlimited Access, Making Waves Following a Spinal Cord Injury, Full Circle After a Non-Traumatic Brain Injury, An Unanticipated Head Injury and Incredibly Bright Future. . The 95% CI for the Waddell questionnaire overlaps with those of all the other scales. Even without the Bonferroni adjustments for the multiple post hoc comparisons, there were no observed differences in area under the ROC curves among the different instruments. Muller U, Roeder C, Dubs L, et al. [2] The English, French and Dutch versions have good test-retest reliability. If a clinician sees few patients with low back problems and fast processing of results is the primary consideration, then the Waddell Disability Index may be appropriate. The results of the reliability portion of our study indicated that the modified Oswestry Disability Questionnaire, the SF-36 Physical Functioning scale, and the Quebec Low Back Disability Scale were the most reliable and had sufficient scale width to detect improvement or worsening in most subjects. Questionnaires sent by mail had a higher rate of incomplete questionnaires (10.8%). HHS Vulnerability Disclosure, Help If the score is less than 7, thenthe MCID = 30% change in score. Please enable it to take advantage of the complete set of features! The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). For the Oswestry questionnaire, the sum of the section scores was divided by the total possible score (50 if all sections are completed), and the resulting total was multiplied by 100 to yield a percentage score. FOIA PW J Int Med Res. It has been demonstrated, however, that even severely abnormal distributions have little effect on the result of the t test or the F test when the samples come from the same population, and violation of the homogeneity of variance assumption has little effect on the result provided the sample sizes are the same.34 To check the validity of measurements obtained with our post hoc method of identifying a stable group of subjects, we calculated ICCs for another group of subjects, those with back pain of more than 6 months' duration, who a priori could be expected to experience little change over a 6-week retest period. Methods of exploring responsiveness can be classified either as those that measure change alone (distribution-based methods) or those that measure clinically meaningful change (criterion-based methods).27,28 Criterion-based methods require that a judgment be made as to whether clinically meaningful change has occurred over the retest period. Itemswere pulled from already existing instruments, such as SIP, OLBPD, QBPD, Dallas Pain Questionnaire (DPQ), RMQ, MOS-36, and PSFS, and interviews with physical therapists (Longo et al., 2010). European Spine Journal. The Quebec back pain disability scale is able to distinguish the difference between patients disability levels and self-rated health. Four tools are recognised as having good psychometric properties and are widely used with linguistic adaptations in different countries. 1173185. Scale Width of Questionnaires at Initial Measurementa, SF-36=Medical Outcomes Study 36-Item Short-Form Health Survey.13,14, bSubjects who self-rated their condition as about the same or a little better/worse and who were classified as unchanged.. In most cases Physiopedia articles are a secondary source and so should not be used as references. The BPFS and RMQ were administered on multiple occasions to 153 patients with low back pain attending physical therapy. 2020 Mar;36(3):227. doi: 10.1097/AJP.0000000000000796. Maras G, Sheidayi S, Yazici G, Yazici MV, Gunaydin G, Citaker S. Asian Spine J. Measurement properties." Johnsen LG, Hellum C, Nygaard OP, Storheim K, Brox JI, Rossvoll I, Leivseth G, Grotle M. Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease. Thirty subjects scored 0, the worst possible score, at both pretest and posttest, but many others showed large improvements and worsening. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Clin J Pain. Patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain. official website and that any information you provide is encrypted Questionnaire Initial and Follow-up Scores for Subjects Classified as Unchanged and Improveda. Spine 25(16): 2095-2102. The test-retest reliability of measurements obtained with the Waddell Disability Index has not previously been reported for a self-administered version of the questionnaire. Clinically important outcomes in low back pain. Thank you for submitting a comment on this article. Reliability, cross-sectional validity, and longitudinal validity (sensitivity to change) coefficients were calculated. (Grade of recommendation: B) [7], Construct validity: Construct validity investigates whether the correct variables were measured in relation to the predefined variables. Find it on PubMed, Stratford, P. W., Binkley, J., et al. Results: , Young NL. * Test-retest reliability was explored for a subgroup of patients who were identified post hoc as not changed by what we believed to be a clinically meaningful amount over the 6-week retest period. The Back Pain Functional Scale (BPFS) is a subjective scale used to measure the patient's physical function after low back pain. These are 'Roland-Morris disability scale', 'Oswestry disability scale', and 'Short form 36 surveys'. government site. (Stratford et al, 2000;n= 77 patients with low back pain who were referred by physicians to 10 outpatient physical therapy clinics located in Canada and the United States; sex = 47 females and 30 males; median age = 44 years; mean duration of symptoms associated with the current episode of back pain was 4.5 weeks, Back Pain), (Stratford and Binkley, 2000;n= 153 patients with low back pain attending physical therapy; 11 Canadian clinics and 8 American clinics participated in the study, Back Pain), Excellenttest-retest reliability (ICC = 0.82), Excellentinternal consistency (ICC = 0.93), There was a ceiling effect for three patients' scores. Accuroc uses a chi-square statistic to compare ROC curves for different questionnaires. 1 by U.S. News & World Report for 32nd Consecutive Year, Amicous Disorders of Consciousness (DoC) Program, Community-Ready Upper Extremity Interactive Rehabilitation, Dr. Richard Lieber Awarded VAs Highest Honor in Rehabilitation Research, Global Advisory Services Hospital Training & Consulting, Medical Student Education & Residency Program, Bundled Webinars: Spinal Cord Injury (3 Titles), 1 Year Webinar Package - Unlimited Access, Making Waves Following a Spinal Cord Injury, Full Circle After a Non-Traumatic Brain Injury, An Unanticipated Head Injury and Incredibly Bright Future.