Development, validity and reliability of the Italian version of the Copenhagen neck functional disability scale

Abstract

BackgroundValid and reliable patient-reported outcome measures support health professionals in evaluating the results of clinical research and practice. The Copenhagen Neck Functional Disability Scale (CNFDS) has shown promising measurement properties to measure disability in patients with neck pain, but an Italian version of this questionnaire is not available. The objective of this study was to cross-culturally adapt the CNFDS into Italian (CNFDS-I), and to assess its validity and reliability in patients with neck pain.MethodsThe CNFDS-I was developed according to well-established guidelines for cross-cultural adaptation of patient-reported outcome measures. A cross-sectional clinimetric study was conducted to evaluate its validity and reliability. Patients with chronic neck pain (pain > 3 months) participated in this study. The following measurement properties (defined by the COSMIN initiative) were assessed: structural validity (exploratory factor analysis), internal consistency (Cronbach’s α), construct validity [by testing hypotheses on expected correlations with the Neck Disability Index (NDI), the Neck Bournemouth Questionnaire (NBQ), and pain Visual Analogue Scale (VAS)]. Test-retest reliability [Intraclass Correlation Coefficient for agreement (ICCagreement)], and measurement error [Smallest Detectable Change (SDC)] were also assessed in 50 clinically stable patients. Floor/ceiling effects and acceptability were calculated.ResultsOne-hundred and sixty-two patients (mean age = 47.9 ± 14.5 years, 70% female) were included. The CNFDS-I exhibited sufficient unidimensionality (one factor explained 83% of the variability) and internal consistency (α = 0.83). Construct validity was sufficient as all correlations with the other questionnaires were as expected (r = 0.846 with NDI, r = 0.708 with NBQ, r = 0.570 with VAS). Test-retest reliability was excellent (ICCagreement = 0.99, 95% CI from 0.995 to 0.999), while measurement error was equal to 8.31 scale points (27% scale range). No floor/ceiling effects were detected. The average time for filling the questionnaire was two minutes.ConclusionsThe CNFDS-I proved to be a valid and reliable outcome measure to assess disability in patients with chronic neck pain. Head-to-head comparison studies on the CNFDS-I measurement properties against other disability measures for neck pain (e.g. NDI and NBQ) are required to determine the relative merits of these different measures.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2332-z) contains supplementary material, which is available to authorized users.

Assessment of the responsiveness of four scales in geriatric patients with chronic neck pain

“…Although, its relatively long and includes 15 questions, each question has three options 'yes, occasionally or no'. This situation reduces the time required for the questions to be answered and for the completion of the scale [ 19 ]. Having only three answer options avoids confusion in the geriatric population.…”

“…Item 15 questions whether the neck pain will affect the future or not. The total score is between 0 and 30, and higher scores demonstrate greater disability [ 19 ]. The Turkish validity and reliability of the scale was conducted by Yapali et al [ 20 ].…”

Psychometric validation of the simplified Chinese Copenhagen Neck Functional Disability Scale in patients with chronic nonspecific neck pain

“…The CNFDS was developed originally by Jordan et al in 1998 for the assessment of cervical dysfunction in patients with nonspecific neck pain and postoperative cervical conditions, and to compensate for the lack of generalizability of the NDI to the European populations 11 . Unlike the NDI and NPQ, the CNFDS was not an adaptation of any already existing scale 12 . The CNFDS consists of 15 items including pain intensity, pain interference with everyday activities and social interactions, and patient perception of the future effect of neck pain.…”

“…The CNFDS consists of 15 items including pain intensity, pain interference with everyday activities and social interactions, and patient perception of the future effect of neck pain. With a minimal amount of text, it is easily understood by patients and is time‐efficient for patients to complete 11,12 . The original version of the CNFDS and its various cross‐cultural adapted versions have all shown good reliability and validity in evaluating pain and dysfunction in patients with chronic neck pain 11–19 .…”

Cross-cultural Adaptation and Validation of the Simplified Chinese Version of the Copenhagen Neck Function Disability Scale

“…[16][17][18] The original version of CNFDS was published in English, and has been crossculturally translated/adapted into French, Polish, Turkish, Iranian, Italian, and Persian versions. [16][17][18][19][20][21] All of these versions above were proven to have good reliability and validity, which facilitated the wider use of CNFDS in assessing pain and disability associated with neck condition. Chinese is the language spoken by the largest population all over the world.…”