Relationships Among Selected Measures of Impairment, Functional Limitation, and Disability in Patients With Cervical Spine Disorders

Abstract

Background and Purpose. Little is known about the relationship among impairments, functional limitations, and disability in people with cervical spine disorders (CSD) despite the fact that these concepts are routinely used in clinical practice. The primary purpose of this study was to investigate the relationships among commonly assessed impairment, functional limitation, and disability measures in patients with CSD. A secondary purpose was to determine the influence of payment source and time since onset of symptoms on these same measures. Subjects. Eighty patients (mean age=45.7 years, SD=15.9, range= 20–88) with CSD who were referred for physical therapy participated in the study. Methods. Data were obtained for 3 measures of impairment, 2 measures of functional limitation, and 3 measures of self-reported disability during the initial visit. Results. All 3 sets of variables (ie, impairment, functional limitation, disability) correlated with each other, with the highest correlation occurring between the impairment measures and the functional limitation measures (r=.82). Other correlations were noted between individual variables. There was no effect of payment type or time since onset of symptoms on the variables. Conclusion and Discussion. Positive correlations were noted among the 3 sets of measures, which supports the assumption that impairments, functional limitations, and disability are related in patients with CSD.

The reliability of the Vernon and Mior neck disability index, and its validity compared with the short form-36 health survey questionnaire

“…Our study has shown that the NDI is valid and reliable in spinal surgery patients and is comparable with the SF36. The male to female ratio in our study is similar to that in other studies [1,[10][11][12][13]22]. The average age of patients in previous studies ranges from 32 to 46 years and the average NDI from 30 to 41% [1, 5, 11-13, 21, 22].…”

The Effect of Chronic Neck Pain and Training on Directional Specificity of Neck Muscle Activation

“…The NDI score explained 13.8% of the variation in Average MVC which is in agreement with previous studies (71,72); however it is not clear which aspects of perceived disability are correlated to MVC since the questionnaire assesses pain and limitations in physical and cognitive performance during leisure or work (76). When NDI and Contraction pain were combined in the multivariate regression, NDI explained an additional 4.2% which suggests that the patient's current pain is one of the main factors contributing to the regressions results although not the only one.…”

“…Some studies indicate that side to side differences in muscle activity exist in patients with unilateral neck pain (89) suggesting that it would have been relevant to assess the outcome measures ipsilateral to the side of greatest pain. However previous studies also suggest that averaging of outcome measures results in stronger correlations between physical impairments, pain and disability compared to correlations of non-averaged measures (34,71,72). Since the vast majority of patients reported bilateral pain, we selected to average the data in this Study.…”

“…In Study 3 the maximum force for each direction of flexion, extension, left and right lateral flexion were averaged (Average MVC) and entered in a regression analysis as the dependent variable. In Study 3, the Average MVC was selected as a representative measure of the subject's global neck strength, as previous reports of averaged and non-averaged MVC indicate that averaging improves sensitivity to measures of neck pain (34,71,72).…”

Physical capacity in non‐ambulatory people with Duchenne muscular dystrophy or spinal muscular atrophy: a longitudinal study

“…The variable contributing most to functional ability was, expectedly, MRC%; an assumption supported by the relation between EK sum and MRC%, being the closest of the three variables examined in the participants with DMD and SMA. Because maintaining functional ability is often the primary goal of rehabilitation, those measures which are most closely related to functional ability are important to identify (Hermann and Reese 2001). DMD Among participants with DMD the variables EK sum, MRC%, and FVC% appeared to be related as measures of change per year (see Figs 4a to c).…”