Responsiveness of Pain and Disability Measures for Chronic Whiplash

Stewart, Mark; Maher, Christopher G.; Refshauge, Kathryn M.; Bogduk, Nikolai; Nicholas, Michael K.

doi:10.1097/01.brs.0000256380.71056.6d

Cited by 89 publications

(82 citation statements)

References 31 publications

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“…3,4 In subsequent years, a number of other questionnaires have been introduced. These include the Whiplash Disability Questionnaire, [5][6][7] the Functional Rating Index, 8 the Northwick Park Neck Pain Questionnaire, 6,7 the Neck Pain and Disability Scale, 6 the Copenhagen Neck Functional Disability Index, 6,9,10 and the EQ-5D. 11 But to date, the NDI has been the most extensively used questionnaire in clinical trials and outcome studies.…”

Section: Introductionmentioning

confidence: 99%

“…11 But to date, the NDI has been the most extensively used questionnaire in clinical trials and outcome studies. 6,10, The general format of the NDI follows that of the Revised Oswestry Disability Index, with a 10-item subscale design. The subscales include Pain Intensity, Personal Care, Lifting, Reading, Headaches, Concentration, Work, Driving, Sleeping, and Recreation.…”

Section: Introductionmentioning

confidence: 99%

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Confirmatory Factor Analysis and Multiple Linear Regression of the Neck Disability Index: Assessment If Subscales Are Equally Relevant in Whiplash and Nonspecific Neck Pain

Croft

Milam

Meylor

et al. 2016

Journal of Chiropractic Medicine

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Objective: Because of previously published recommendations to modify the Neck Disability Index (NDI), we evaluated the responsiveness and dimensionality of the NDI within a population of adult whiplash-injured subjects. The purpose of the present study was to evaluate the responsiveness and dimensionality of the NDI within a population of adult whiplash-injured subjects. Methods: Subjects who had sustained whiplash injuries of grade 2 or higher completed an NDI questionnaire. There were 123 subjects (55% female, of which 36% had recovered and 64% had chronic symptoms. NDI subscales were analyzed using confirmatory factor analysis, considering only the subscales and, secondly, using sex as an 11th variable. The subscales were also tested with multiple linear regression modeling using the total score as a target variable. Results: When considering only the 10 NDI subscales, only a single factor emerged, with an eigenvalue of 5.4, explaining 53.7% of the total variance. Strong correlation (N .55) (P b .0001) between all variables was found. Multiple linear regression modeling revealed high internal consistency with all coefficients reaching significance (P b .0001). The 4 NDI subscales exerting the greatest effect were, in decreasing order, Sleeping, Lifting, Headaches, and Pain Intensity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Confirmatory Factor Analysis and Multiple Linear Regression of the Neck Disability Index: Assessment If Subscales Are Equally Relevant in Whiplash and Nonspecific Neck Pain

Croft

Milam

Meylor

et al. 2016

Journal of Chiropractic Medicine

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“…7 In subsequent years, a number of other questionnaires have been developed for evaluating neck pain. These include the Whiplash Disability Questionnaire, [8][9][10] the Functional Rating Index, 11 the Northwick Park Neck Pain Questionnaire, 9,10 the Neck Pain and Disability Scale, 9 the Copenhagen Neck Functional Disability Index, 9,12,13 and the EQ-5D. 14 To date, the NDI has been the most extensively used questionnaire in clinical trials and prognosis studies.…”

Section: Introductionmentioning

confidence: 99%

“…14 To date, the NDI has been the most extensively used questionnaire in clinical trials and prognosis studies. 9,13, The general format follows that of the Oswestry questionnaire, with a 10-item design. These items or subscales include Pain Intensity, Personal Care, Lifting, Reading, Headaches, Concentration, Work, Driving, Sleeping, and Recreation.…”

Section: Introductionmentioning

confidence: 99%

Classifying Whiplash Recovery Status Using the Neck Disability Index: Optimized Cutoff Points Derived From Receiver Operating Characteristic

Croft

Workman

Szatalowicz³

et al. 2016

Journal of Chiropractic Medicine

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Objective: Researchers often use Neck Disability Index (NDI) scores to classify recovery status in whiplash patients. The purpose of this study was to investigate the optimal cutoff point score for the NDI as a mechanism for differentiating recovery from nonrecovery after whiplash. Methods: Subjects (N = 123) who had previously sustained whiplash injuries were recruited from 12 clinics. Subjects rated themselves as being recovered (36%) or nonrecovered (64%). This state variable was compared with their NDI score as test variable using the receiver operating characteristic statistic. The area under the receiver operating characteristic curve and optimized cutoff points were computed for the whole group and also dichotomized for sex and age. Results: The mean NDI score for the recovered group was 7.8. It was 27.1 for the nonrecovered group. The cutoff point that optimized sensitivity and specificity for the whole group was an NDI score of 15. For women, it was 19; for older persons, it was 21. Conclusion: The optimal NDI score cutoff point for differentiating the recovery state after whiplash is 15. Misclassification errors are likely when using lower values.

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“…29 As a clinical outcome measure, the PSFS allows patients to report on their functional status at baseline and at a follow-up session, to determine if a meaningful change in functional status has occurred. Since its development in 1995 for patients with low back pain, the PSFS has been compared to the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for patients with knee dysfunction 5 and chronic whiplash 28 and for workers' compensation claimants for a variety of conditions, 12 the Neck Disability Index (NDI) for neck dysfunction, 33 cervical radiculopathy, 6 and chronic whiplash, 28 and the Roland-Morris Disability Questionnaire (RMQ) for low back pain. 21 No study to date has compared the PSFS to an upper extremity outcome measure nor examined the psychometric properties of the PSFS for patients with musculoskeletal problems of the upper extremity.…”

mentioning

confidence: 99%

The Patient-Specific Functional Scale: Validity, Reliability, and Responsiveness in Patients With Upper Extremity Musculoskeletal Problems

Hefford¹,

Abbott²,

Arnold³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

176

102

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Study Design Clinical measurement, longitudinal; multicenter prospective cohort study. Objectives To examine the validity, reliability, and responsiveness of the Patient-Specific Functional Scale (PSFS) in patients with musculoskeletal upper extremity problems being treated in physical therapy. Background The clinimetric properties of the PSFS have not been established nor compared with region-specific outcome measures in patients with upper extremity problems. Methods Patients completed the PSFS, Upper Extremity Functional Index (UEFI), and numeric pain rating scale (NPRS) at baseline and follow-up, and were categorized as improved, stable, or worsened, using the global rating of change. Construct validity was assessed by comparing the change scores of the stable and improved groups, using independent-samples t tests. Reliability was evaluated using intraclass correlation coefficient (ICC2,1) with 95% confidence intervals. Bland-Altman plots determined limits of agreement. Responsiveness and minimal important difference (MID) were determined with receiver operator characteristic (ROC) curves. Results One hundred eighty patients met the inclusion criteria. Construct validity was supported for the PSFS and the UEFI (P<.001). Reliability was moderate to good for the PSFS (ICC2,1 = 0.713) and UEFI (ICC2,1 = 0.848). Reported estimates of reliability may be lower than true values because the group of “stable” patients from this cohort had, on average, a small positive change. Bland-Altman plots indicated good agreement. The area under the ROC curve (AUC) was significantly different from the null value of 0.5 for the PSFS (0.887) and the UEFI (0.877), indicating good accuracy in distinguishing improved patients from stable patients. MID was 1.2 for the PSFS (scale, 0–10) and 8.5 for the UEFI (scale, 0–80). Conclusion The PSFS is a valid, reliable, and responsive outcome measure for patients with upper extremity problems. J Orthop Sports Phys Ther 2012;42(2):56–65. doi:10.2519/jospt.2012.3953

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Responsiveness of Pain and Disability Measures for Chronic Whiplash

Abstract: Pain bothersomeness and the Patient Specific Functional Scale provide the most responsive measures of pain and disability, respectively, in patients with chronic whiplash.

Cited by 89 publications

References 31 publications

Confirmatory Factor Analysis and Multiple Linear Regression of the Neck Disability Index: Assessment If Subscales Are Equally Relevant in Whiplash and Nonspecific Neck Pain

Confirmatory Factor Analysis and Multiple Linear Regression of the Neck Disability Index: Assessment If Subscales Are Equally Relevant in Whiplash and Nonspecific Neck Pain

Classifying Whiplash Recovery Status Using the Neck Disability Index: Optimized Cutoff Points Derived From Receiver Operating Characteristic

The Patient-Specific Functional Scale: Validity, Reliability, and Responsiveness in Patients With Upper Extremity Musculoskeletal Problems

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