Neck Pain and Disability Scale and the Neck Disability Index: reproducibility of the Dutch Language Versions

The first aim of this study was to translate the Neck Pain and Disability Scale (NPAD) from English into Dutch producing the NPAD–Dutch Language Version (DLV). The second aim was to analyze test–retest reliability and agreement of the NPAD–DLV and the Neck Disability Index (NDI)–DLV. The NPAD was translated according to established guidelines. Thirty-four patients (mean age 37.5 years, 68% female) with chronic neck pain (CNP), within an outpatient rehabilitation setting, participated in this study. The NPAD–DLV and the NDI–DLV were filled out twice with a mean test–retest interval of 18 days. The intraclass correlation coefficient of the NPAD–DLV was 0.76 (95% confidence interval (CI) 0.57–0.87) and of the NDI–DLV 0.84 (95% CI 0.69–0.92). The limits of agreement of the NPAD–DLV and the NDI–DLV were, respectively, ±20.9 (scale 0–100) and ±6.5 (scale 0–50). The reliability of the NPAD–DLV and the NDI–DLV was acceptable for patients with CNP. The variation (‘instability’) in the NPAD–DLV total scores was relatively large and larger than the variation of the NDI–DLV

Disability in patients with chronic neck pain:the clinimetric properties of instruments

Beperkingen patiënten met chronische nekpijn beter in kaart brengen Maar liefst een derde van de patiënten met chronische nekpijn die aan een multidisciplinair pijnrevalidatieprogramma begint valt af. Van de patiënten die het programma wél afmaken geeft zestig procent aan helemaal of grotendeels hersteld te zijn. Dat stelde Wim Jorritsma vast in een onderzoek naar hoe de beperkingen van patiënten met chronische nekpijn gemeten kunnen worden. Chronische nekpijn komt veel voor en kan leiden tot ernstige beperkingen in de dagelijkse bezigheden of op het werk. Bij het merendeel van de patiënten kan geen specifieke onderliggende aandoening worden geconstateerd. Wim Jorritsma deed onderzoek naar de betrouwbaarheid van veelgebruikte nekpijnvragenlijsten, de Neck Disability Index (NDI) en de Neck Pain and Disability Scale (NPAD). Die laatste lijst liet hij voor dit onderzoek in het Nederlands vertalen. Jorritsma liet 34 patiënten met chronische nekpijn beide lijsten invullen om de onderlinge overeenstemming te bepalen. Om de geldigheid van beide lijsten nader te bepalen, deed hij vervolgonderzoek bij 111 patiënten van een universitaire revalidatiekliniek, die de lijsten voor en na hun behandeling invulden. Hij concludeert dat beide lijsten een goed beeld geven van zelfgerapporteerde nekpijngerelateerde beperkingen, maar dat de Neck Disability Index (NDI) de beste klinimetrische eigenschappen heeft

Concurrent validity of questionnaire and performance-based disability measurements in patients with chronic nonspecific low back pain

This study aimed to investigate the concurrent validity of two approaches to disability measurement in patients with chronic nonspecific low back pain (CLBP). It was hypothesized that if both are measuring the same construct, the instruments would lead to similar disability results and would correlate strongly (r > 0.75). The study compared the results of self-reported and performance-based measures of disability in 64 consecutive patients with CLBP. Participants mean age was 38.0 years, the mean duration of the current episode of back pain 9.9 months, and 90% were off work due to CLBP. The self-report measures used were: the Roland Disability Questionnaire (Roland); the Oswestry Disability Questionnaire (Oswestry); and the Quebec Back Pain Disability Questionnaire (Quebec). Performance was measured using the Isernhagen Work Systems Functional Capacity Evaluation (FCE). The mean scores from the self-report measure are as follows: Roland 13.5 (scale 0-24), Oswestry 28.2 (scale 0-100), Quebec 37.8 (scale 0-100) consistent with moderate to severe disability. In contrast the results from the performance-based measures suggested that the subjects should be able to work at a physical intensity level of moderate to heavy. Little to moderate correlation was observed between the self-report and performance-based measures (Spearman rank correlations: Roland-FCE (-0.20), p > 0.05; Oswestry-FCE (-0.52), p < 0.01; Quebec-FCE (-0.50), p < 0.01). Results are interpreted to suggest that both performance-based and self-report measures of disability should be used in order to obtain a comprehensive picture of the disability in patients with CLBP.

Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index

Abstract Purpose To investigate relevant change on the Neck Pain and Disability Scale (NPAD) and Neck Disability Index (NDI) and which questionnaire is the most responsive in patients with non-specific chronic neck pain (CNP). Methods Seventy-six patients with non-specific CNP in an outpatient tertiary rehabilitation setting were dichotomized into &apos;&apos;improved&apos;&apos; and &apos;&apos;stable&apos;&apos; based on global perceived effect (GPE) scores. To investigate relevant change minimal detectable change (MDC) and minimal important change (MIC) with the receiver operator characteristic (ROC) cut-off point were assessed. Comparison of responsiveness was performed using areas under the ROC curve (AUC) and correlations between change scores of NPAD and NDI, and GPE. Results MDC and MIC on NPAD (scale 0-100) were 31.7 and 11.5 points, respectively. MDC and MIC on NDI (scale 0-50) were 8.4 and 3.5 points, respectively. Changes should exceed this MDC or MIC cut-off to be interpreted as relevant. AUC was 0.75 for both NPAD and NDI. Correlations between change scores of NPAD and NDI, and GPE were, respectively,. Conclusions Relevant change on both NPAD and NDI assessed with MDC and MIC resulted in different cut-offs and consequently with different amounts of certainty that the patient is improved. Responsiveness of NPAD and NDI was similar

Neck Pain and Disability Scale and Neck Disability Index: validity of Dutch language versions

To investigate the validity of the Neck Pain and Disability Scale Dutch Language Version (NPAD-DLV) and the Neck Disability Index (NDI)-DLV. NPAD-DLV, NDI-DLV, Short-Form-36 Health Survey (SF-36)-DLV, visual analog scale (VAS)(pain) and VAS(disability) were administered to 112 patients with non-specific chronic neck pain in an outpatient tertiary rehabilitation setting. Twenty seven hypotheses were formulated regarding validity. NPAD-DLV and NDI-DLV were evaluated for content validity (normal distribution total scores, missing items, floor and ceiling effects), internal consistency (Cronbach's alpha and Spearman Item-total correlations), construct validity (Pearson correlations with SF-36 domains, VAS(pain) and VAS(disability) and Pearson correlation between total scores of NPAD-DLV and NDI-DLV). NPAD-DLV and NDI-DLV scores were distributed normally. Missing items were negligible. Floor and ceiling effects were absent in NPAD-DLV and in NDI-DLV two items had floor effects and one item had a ceiling effect. Cronbach's alpha of NPAD-DLV was 0.93 and of NDI-DLV 0.83. Item-total correlations ranged for NPAD-DLV from 0.45 to 0.73 and for NDI-DLV from 0.40 to 0.64. The correlation between, respectively, NPAD-DLV and NDI-DLV and: SF-36 domains ranged from -0.36 to -0.70 and from -0.34 to -0.63; VAS(pain) was 0.54 and 0.43; VAS(disability) was 0.57 and 0.52. The correlation between the total scores of NPAD-DLV and NDI-DLV was 0.77. Twenty six hypotheses were not rejected and one hypothesis was rejected. The NPAD-DLV and NDI-DLV are valid measures of self-reported neck-pain related disability