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Alanazi F, Alrwaily M. Cultural Adaptation, Reliability and Validation of the Arabic Örebro Musculoskeletal Pain Questionnaire in Patients with Low Back Pain. J Pain Res 2023; 16:317-325. [PMID: 36756204 PMCID: PMC9900143 DOI: 10.2147/jpr.s375202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Abstract
Background The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) assesses the psychosocial factors in people with complaints of musculoskeletal disorders and predicts those likely to develop persistent symptoms. Objective To culturally-adapt and assess the validity of the ÖMPQ in an Arabic population with low back pain (LBP). Methods This was a prospective cohort validation study of the ÖMPQ. The Arabic-ÖMPQ was created by forward translation, translation synthesis and backward translation in an Arabic population. Participants were included if they were 18 years or older, had acute or chronic LBP and were fluent in Arabic. Eighty-four patients completed the questionnaires at baseline, 2 days later and 3 months follow-up. We assessed specific agreement and test-retest reliability using the interclass correlation coefficient (ICC). We assessed predictive validity using linear regression and relative risk. We assessed content validity by investigating the ceiling and floor effects. Results To construct validity, the Arabic-ÖMPQ had a moderate (r≥0.3, <0.5) to high (r≥0.5) correlation with pain, disability, fear-avoidance and catastrophizing questionnaires. The test-rest reliability was high ICC2,1=0.92 (95% CI: 0.83-0.96). The Arabic-ÖMPQ score at baseline can significantly predict disability at 3 months F(1,82)=33.87, p<0.01; R2=0.29. Conclusion The translation of the Arabic-ÖMPQ into Arabic was successful. The Arabic-ÖMPQ showed very good reliability and proper validity and thus can be used to predict the risk of developing persistent disability amongst patients with LBP in an Arabic population.
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Affiliation(s)
- Fahad Alanazi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka, Jouf Region, Saudi Arabia,Correspondence: Fahad Alanazi, Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Sakaka, Jouf Region, Saudi Arabia, Email
| | - Muhammad Alrwaily
- Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, USA
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2
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Irgens P, Myhrvold BL, Kongsted A, Natvig B, Vøllestad NK, Robinson HS. Exploring visual pain trajectories in neck pain patients, using clinical course, SMS-based patterns, and patient characteristics: a cohort study. Chiropr Man Therap 2022; 30:37. [PMID: 36076234 PMCID: PMC9454174 DOI: 10.1186/s12998-022-00443-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background The dynamic nature of neck pain has so far been identified through longitudinal studies with frequent measures, a method which is time-consuming and impractical. Pictures illustrating different courses of pain may be an alternative solution, usable in both clinical work and research, but it is unknown how well they capture the clinical course. The aim of this study was to explore and describe self-reported visual trajectories in terms of details of patients’ prospectively reported clinical course, their SMS-based pattern classification of neck pain, and patient’s characteristics. Methods Prospective cohort study including 888 neck pain patients from chiropractic practice, responding to weekly SMS-questions about pain intensity for 1 year from 2015 to 2017. Patients were classified into one of three clinical course patterns using definitions based on previously published descriptors. At 1-year follow-up, patients selected a visual trajectory that best represented their retrospective 1-year course of pain: single episode, episodic, mild ongoing, fluctuating and severe ongoing. Results The visual trajectories generally resembled the 1-year clinical course characteristics on group level, but there were large individual variations. Patients selecting Episodic and Mild ongoing visual trajectories were similar on most parameters. The visual trajectories generally resembled more the clinical course of the last quarter. Discussion The visual trajectories reflected the descriptors of the clinical course of pain captured by weekly SMS measures on a group level and formed groups of patients that differed on symptoms and characteristics. However, there were large variations in symptoms and characteristics within, as well as overlap between, each visual trajectory. In particular, patients with mild pain seemed predisposed to recall bias. Although the visual trajectories and SMS-based classifications appear related, visual trajectories likely capture more elements of the pain experience than just the course of pain. Therefore, they cannot be seen as a proxy for SMS-tracking of pain over 1 year. Supplementary Information The online version contains supplementary material available at 10.1186/s12998-022-00443-3.
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Affiliation(s)
- Pernille Irgens
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway.
| | - Birgitte Lawaetz Myhrvold
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense M, Denmark
| | - Bård Natvig
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nina Køpke Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
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3
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Myhrvold BL, Kongsted A, Irgens P, Robinson HS, Vøllestad NK. The association between different outcome measures and prognostic factors in patients with neck pain: a cohort study. BMC Musculoskelet Disord 2022; 23:673. [PMID: 35836161 PMCID: PMC9281081 DOI: 10.1186/s12891-022-05558-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background Health domains like pain, disability, and health-related quality of life are commonly used outcomes for musculoskeletal disorders. Most prognostic studies include only one outcome, and it is unknown if prognostic factors and models may be generic across different outcomes. The objectives of this study were to examine the correlation among commonly used outcomes for neck pain (pain intensity, disability, and health-related quality of life) and to explore how the predictive performance of a prognostic model differs across commonly used outcomes. Methods We conducted an observational prospective cohort study with data from patients with neck pain aged 18–84 years consulting Norwegian chiropractors. We used three different outcomes: pain intensity (Numeric Pain Rating Scale), the Neck Disability Index (NDI), and health-related quality of Life (EQ-5D). We assessed associations between change in outcome scores at 12-weeks follow-up with Pearson’s correlation coefficient. We used multivariable linear regression models to explore differences in explained variance and relationship between predictors and outcomes. Results The study sample included 1313 patients and 941 (72%) completed follow-up at 12 weeks. The strongest correlation was between NDI and EQ-5D (r = 0.57) while the weakest correlation was between EQ-5D and pain intensity (r = 0.39). The correlation between NDI and pain intensity was moderate (r = 0.53) In the final regression models, the explained variance ranged from adjusted R2 of 0.26 to 0.60, highest with NDI and lowest with pain intensity as outcome. The predictive contributions of the included predictors were similar across outcomes. Among the investigated predictors, pain patterns and the baseline measure of the corresponding outcome measure contributed the most to explained variance across all outcomes. Conclusions The highest correlation was found between NDI and EQ-5D and the lowest with pain intensity. The same prognostic model showed highest predictive performance with NDI as outcome and poorest with pain intensity as outcome. These results suggest that we need more knowledge on the reasons for the differences in predictive performance variation across outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05558-5.
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Affiliation(s)
- Birgitte Lawaetz Myhrvold
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway.
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
| | - Pernille Irgens
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | - Nina K Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
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Rysstad T, Grotle M, Aasdahl L, Hill JC, Dunn KM, Tingulstad A, Tveter AT. Stratifying workers on sick leave due to musculoskeletal pain: translation, cross-cultural adaptation and construct validity of the Norwegian Keele STarT MSK tool. Scand J Pain 2022; 22:325-335. [PMID: 35148473 DOI: 10.1515/sjpain-2021-0144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Stratified care using prognostic models to estimate the risk profiles of patients has been increasing. A refined version of the popular STarT Back tool, the Keele STarT MSK tool, is a newly developed model for matched treatment across a wide range of musculoskeletal pain presentations. The aim of this study was to translate and culturally adapt the Keele STarT MSK tool into Norwegian, examine its construct validity and assess the representativeness of the included sample. METHODS The Keele STarT MSK tool was formally translated into Norwegian following a multistep approach of forward and backward translation. A pre-final version was tested in 42 patients. Minor changes were implemented. To assess its construct validity, an online survey was conducted among workers aged 18-67 years who were on sick leave (>4 weeks) due to musculoskeletal disorders. Construct validity was evaluated in terms of convergent and discriminant validity using Pearson's correlation coefficient, and known-group validity by comparing risk subgroups as suggested by the COSMIN checklist. The representativeness of the sample was assessed by comparing demographic and sick leave information of participants to eligible non-participants (n=168,137). RESULTS A representative sample of 549 workers participated in the validity assessment; 74 participants (13.5%) were categorised as low risk, 314 (57.2%) as medium risk and 161 (29.3%) as high risk. The construct validity was found sufficient, with 90.9% and 75.0% of the pre-defined hypotheses confirmed for convergent and discriminant validity, and known-group validity, respectively. Floor or ceiling effects were not found. CONCLUSIONS The Keele STarT MSK tool was successfully translated into Norwegian. The construct validity of the tool was acceptable in a representative cohort of workers on sick leave as a result of musculoskeletal pain. However, the analyses raised concerns as to whether one of the questions captures the construct it is intended to measure.
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Affiliation(s)
- Tarjei Rysstad
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Research- and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Jonathan C Hill
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Kate M Dunn
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Alexander Tingulstad
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Korogod N, Steyaert A, Nonclercq O, Opsommer E, Berquin A. Can the French version of the short Örebro Musculoskeletal Pain Screening Questionnaire or its subsets predict the evolution of patients with acute, (sub) acute and chronic pain? BMC Musculoskelet Disord 2022; 23:311. [PMID: 35365109 PMCID: PMC8976369 DOI: 10.1186/s12891-021-04944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background Prevention of chronic pain relies on accurate detection of at-risk patients. Screening tools have been validated mainly in (sub) acute spinal pain and the need of more generic tools is high. We assessed the validity of the French version of the short Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) in patients with a large range of pain duration and localization. Methods First, we re-analyzed data from a 6-month longitudinal study of 73 patients with (sub) acute spinal pain consulting in secondary line settings. Secondly, we performed a new 12-month longitudinal study of 542 primary care patients with (sub) acute and chronic pain in different localizations (spinal, limbs, “non-musculoskeletal”). The area under the receiver operating characteristic curve and cutoff scores were computed and compared for different subpopulations and ÖMPSQ subscores. Results Data from patients suffering from (sub) acute and chronic spinal pain consulting in both primary and secondary care settings confirmed the validity of the short French ÖMPSQ version and its subsets. In the primary care cohort, the performance of the questionnaire and its psychosocial subscore was variable but at least “fair” in most populations ((sub) acute and chronic, spinal and limb pain). Cutoff scores showed quite large variability depending on the outcome and the subpopulation considered. Conclusions These results confirm the usefulness of the short French ÖMPSQ for prediction of the evolution of (sub) acute and chronic patients with spinal and limb pain, whatever its duration. However, increasing population heterogeneity results in slightly worse predictive performance and largely variable cutoff scores. Consequently, it might be difficult to choose universal cutoff scores and other criteria, such as patients’ values and the available resources for patient management, should be taken into account. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04944-9.
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Affiliation(s)
- Natalya Korogod
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont, 21, 1011, Lausanne, Switzerland
| | - Arnaud Steyaert
- Department of Anesthesiology, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10/1650, 1200, Brussels, Belgium.,Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Olivier Nonclercq
- Grand Hôpital de Charleroi, Service de Médecine Physique et Réadaptation, 6061, Montignies-sur-Sambre, Belgium
| | - Emmanuelle Opsommer
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Avenue de Beaumont, 21, 1011, Lausanne, Switzerland
| | - Anne Berquin
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium. .,Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10/1650, 1200, Brussels, Belgium.
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6
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Wong JJ, Tricco AC, Côté P, Liang CY, Lewis JA, Bouck Z, Rosella LC. Association Between Depressive Symptoms or Depression and Health Outcomes for Low Back Pain: a Systematic Review and Meta-analysis. J Gen Intern Med 2022; 37:1233-1246. [PMID: 34383230 PMCID: PMC8971223 DOI: 10.1007/s11606-021-07079-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Study results vary on whether depressive symptoms are associated with worse prognosis for low back pain (LBP). We assessed the association between depressive symptoms or depression and health outcomes in persons with LBP. METHODS We searched MEDLINE, Embase, CINAHL, and PsycINFO from inception to June 2020. Eligible studies were cohort and case-control studies assessing the association between depressive symptoms (questionnaires) or depression (diagnoses) and health outcomes in persons aged ≥16 years with LBP in the absence of major pathology. Reviewers independently screened articles, extracted data, and assessed risk of bias using the Quality in Prognosis Studies tool. We classified exploratory versus confirmatory studies based on phases of prognostic factor investigation. We conducted random-effects meta-analyses and descriptive synthesis where appropriate. RESULTS Of 13,221 citations screened, we included 62 studies (63,326 participants; 61 exploratory studies, 1 confirmatory study). For acute LBP, depressive symptoms were associated with self-reported disability (descriptive synthesis: 6 studies), worse recovery (descriptive synthesis: 5 studies), and slower traffic injury-related claim closure (1 study), but not pain or work-related outcomes. Depressive symptoms were associated with greater primary healthcare utilization for acute LBP (1 confirmatory study). For chronic LBP, depressive symptoms were associated with higher pain intensity (descriptive synthesis: 9 studies; meta-analysis: 3 studies, 2902 participants, β=0.11, 95% confidence interval (CI) 0.05-0.17), disability (descriptive synthesis: 6 studies; meta-analysis: 5 studies, 3549 participants, β=0.16, 95% CI 0.04-0.29), and worse recovery (descriptive synthesis: 2 studies; meta-analysis: 2 studies, 13,263 participants, relative risk (RR)=0.91, 95% CI 0.88-0.95), but not incident chronic widespread pain (1 study). DISCUSSION Depressive symptoms may be associated with self-reported disability and worse recovery in persons with acute and chronic LBP, and greater primary healthcare utilization for acute LBP. Our review provides high-quality prognostic factor information for LBP. Healthcare delivery that addresses depressive symptoms may improve disability and recovery in persons with LBP. Confirmatory studies are needed to assess the association between depressive symptoms and health outcomes in persons with LBP. PROTOCOL REGISTRATION PROSPERO database (CRD42019130047).
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Affiliation(s)
- Jessica J Wong
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada. .,Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada.
| | - Andrea C Tricco
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada.,Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Room 716, Toronto, Ontario, M5B 1W8, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th floor, Toronto, Ontario, M5B 1T8, Canada
| | - Pierre Côté
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada.,Centre for Disability Prevention and Rehabilitation, Ontario Tech University and Canadian Memorial Chiropractic College, 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th floor, Toronto, Ontario, M5B 1T8, Canada.,Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, L1H 7K4, Canada
| | - Catherine Y Liang
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada
| | - Jeremy A Lewis
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada
| | - Zachary Bouck
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada.,Centre for Drug Policy and Evaluation, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, 3rd Floor, Toronto, Ontario, M5B 1T8, Canada
| | - Laura C Rosella
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario, M5T 3M7, Canada.,ICES, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.,Stephen Family Chair in Community Health, Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, Ontario, L5B 1B8, Canada
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7
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Langella F, Vanni D, Høgh M, Palsson TS, Christensen SWM, Bellosta-López P, Villafañe JH, Jensen PS, Silva PDB, Herrero P, Barletta P, Domenéch-García V, Berjano P. Development of the Prevent for Work Questionnaire (P4Wq) for the assessment of musculoskeletal risk factors in the workplace: part 2-pilot study for questionnaire development and validation. BMJ Open 2021; 11:e053988. [PMID: 34952882 PMCID: PMC9066351 DOI: 10.1136/bmjopen-2021-053988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders (WMSDs). DESIGN Data were collected from otherwise healthy workers employed in three service areas at a specialist hospital in Italy: healthcare, administration and ancillary services. SETTING AND PARTICIPANTS In all, 115 participants were enrolled (67% women; average age 41.5±9.94 years). The content of the tool for WMSDs was derived from three participation rounds of analysis involving a select group of experts who identified the questionnaire domains and items. Participants responded to 89 items in addition to the EuroQol 5 Dimensions Questionnaire (EQ-5D-5L), Fear-Avoidance Beliefs Questionnaire (FABq) and Oswestry Disability Index (ODI). The proportion of missing data and the distribution of responses were analysed for each item. Items with a discrimination index >0.40 and an interitem correlation <0.80 were retained. Factor analysis was performed using the VARIMAX rotation method, factor extraction, and identification, assignment of items to subscales, and assignment of scores to items. Internal consistency, reliability, construct validity and face validity were also assessed. RESULTS A total of 52 items were included in the factor analysis and four subscales identified: Physical Stress Subscore (six items); Mental Stress Subscore (six items); Job Satisfaction Subscore (four items) and Kinesiophobia/Catastrophizing Subscore (four items). The items in the final questionnaire version had a factor loading >0.7. The questionnaire consisted of 20 items with good internal consistency (Cronbach's alpha 0.81-0.91), reliability (weighted kappa coefficient 0.617-1.00), good construct validity (EQ-5D-5L, r=-0.549, p<0.001; ODI, r=0.549, p<0.001; FABq work, r=0.688, p<0.001) and satisfactory face validity (universal validity index 96.04%). CONCLUSION The P4Wq is a 20-item, multifactorial self-report risk assessment questionnaire. It may provide a useful tool for screening for WMSDs by specifically addressing back disorders. It investigates risks for individual workers and may inform educational programmes and preventive strategies tailored to a worker's needs. TRIAL REGISTRATION NUMBER NCT04192604.
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Affiliation(s)
| | | | - Morten Høgh
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Steffan Wittrup McPhee Christensen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - Pablo Bellosta-López
- Department of Physiotherapy, Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
| | | | - Palle Schlott Jensen
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | | | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Aragón, Spain
| | | | - Victor Domenéch-García
- Department of Physiotherapy, Faculty of Health Sciences, Universidad San Jorge, 50830 Villanueva de Gállego, Zaragoza, Spain
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8
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Fuhro FF, Fagundes FR, Manzoni ACT, Cabral CM. Discriminative and Predictive Analysis of the Brazilian Version of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) Short-Form in Patients With Low Back Pain. J Chiropr Med 2021; 20:191-198. [DOI: 10.1016/j.jcm.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
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9
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Irgens P, Myhrvold BL, Kongsted A, Waagan K, Engebretsen KB, Vøllestad NK, Robinson HS. The clinical course of neck pain: Are trajectory patterns stable over a 1-year period? Eur J Pain 2021; 26:531-542. [PMID: 34699124 DOI: 10.1002/ejp.1879] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Recent studies with data-driven approaches have established common pain trajectories. It is uncertain whether these trajectory patterns are consistent over time, and if a shorter measurement period will provide accurate trajectories. METHODS We included 1,124 patients with non-specific neck pain in chiropractic practice. We classified patients into pre-defined trajectory patterns in each of four quarters of the follow-up year (persistent, episodic, and recovery) based on measures of pain intensity and frequency from weekly SMS. We explored the shifts between patterns and compared patients with stable and shifting patterns on baseline characteristics and clinical findings. RESULTS 785 (70%) patients were in the same pattern in 1st and 4th quarters. Patients with episodic pattern in the 1st quarter shifted to other patterns more frequently than patients in the other patterns. A stable persistent pattern was associated with reduced function and higher scores on psychosocial factors. There was a decreased frequency of patients classified as persistent pattern (75% to 63%) and an increase of patients in recovery pattern (4% to 15%) throughout the four quarters. The frequency of patients classified as episodic remained relatively stable (21% to 24%). CONCLUSIONS We found an overall stability of the persistent pattern, and that episodic patterns have more potential for shifts. Shifts mostly occurred between patterns closest in pain variation. The deviation in pattern distribution compared with previous studies suggests that the duration of measurement periods has an impact on the results of the classification. SIGNIFICANCE Having persistent pain and having very minor pain is relatively stable over one year, while episodic pain has more potential for shifts. The duration of measurement periods appears to have an impact on the results of the classification. The given criteria resulted in a reduced frequency of episodic pattern due to shorter measurement periods. Our findings contribute to improved understanding and predicting NP using a combination of patient characteristics and trajectory patterns.
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Affiliation(s)
- Pernille Irgens
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Birgitte Lawaetz Myhrvold
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
| | - Knut Waagan
- Department for Data Capture and Collections Management, University Center for Information Technology, University of Oslo, Oslo, Norway
| | - Kaia Beck Engebretsen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nina Køpke Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
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10
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Şimşek Ş, Yağcı N, Şenol H. Cultural adaptation, validity and reliability of the Turkish version of the Örebro Musculoskeletal Pain Questionnaire in acute and subacute neck pain. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims The Örebro Musculoskeletal Pain Questionnaire is categorised as a ‘yellow flag’ pain-associated psychological distress screening tool, which predicts long-term disability. The aim of this study was to assess the validity and reliability of the Turkish translation of the Örebro Musculoskeletal Pain Questionnaire in patients with acute and subacute neck pain. Methods The test–retest reliability and internal consistency were assessed with the intraclass correlation coefficient and Cronbach's α. Construct validity was assessed with a visual analogue scale, the Neck Disability Index and the Fear Avoidance Belief Questionnaire. Results Cronbach's α value was found to be 0.790, test–retest reliability was 0.99. The intraclass correlation coefficient was 0.999 (95% confidence interval: 0.998–0.999; P=0.000). The Örebro Musculoskeletal Pain Questionnaire showed a moderate positive correlation with the Neck Disability Index (r=0.544; P=0.0001), a weak correlation with the Fear Avoidance Belief Questionnaire (r=0.264; P=0.0001) but no correlation with the visual analogue scale. Conclusions The Turkish version of the Örebro Musculoskeletal Pain Questionnaire is a valid, reliable and acceptable screening tool in patients with acute and subacute neck pain.
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Affiliation(s)
- Şule Şimşek
- Department of Therapy and Rehabilitation, Sarayköy Vacational School, Pamukkale University, Denizli, Turkey
| | - Nesrin Yağcı
- School of Physical Therapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Hande Şenol
- Department of Biostatistics, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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11
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Koç M, Bazancir Z, Apaydın H, Talu B, Bayar K. Cross-cultural adaptation and validation of the Turkish Yellow Flag Questionnaire in patients with chronic musculoskeletal pain. Korean J Pain 2021; 34:501-508. [PMID: 34593668 PMCID: PMC8494960 DOI: 10.3344/kjp.2021.34.4.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/23/2021] [Indexed: 11/05/2022] Open
Abstract
Background Yellow flags are psychosocial factors shown to be indicative of longterm chronicity and disability. The purpose of the study was to evaluate the psychometric properties of the Turkish Yellow Flag Questionnaire (YFQ) in patients with chronic musculoskeletal pain (CMP). Methods The cross-cultural adaptation was conducted with translation and backtranslation of the original version. Reliability (internal consistency and test-retest) was examined for 231 patients with CMP. Construct validity was assessed by correlating the YFQ with the Hospital Anxiety and Depression Scale (HADS), Orebro Musculoskeletal Pain Questionnaire (OMPQ), and Tampa Kinesiophobia Scale (TKS). Factorial validity was examined with both exploratory and confirmatory factorial analysis. Results The YFQ showed excellent test/retest reliability with an Intraclass correlation coefficient of 0.82. The internal consistency was moderate (Cronbach's alpha of 0.797). As a result of the exploratory factor analysis, there were 7 domains compatible with the original version. As a result of confirmatory factor analysis, the seven-factor structure of YFQ was confirmed. There was a statistically significant correlation between YFQ-total score and OMPQ (r = 0.57, P < 0.001), HADS-anxiety (r = 0.32, P < 0.001), HADS-depression (r = 0.44, P < 0.001), and TKS (r = 0.37, P < 0.001). Conclusions This study's results provide considerable evidence that the Turkish version of the YFQ has appropriate psychometric properties, including test-retest reliability, internal consistency, construct validity and factorial validity. It can be used for evaluating psychosocial impact in patients with CMP.
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Affiliation(s)
- Meltem Koç
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğ la Sıtkı Koçman University, Muğ la, Turkey
| | - Zilan Bazancir
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hakan Apaydın
- Department of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | - Burcu Talu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Kılıçhan Bayar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muğ la Sıtkı Koçman University, Muğ la, Turkey
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Wassinger CA, Sole G. Agreement and screening accuracy between physical therapists ratings and the Ӧrebro Musculoskeletal Pain Questionnaire in screening for risk of chronic pain during Musculoskeletal evaluation. Physiother Theory Pract 2021; 38:2949-2955. [PMID: 34266347 DOI: 10.1080/09593985.2021.1949766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Identifying patients at risk for chronic musculoskeletal pain can inform evaluation and treatment decisions. The ability of physical therapists to assess patients' risk for chronic pain without use of validated tools has been questioned. The Ӧrebro Musculoskeletal Pain Questionnaire (OMPQ) is used to determine risk for chronic pain.Methods: The aim of this pragmatic study was to prospectively quantify the agreement between physical therapists' assessment of patients' risk for chronic symptoms compared to the OMPQ. Patients were asked to complete the OMPQ during the initial visit. Physical therapists, blinded to OMPQ risk classification, carried out their usual patient assessment procedures. The physical therapists rated patients as either high or low risk for chronic pain based on their clinical assessment. Agreement between therapist and OMPQ was determined using Cohen's Kappa (κ) and screening accuracy compared clinician risk to the OMPQ risk classification (reference standard) by way of contingency table analysis.Results: Ninety-six (96) patients' risk classifications and 15 corresponding physical therapists' risk estimates were available for analysis. The OMPQ identified a 47% prevalence for high risk of chronic pain. Agreement (κ and 95% confidence interval) between physical therapist rating and OMPQ was slight, κ = 0.272 (0.033-0.421), p = .026. Therapists' sensitivity and specificity (95% CI) for determining risk classifications were 60.0% (44.3-74.3) and 62.8% (48.1-75.6), respectively. The positive and negative likelihood ratios (95% CI) were 1.61 (1.05-2.47) and 0.64 (0.42-0.97).Discussion: The use of validated self-report questionnaires are recommended to supplement clinician prognosis for patients at risk of chronic musculoskeletal pain.
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Affiliation(s)
- Craig A Wassinger
- Department of Physical Therapy, East Tennessee State University, Johnson City, USA
| | - Gisela Sole
- School of Physiotherapy, Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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Ahmed UA, Maharaj SS, Nadasan T, Kaka B. Cross-cultural adaptation and psychometric validation of the Hausa version of Örebro Musculoskeletal Pain Screening Questionnaire in patients with non-specific low back pain. Scand J Pain 2021; 21:103-111. [PMID: 32892191 DOI: 10.1515/sjpain-2020-0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) is widely used in clinical practice and for research purpose to screen the risk of chronicity in patients with Non-specific low back pain (NSLBP). The questionnaire has been cross-culturally adapted into different languages, but to date, there has not been Hausa version of the questionnaire. This study is important as the Hausa language is widely spoken across sub-Saharan Africa. The study aims to cross-culturally translate the English version of the (OMPSQ) into Hausa language (OMPSQ-H) and to test its psychometric properties in Hausa patients with NSLBP. METHODS This observational study involved the use of forward-backwards translation method for the English version of OMPSQ. Thus, 124 male and female participants with subacute NSLBP were recruited using convenient sampling techniques. The psychometric properties statistically tested included reliability, internal-consistency, ceiling and floor effects, acceptability and construct validity. RESULTS The Hausa version of OMPSQ has demonstrated good reliability (ICC=0.82) and internal consistency (Cronbach's alpha=0.72) with good acceptability as all questions were answered in 5 min. Responsiveness was adequate as OMPSQ-H retest scores demonstrated good correlation with the global rating of change scale scores (r=0.67, p=0.01). Construct validity was evaluated using principal component analysis and it reveals six components structure for the OMPSQ-H. CONCLUSIONS The OMPSQ-H was successfully translated and cross-culturally adapted with no problem of comprehension. Moreover, it has shown adequate psychometric properties in terms of internal consistency, reliability, responsiveness and constructs validity. Consequently, the OMPSQ-H can be considered as a valid tool for identifying and screening both psychosocial risk factors and risk of chronicity of NSLBP in Hausa population.
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Affiliation(s)
- Usman Abba Ahmed
- Department of Physiotherapy, Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria.,Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sonill S Maharaj
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thayananthee Nadasan
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Bashir Kaka
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
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Glare P, Overton S, Aubrey K. Transition from acute to chronic pain: where cells, systems and society meet. Pain Manag 2020; 10:421-436. [PMID: 33111634 DOI: 10.2217/pmt-2019-0039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Current treatments for chronic pain are often ineffective. At the same as searching for novel therapeutics, there is growing interest in preventing acute pain becoming chronic. While the field is still in its infancy, its knowledge base is increasingly expanding. Certainly, biomedical factors, for example, the type of tissue damage, are important but they are often not modifiable. Psychosocial risk factors (e.g., thoughts and beliefs about pain, mood, social support, workplace problems) are modifiable. There is an increasing body of research that cognitive behavioral therapy can prevent transition. Internet-based delivery of cognitive behavioral therapy improves access. Clinicians need to be aware that they may inadvertently promote pain chronification in their patients by what they say and do.
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Affiliation(s)
- Paul Glare
- Pain Management Research Institute, Faculty of Medicine & Health, University of Sydney, NSW, 2028, Australia
| | - Sarah Overton
- Pain Management Research Centre, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - Karin Aubrey
- Pain Management Research Institute, Faculty of Medicine & Health, University of Sydney, NSW, 2028, Australia.,Kolling Institute of Medical Research, University of Sydney and Northern Sydney Local Health District, NSW, 2065, Australia
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Ford JJ, Kaddour O, Gonzales M, Page P, Hahne AJ. Clinical features as predictors of histologically confirmed inflammation in patients with lumbar disc herniation with associated radiculopathy. BMC Musculoskelet Disord 2020; 21:567. [PMID: 32825815 PMCID: PMC7442978 DOI: 10.1186/s12891-020-03590-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/13/2020] [Indexed: 11/29/2022] Open
Abstract
Background An understanding of the clinical features of inflammation in low back pain with or without leg symptoms may allow targeted evaluations of anti-inflammatory treatment in randomised-controlled-trials and clinical practice. Purpose This study evaluated the diagnostic accuracy of clinical features to predict the presence/absence of histologically confirmed inflammation in herniated disc specimens removed at surgery in patients with lumbar disc herniation and associated radiculopathy (DHR). Study design Cohort Study. Methods Disc material from patients with DHR undergoing lumbar discectomy was sampled and underwent histological/immunohistochemistry analyses. Control discs were sampled from patients undergoing surgical correction for scoliosis. Baseline assessment comprising sociodemographic factors, subjective examination, physical examination and psychosocial screening was conducted and a range of potential clinical predictors of inflammation developed based on the existing literature. Multi-variate analysis was undertaken to determine diagnostic accuracy. Results Forty patients with DHR and three control patients were recruited. None of the control discs had evidence of inflammation compared to 28% of patients with DHR. Predictors of the presence of histologically confirmed inflammation included back pain < 5/10, symptoms worse the next day after injury, lumbar flexion range between 0 and 30° and a positive clinical inflammation score (at least 3 of: constant symptoms, morning pain/stiffness greater than 60-min, short walking not easing symptoms and significant night symptoms). The model achieved a sensitivity of 90.9%, a specificity of 92.9%, and a predictive accuracy of 92.3%. Conclusion In a sample of patients with lumbar DHR a combination of clinical features predicted the presence or absence of histologically confirmed inflammation. Clinical relevance These clinical features may enable targeted anti-inflammatory treatment in future RCTs and in clinical practice.
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Affiliation(s)
- Jon J Ford
- College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, 3085, Australia.
| | - Omar Kaddour
- Back in Form Physiotherapy, Ascot Vale, Victoria, Australia
| | | | - Patrick Page
- Box Hill Radiology, Epworth Eastern Hospital, Box Hill, Victoria, Australia
| | - Andrew J Hahne
- College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, 3085, Australia
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Skonnord T, Skjeie H, Brekke M, Klovning A, Grotle M, Aas E, Mdala I, Fetveit A. Acupuncture for acute non-specific low back pain: a randomised, controlled, multicentre intervention study in general practice-the Acuback study. BMJ Open 2020; 10:e034157. [PMID: 32764081 PMCID: PMC7412620 DOI: 10.1136/bmjopen-2019-034157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate whether a single treatment session of acupuncture, when applied in addition to standard treatment for acute low back pain (ALBP), reduces the time to recovery compared with standard treatment alone. DESIGN A multicentre, randomised, controlled trial. SETTING Conducted at 11 Norwegian general practitioners' (GPs') offices. PARTICIPANTS 171 adults aged 20-55 years seeking their GP for ALBP (≤14 days) between March 2014 and March 2017. Patients with secondary back pain and previous sick leave and acupuncture treatment was excluded. INTERVENTIONS The participants were randomised to either the control group (CG) or the acupuncture group (AG) by online software. The CG received standard treatment according to the Norwegian guidelines, while the AG received one session of Western medical acupuncture treatment in addition to standard treatment. The statistician was blinded to group status. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was median days to recovery. Secondary outcomes were pain intensity, global improvement, back-specific functional status, sick leave, medication and adverse effects. RESULTS 185 participants were randomised, 95 in the CG and 90 in the AG. 14 participants did not receive the allocated intervention and 4 were excluded from the analysis. Thus, 167 participants were included in the analysis, 86 in the CG and 81 in the AG. The groups were similar according to baseline characteristics. The median time to recovery was 14 days for the CG and 9 days for the AG, HR 1.37 (95% CI 0.95 to 1.96), (p=0.089). No serious adverse effects were reported. CONCLUSIONS We did not find any statistically significant reduction in time-to-recovery after a single session of acupuncture for ALBP compared with standard care. TRIAL REGISTRATION NUMBER NCT01439412.
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Affiliation(s)
- Trygve Skonnord
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Holgeir Skjeie
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Mette Brekke
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Atle Klovning
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health, Oslo universitetssykehus Ulleval, Oslo, Norway
| | - Eline Aas
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway
| | - Ibrahimu Mdala
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Arne Fetveit
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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Myhrvold BL, Irgens P, Robinson HS, Engebretsen K, Natvig B, Kongsted A, Køpke Vøllestad N. Visual trajectory pattern as prognostic factors for neck pain. Eur J Pain 2020; 24:1752-1764. [PMID: 32755021 DOI: 10.1002/ejp.1622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/12/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND A novel approach capturing both temporal variation and pain intensity of neck pain is by visual trajectory patterns. Recently, both previous and expected visual trajectory patterns were identified as stronger predictors of outcome than traditional measures of pain history and psychological distress. Our aim was to examine patient characteristics within the various previous and expected patterns, relationship between the two patterns and predictive value of a variable combining the previous and expected patterns. METHODS Patients with neck pain (n = 932) consulting chiropractors were included. Baseline measures included pain intensity, disability, psychological variables and symptom history and expectations. Participants reported global perceived effect after 12 weeks. Analyses included descriptive statistics and logistic regression. RESULTS Pain intensity, disability, psychological and worse outcome expectations increased from a single pain episode to severe ongoing pain of previous and expected patterns. Having a severe pain history was associated with poor prognosis, particularly if combined with negative expectations. The variable combining previous and expected patterns had a discriminative ability similar to that of other predictors AUC = 0.64 (95% CI = 0.60-0-67) versus AUC = 0.66 (95% CI = 0.62-0.70). The model with highest discriminative ability was achieved when adding the combined patterns to other predictors AUC = 0.70 (95% CI = 0.66-0.73). CONCLUSION The study indicates that pain expectations are formed by pain history. The patients' expectations were similar to or more optimistic compared with their pain history. The prognostic ability of the model including a simplified combination of previous and expected patterns, together with a few other predictors, suggests that the trajectory patterns might have potential for clinical use. SIGNIFICANCE The dynamic nature of neck pain can be captured by visual illustrations of trajectory patterns. We report, that trajectory patterns of pain history and future expectations to some extent are related. The patterns also reflect a difference in severity assessed by higher degree of symptoms and distress. Moreover, the visual trajectory patterns predict outcome at 12-weeks. Since the patterns are easily applicable, they might have potential as a clinical tool.
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Affiliation(s)
- Birgitte Lawaetz Myhrvold
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, Oslo, Norway
| | - Pernille Irgens
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, Oslo, Norway
| | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, Oslo, Norway
| | - Kaia Engebretsen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Bård Natvig
- Department of General practice, Institute of Health and Society, Blindern, Oslo, Norway
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark & Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Nina Køpke Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, Oslo, Norway
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18
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Ford JJ, Kaddour O, Page P, Richards MC, McMeeken JM, Hahne AJ. A multivariate prognostic model for pain and activity limitation in people undergoing lumbar discectomy. Br J Neurosurg 2020; 34:381-387. [PMID: 32216592 DOI: 10.1080/02688697.2020.1742288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: The purpose of this study was to identify a multivariate predictive model for 6-month outcomes on overall pain, leg pain and activity limitation in patients undergoing lumbar discectomy. Identification of predictors of outcome for lumbar discectomy has the potential to assist identifying treatment targets, clinical decision making and disease understanding.Materials and methods: Prospective cohort design. Ninety-seven patients deemed by study surgeons to be suitable for lumbar discectomy completed a comprehensive clinical and radiological baseline assessment. At 6-months post surgery outcome measures of overall and leg pain (visual analogue scale) as well as activity limitation (Oswestry Disability Index) were completed. Univariate and multivariate analyses were conducted to determine the best multivariate predictive model of outcome.Results: In the multivariate model, presence of a compensation claim, longer duration of injury and presence of below knee pain and/or parasthesia were negative prognostic indicators for at least two of the outcomes. Peripheralization in response to mechanical loading strategies was a positive prognostic indicator for overall pain and leg pain. A range of other prognostic indicators for one outcome were also identified. The prognostic model explained up to 32% of the variance in outcome.Conclusions: An 11-factor prognostic model was identified from a range of clinically and radiologically assessed variables in accordance with a biopsychosocial model. The multivariate model has potential implications for researchers and practitioners in the field. Further high quality research is required to externally validate the prognostic model, evaluate effect of the identified prognostic factors on treatment effectiveness and explore potential mechanisms of effect.
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Affiliation(s)
- Jon J Ford
- College of Science, Health & Engineering, La Trobe University, Bundoora, Australia.,Advance Healthcare, Boronia, Australia
| | | | - Patrick Page
- Box Hill Radiology, Epworth Eastern Hospital, Box Hill, Australia
| | - Matthew C Richards
- College of Science, Health & Engineering, La Trobe University, Bundoora, Australia.,Advance Healthcare, Boronia, Australia
| | - Joan M McMeeken
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Parkville, Australia
| | - Andrew J Hahne
- College of Science, Health & Engineering, La Trobe University, Bundoora, Australia
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Hayden JA, Wilson MN, Riley RD, Iles R, Pincus T, Ogilvie R. Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review. Cochrane Database Syst Rev 2019; 2019:CD011284. [PMID: 31765487 PMCID: PMC6877336 DOI: 10.1002/14651858.cd011284.pub2] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low back pain is costly and disabling. Prognostic factor evidence can help healthcare providers and patients understand likely prognosis, inform the development of prediction models to identify subgroups, and may inform new treatment strategies. Recent studies have suggested that people who have poor expectations for recovery experience more back pain disability, but study results have differed. OBJECTIVES To synthesise evidence on the association between recovery expectations and disability outcomes in adults with low back pain, and explore sources of heterogeneity. SEARCH METHODS The search strategy included broad and focused electronic searches of MEDLINE, Embase, CINAHL, and PsycINFO to 12 March 2019, reference list searches of relevant reviews and included studies, and citation searches of relevant expectation measurement tools. SELECTION CRITERIA We included low back pain prognosis studies from any setting assessing general, self-efficacy, and treatment expectations (measured dichotomously and continuously on a 0 - 10 scale), and their association with work participation, clinically important recovery, functional limitations, or pain intensity outcomes at short (3 months), medium (6 months), long (12 months), and very long (> 16 months) follow-up. DATA COLLECTION AND ANALYSIS We extracted study characteristics and all reported estimates of unadjusted and adjusted associations between expectations and related outcomes. Two review authors independently assessed risks of bias using the Quality in Prognosis Studies (QUIPS) tool. We conducted narrative syntheses and meta-analyses when appropriate unadjusted or adjusted estimates were available. Two review authors independently graded and reported the overall quality of evidence. MAIN RESULTS We screened 4635 unique citations to include 60 studies (30,530 participants). Thirty-five studies were conducted in Europe, 21 in North America, and four in Australia. Study populations were mostly chronic (37%), from healthcare (62%) or occupational settings (26%). General expectation was the most common type of recovery expectation measured (70%); 16 studies measured more than one type of expectation. Usable data for syntheses were available for 52 studies (87% of studies; 28,885 participants). We found moderate-quality evidence that positive recovery expectations are strongly associated with better work participation (narrative synthesis: 21 studies; meta-analysis: 12 studies, 4777 participants: odds ratio (OR) 2.43, 95% confidence interval (CI) 1.64 to 3.62), and low-quality evidence for clinically important recovery outcomes (narrative synthesis: 12 studies; meta-analysis: 5 studies, 1820 participants: OR 1.89, 95% CI 1.49 to 2.41), both at follow-up times closest to 12 months, using adjusted data. The association of recovery expectations with other outcomes of interest, including functional limitations (narrative synthesis: 10 studies; meta-analysis: 3 studies, 1435 participants: OR 1.40, 95% CI 0.85 to 2.31) and pain intensity (narrative synthesis: 9 studies; meta-analysis: 3 studies, 1555 participants: OR 1.15, 95% CI 1.08 to 1.23) outcomes at follow-up times closest to 12 months using adjusted data, is less certain, achieving very low- and low-quality evidence, respectively. No studies reported statistically significant or clinically important negative associations between recovery expectations and any low back pain outcome. AUTHORS' CONCLUSIONS We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain.
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Affiliation(s)
- Jill A Hayden
- Dalhousie UniversityDepartment of Community Health & Epidemiology5790 University AvenueRoom 403HalifaxNSCanadaB3H 1V7
| | - Maria N Wilson
- Dalhousie UniversityDepartment of Community Health and EpidemiologyHalifaxNova ScotiaCanada
| | - Richard D Riley
- Keele UniversitySchool of Primary, Community and Social CareDavid Weatherall Building, Keele University CampusKeeleStaffordshireUKST5 5BG
| | - Ross Iles
- Monash UniversityDepartment of Physiotherapy, Faculty of Medicine, Nursing and Health SciencesPeninsula CampusFrankstonVictoriaAustralia3199
| | - Tamar Pincus
- Royal Holloway University of LondonDepartment of PsychologyEghamSurreyUKTW20 0EX
| | - Rachel Ogilvie
- Dalhousie UniversityCommunity Health & Epidemiology5760 University AvenueHalifaxCanadaB3H 1V7
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20
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Broad External Validation and Update of a Prediction Model for Persistent Neck Pain After 12 Weeks. Spine (Phila Pa 1976) 2019; 44:E1298-E1310. [PMID: 31689251 DOI: 10.1097/brs.0000000000003144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective observational study. OBJECTIVE To externally validate the prediction model developed by Schellingerhout and colleagues predicting global perceived effect at 12 weeks in patients with neck pain and to update and internally validate the updated model. SUMMARY OF BACKGROUND DATA Only one prediction model for neck pain has undergone some external validation with good promise. However, the model needs testing in other populations before implementation in clinical practice. METHODS Patients with neck pain (n = 773) consulting Norwegian chiropractors were followed for 12 weeks. Parameters from the original prediction model were applied to this sample for external validation. Subsequently, two random samples were drawn from the full study sample. One sample (n = 436) was used to update the model; by recalibration, removing noninformative covariates, and adding new possible predictors. The updated model was tested in the other sample (n = 303) using stepwise logistic regression analysis. Main outcomes for performance of models were discrimination and calibration plots. RESULTS Three hundred seventy patients (47%) in the full study sample reported persistent pain at 12 weeks. The performance of the original model was poor, area under the receiver operating characteristics curve was 0.55 with a Confidence Interval of 0.51-0.59. The updated model included Radiating pain to shoulder and/or elbow, education level, physical activity, consultation-type (first- time, follow-up or maintenance consultation), expected course of neck pain, previous course of neck pain, number of pain sites, and the interaction term Physical activity##Number of pain sites. The area under the receiver operating characteristics curve was 0.65 with a 95% Confidence Interval of 0.58-0.71 for the updated model. CONCLUSION The predictive accuracy of the original model performed insufficiently in the sample of patients from Norwegian chiropractors and the model is therefore not recommended for that setting. Only one predictor from the original model was retained in the updated model, which demonstrated reasonable good performance predicting outcome at 12 weeks. Before considering clinical use, a new external validation is required. LEVEL OF EVIDENCE 3.
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Multidimensional screening for predicting pain problems in adults: a systematic review of screening tools and validation studies. Pain Rep 2019; 4:e775. [PMID: 31875182 PMCID: PMC6882575 DOI: 10.1097/pr9.0000000000000775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 12/14/2022] Open
Abstract
Screening tools allowing to predict poor pain outcomes are widely used. Often these screening tools contain psychosocial risk factors. This review (1) identifies multidimensional screening tools that include psychosocial risk factors for the development or maintenance of pain, pain-related distress, and pain-related disability across pain problems in adults, (2) evaluates the quality of the validation studies using Prediction model Risk Of Bias ASsessment Tool (PROBAST), and (3) synthesizes methodological concerns. We identified 32 articles, across 42 study samples, validating 7 screening tools. All tools were developed in the context of musculoskeletal pain, most often back pain, and aimed to predict the maintenance of pain or pain-related disability, not pain-related distress. Although more recent studies design, conduct, analyze, and report according to best practices in prognosis research, risk of bias was most often moderate. Common methodological concerns were identified, related to participant selection (eg, mixed populations), predictors (eg, predictors were administered differently to predictors in the development study), outcomes (eg, overlap between predictors and outcomes), sample size and participant flow (eg, unknown or inappropriate handling of missing data), and analysis (eg, wide variety of performance measures). Recommendations for future research are provided.
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Dorscht L, Schön C, Geiss C, Gräßel E, Donath C. Access to Pain Management Programs: A Multifactorial Analysis of the Pathways of Care for Chronic Pain Patients in the University Clinic Erlangen. DAS GESUNDHEITSWESEN 2019; 82:e94-e107. [PMID: 31185498 DOI: 10.1055/a-0832-2173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Different treatment options are offered for patients suffering from chronic pain, which differ in intensity and costs: 1) monodisciplinary treatment, mostly in outpatient care and 2) interdisciplinary treatment with the option of participating in pain management programs as outpatients or inpatients. The present work investigates how patients at the University Clinic Erlangen receiving monodisciplinary treatment differ from those receiving interdisciplinary treatment (research question I) as well as how patients participating in a pain management program differ from those who do not (research question II). The aim is to generate insights into whether the differences between the patient groups under various treatment modalities reflect the officially defined criteria for the indication of chronic pain management programs. METHODS Routine data of 1,833 patients treated from January 2008 to March 2013 at the University Clinic Erlangen were analyzed. After univariate preanalyses and checks for multicollinearity, the remaining variables were used for the final multivariate model (multiple binary logistic regression) for research question I and II. RESULTS Research question I: Patients getting interdisciplinary treatment were more often employed, had higher affective experience of pain, more often regarded their pain as treatable, had more often participated in at least one pain-associated rehabilitation treatment in the past, were younger and rarely had application for retirement in consideration. Research question II: Patients who participated in a pain management program were more often female, more often employed, described their pain as mainly located at the upper part of the body, had more concomitant symptoms, were more often diagnosed with musculoskeletal pain and rarely had a retirement request pending. CONCLUSIONS It could be shown that patients in the analyzed pathways of care mainly differed in demographic variables, and regarding pain management programs, also in the type of pain. Differences between patients in different treatment paths reflecting the officially defined indication criteria for chronic pain management programs were detectable only to a minor extent. Clearer and operational practical guidance should help support the clinical decision to assign patients to different treatment options and close the gap between theory and practice.
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Affiliation(s)
- Lisa Dorscht
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische Universitätsklinik Erlangen, Erlangen
| | - Christoph Schön
- Interdisziplinäres Schmerzzentrum, Universitätsklinikum Erlangen, Erlangen
| | - Christa Geiss
- Interdisziplinäres Schmerzzentrum, Universitätsklinikum Erlangen, Erlangen
| | - Elmar Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische Universitätsklinik Erlangen, Erlangen
| | - Carolin Donath
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische Universitätsklinik Erlangen, Erlangen
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Tsang RCC, Lee EWC, Lau JSY, Kwong SSF, So EML, Wong TFY, Law RKY. Development of a short form of the Hong Kong Chinese orebro musculoskeletal pain screening questionnaire. Hong Kong Physiother J 2019; 39:57-66. [PMID: 31156317 PMCID: PMC6467830 DOI: 10.1142/s1013702519500057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/26/2017] [Indexed: 11/25/2022] Open
Abstract
Background: The Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) is a valid screening tool to identify those musculoskeletal patients at risk of developing chronicity and disability. A Hong Kong Chinese version of the OMPSQ (COMPSQ-HK) was developed with satisfactory construct validity and predictive validity. Objective: The aim of this study was to develop a 10-item short form of the COMPSQ-HK (COMPSQ-HK10) and examine its measurement properties. Methods: The 10 items were identified from the suggestion by the original author of OMPSQ. The data of the 10 items were extracted from the main study to develop the COMPSQ-HK conducted from 2010 to 2013. The internal consistency using Cronbach’s alpha, test–retest reliability examining intraclass correlation coefficient (ICC1,1), minimum detectable change and 95% limits of agreement, construct validity by correlating COMPSQ-HK10 with pain, disability score, kinesiophobia score and Medical Outcomes Study Short Form 12, and predictive validity investigating receiver operating characteristic (ROC) curve analyses with sick leave >60 days and return-to-work status at one year were calculated. Results: A total of 305 back patients and 160 neck patients were recruited with about 30% of patients lost to follow-up at one year. Both the internal consistency (Cronbach’s alpha as 0.732 to 0.757) and test–retest reliabilities (ICC1,1 as 0.868 for both back and neck patients) were satisfactory. The correlations between COMPSQ-HK10 and COMPSQ-HK for back and neck patients were excellent (Pearson r as 0.919 and 0.896, respectively, p<0.001). The areas under the ROC curves for back and neck patients were similar for COMPSQ-HK10 and COMPSQ-HK, ranging from 0.603 to 0.712. A cut-off score of 54 of COMPSQ-HK10 was recommended in predicting “sick leave of more than 60 days at one year” and “return to work for at least four consecutive weeks at one year”. Conclusion: The COMPSQ-HK10 has comparable measurement properties with the COMPSQ-HK. It is recommended to use the COMPSQ-HK10 for routine screening to identify patients of back and neck pain at risk of developing chronic pain and disability.
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Affiliation(s)
- Raymond C C Tsang
- Physiotherapy Department, MacLehose Medical Rehabilitation Centre, Hospital Authority, Hong Kong, P. R. China
| | - Edwin W C Lee
- Occupation Medicine Care Service, New Territories East Cluster, Hospital Authority, Hong Kong, P. R. China
| | - Jamie S Y Lau
- Physiotherapy Department, Prince of Wales Hospital, Hospital Authority, Hong Kong, P. R. China
| | - Susane S F Kwong
- Physiotherapy Department, Hong Kong East Cluster, Hospital Authority, Hong Kong, P. R. China
| | - Eric M L So
- Physiotherapy Department, Princess Margaret Hospital, Hospital Authority, Hong Kong, P. R. China
| | - Thomas F Y Wong
- Physiotherapy Department, Kowloon Hospital, Hospital Authority, Hong Kong, P. R. China
| | - Rainbow K Y Law
- Physiotherapy Department, Alice Ho Miu Ling Nethersole Hospital, Hospital Authority, Hong Kong, P. R. China
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Jenkins LC, Chang WJ, Buscemi V, Liston M, Toson B, Nicholas M, Graven-Nielsen T, Ridding M, Hodges PW, McAuley JH, Schabrun SM. Do sensorimotor cortex activity, an individual's capacity for neuroplasticity, and psychological features during an episode of acute low back pain predict outcome at 6 months: a protocol for an Australian, multisite prospective, longitudinal cohort study. BMJ Open 2019; 9:e029027. [PMID: 31123007 PMCID: PMC6538004 DOI: 10.1136/bmjopen-2019-029027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/20/2019] [Accepted: 03/20/2019] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) is the leading cause of disability worldwide, with prevalence doubling in the past 14 years. To date, prognostic screening tools display poor discrimination and offer no net benefit of screening over and above a 'treat all' approach. Characteristics of the primary sensory (S1) and motor (M1) cortices may predict the development of chronic LBP, yet the prognostic potential of these variables remains unknown. The Understanding persistent Pain Where it ResiDes (UPWaRD) study aims to determine whether sensorimotor cortex activity, an individual's capacity for plasticity and psychosocial factors in the acute stage of pain, predict LBP outcome at 6 months. This paper describes the methods and analysis plan for the development of the prediction model. METHODS AND ANALYSIS The study uses a multicentre prospective longitudinal cohort design with 6-month follow-up. 120 participants, aged 18 years or older, experiencing an acute episode of LBP (less than 6 weeks duration) will be included. Primary outcomes are pain and disability. ETHICS AND DISSEMINATION Ethical approval has been obtained from Western Sydney University Human Research Ethics Committee (H10465) and from Neuroscience Research Australia (SSA: 16/002). Dissemination will occur through presentations at national and international conferences and publications in international peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12619000002189; Pre-results.
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Affiliation(s)
- Luke C Jenkins
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Wei-Ju Chang
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Valentina Buscemi
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Matthew Liston
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Science and Health, The University of Western Sydney, Penrith, New South Wales, Australia
| | - Barbara Toson
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Michael Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | - Michael Ridding
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - James H McAuley
- University of New South Wales, Neuroscience Research Australia, Sydney, New South Wales, Australia
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Lheureux A, Berquin A. Comparison between the STarT Back Screening Tool and the Örebro Musculoskeletal Pain Screening Questionnaire: Which tool for what purpose? A semi-systematic review. Ann Phys Rehabil Med 2019; 62:178-188. [PMID: 30342997 DOI: 10.1016/j.rehab.2018.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/31/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prevention of chronicization of low back pain requires accurate detection of at-risk patients. Questionnaires have been validated, including the STarT Back Screening Tool (SBST) and the Örebro Musculoskeletal Pain Screening Questionnaire (OMPSQ). This review aims to compare these questionnaires in terms of predictive value and in terms of aims, to guide the choice in clinical practice. METHODS This study is a semi-systematic literature review. Studies evaluating at least one of the questionnaires and written between 1997 and October 10th 2017 were selected from Pubmed database. Inclusion criteria were pain duration<3months, outcomes including pain, function and/or global recovery. For work outcomes, inclusion criteria were extended to chronic patients. Studies had to provide information on sensitivity, specificity and area under the ROC Curve (AUC). RESULTS Twenty-eight studies met our inclusion criteria (7 SBST, 21 original OMPSQ, 3 short OMPSQ). The OMPSQ best predicted a Pain NRS≥3 at 3 months (AUC=0.64 (0.50-0.78)) and at 6 months (AUC between 0.70 (no confidence interval provided) and 0.84 (0.71-0.97)). The SBST and the OMPSQ are comparable to predict an Oswestry Disability Index≥30% at 6 months. A single study showed no difference between the SBST and the OMPSQ to predict absenteeism≥30 days at 6 months. The two questionnaires cannot be compared for "global recovery" outcomes. CONCLUSION The OMPSQ seems better than the SBST for predicting "pain" and "work" outcomes, the SBST may be better for "function" outcomes. These results should be taken with caution because of the high heterogeneity between studies. It should be noted that the OMPSQ was elaborated with the aim of creating a prognostic tool while the SBST was devised as a treatment-allocating tool and is easier to use in clinical practice. This should guide the choice of using one questionnaire rather than the other.
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Affiliation(s)
- Alexis Lheureux
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal lab, Avenue Mounier 53/B1.53.07, 1200 Brussels, Belgium.
| | - Anne Berquin
- Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10/1650, 1200 Brussels, Belgium.
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Ford JJ, Slater SL, Richards MC, Surkitt LD, Chan AY, Taylor NF, Hahne AJ. Individualised manual therapy plus guideline-based advice vs advice alone for people with clinical features of lumbar zygapophyseal joint pain: a randomised controlled trial. Physiotherapy 2019; 105:53-64. [DOI: 10.1016/j.physio.2018.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/29/2018] [Indexed: 11/26/2022]
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Psychosoziale Risikofaktoren für chronischen Rückenschmerz in der Allgemeingesellschaft und im Leistungssport. MANUELLE MEDIZIN 2018. [DOI: 10.1007/s00337-018-0450-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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[Psychosocial risk factors for chronic back pain in the general population and in competitive sports : From theory to clinical screening-a review from the MiSpEx network]. Schmerz 2018; 32:259-273. [PMID: 29946960 DOI: 10.1007/s00482-018-0307-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lumbar back pain and the high risk of chronic complaints is not only an important health concern in the general population but also in high performance athletes. In contrast to non-athletes, there is a lack of research into psychosocial risk factors in athletes. Moreover, the development of psychosocial screening questionnaires that would be qualified to detect athletes with a high risk of chronicity is in the early stages. The purpose of this review is to give an overview of research into psychosocial risk factors in both populations and to evaluate the performance of screening instruments in non-athletes. METHODS The databases MEDLINE, PubMed, and PsycINFO were searched from March to June 2016 using the keywords "psychosocial screening", "low back pain", "sciatica" and "prognosis", "athletes". We included prospective studies conducted in patients with low back pain with and without radiation to the legs, aged ≥18 years and a follow-up of at least 3 months. RESULTS We identified 16 eligible studies, all of them conducted in samples of non-athletes. Among the most frequently published screening questionnaires, the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) demonstrated a sufficient early prediction of return to work and the STarT Back Screening Tool (SBT) revealed acceptable performance predicting pain-related impairment. The prediction of future pain was sufficient with the Risk Analysis of Back Pain Chronification (RISC-BP) and the Heidelberg Short Questionnaire (HKF). CONCLUSION Psychosocial risk factors of chronic back pain, such as chronic stress, depressive mood, and maladaptive pain processing are becoming increasingly more recognized in competitive sports. Screening instruments that have been shown to be predictive in the general population are currently being tested for suitability in the German MiSpEx research consortium.
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Ford JJ, Richards MC, Surkitt LD, Chan AYP, Slater SL, Taylor NF, Hahne AJ. Development of a Multivariate Prognostic Model for Pain and Activity Limitation in People With Low Back Disorders Receiving Physiotherapy. Arch Phys Med Rehabil 2018; 99:2504-2512.e12. [PMID: 29852152 DOI: 10.1016/j.apmr.2018.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/19/2018] [Accepted: 04/21/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs). DESIGN Prospective inception cohort study. SETTING Primary care private physiotherapy clinics in Melbourne, Australia. PARTICIPANTS Individuals (N=300) aged 18-65 years with low back and/or referred leg pain of ≥6 weeks and ≤6 months duration. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Numeric rating scales for back pain and leg pain as well as the Oswestry Disability Scale. RESULTS Prognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors, and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain, and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (P<.05) associations with at least 1 of the 3 outcomes. There were 5 indicators of positive outcome (2 types of LBD subgroups, paresthesia below waist, walking as an easing factor, and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity, and higher pain drawing percentage coverage). The preliminary model identifying predictors of LBDs explained up to 37% of the variance in outcome. CONCLUSIONS This study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of LBDs. The preliminary multivariate model requires further validation before being considered for clinical use.
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Affiliation(s)
- Jon J Ford
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia.
| | - Matt C Richards
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Luke D Surkitt
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Alexander Y P Chan
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Sarah L Slater
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Nicholas F Taylor
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Andrew J Hahne
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
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Opseth G, Wahl AK, Bjørke G, Mengshoel AM. Negative perceptions of illness and health are associated with frequent use of physiotherapy in primary healthcare. Musculoskeletal Care 2018; 16:133-138. [PMID: 29266659 DOI: 10.1002/msc.1224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/02/2017] [Accepted: 11/04/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND There is growing concern that an ageing population and increasing number of patients with chronic illnesses in the future will foster a need for health services beyond the resources available in society. Patients with chronic illnesses are reported to be frequent users of physicians' services in the primary health sector. Therapies for patients with chronic musculoskeletal illnesses are delivered by physiotherapists in this sector. However, we know little about the use of physiotherapy services and the factors that may explain their use. PURPOSE The aim of the present study was to examine the association between the regular/non-regular use of physiotherapy services, impacts of illness, and perceptions of illness and health. METHODS A cross-sectional survey included patients between 18 and 70 years of age who visited a physiotherapy outpatient clinic in Oslo during one randomly chosen week. Patient characteristics and use of physiotherapy were mapped. The Brief Illness Perception Questionnaire (BIPQ), a single item of the Short Form Health Survey (SF-12) and the Ørebro Musculoskeletal Pain Questionnaire (ØMPQ) were used to assess perceptions of illness and health, and impacts of illness. Data were analysed using independent sample t-tests and logistic regression analysis. RESULTS A total of 507 patients with a mean age of 46 (standard deviation 12) years participated, of whom 54% were regular users of physiotherapy. BIPQ (p = 0.02; β = 0.03) and the single-item on general health perception (p = 0.001; β = 0.44,) were the only significant variables in the final equation associated with regular use of physiotherapy. CONCLUSION About half of the participants were regular, high consumers of physiotherapy, and negative perceptions of illness and health were associated with this regular use.
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Affiliation(s)
| | - Astrid Klopstad Wahl
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Anne Marit Mengshoel
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
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Casser HR, Seddigh S, Rauschmann M. Acute Lumbar Back Pain. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 113:223-34. [PMID: 27120496 DOI: 10.3238/arztebl.2016.0223] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Back pain has many causes. In Germany, about 70% of adults have at least one episode of back pain per year. METHODS This review is based on a selective literature search and on the German National Disease Management Guideline for Low Back Pain. RESULTS The physician taking the history from a patient with back pain should ask about the nature, onset, course, localization, and radiation of the pain and its dependence on physical activity and/or emotional stress. In the differential diagnosis, neurologic deficits and any "red flags" suggesting dangerous conditions such as spinal fracture, bacterial infection, and tumors must be ruled out. If no specific cause of the pain can be identified, no imaging studies are indicated on initial presentation. The treatment of acute, nonspecific low back pain focuses on pain relief and functional improvement. Adequate patient education and counseling are essential. Exercise therapy is no more effective than the continuation of normal daily activities. Restriction of activity, including bed rest, is of no benefit and merely prolongs recovery and the resumption of normal activity. Further diagnostic testing is indicated if there is any suspicion of a fracture, infection, or tumor. CONCLUSION After dangerous conditions have been ruled out, low back pain can be pragmatically classified as either nonspecific or specific. More research is needed so that the diagnostic assessment and individualized treatment of acute lower back pain can be further refined.
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Affiliation(s)
- Hans-Raimund Casser
- DRK Pain Center Mainz, Department of Spine Surgery, Orthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt:
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Tsang Chi Chung R, Lau Sau Ying J, Kwong So Fong S, So Ming Loi E, Law Ka Yee R, Wong Fu Yan T, Lee Wai Chi E. Reliability, Construct and Predictive Validity of the Hong Kong Chinese Orebro Musculoskeletal Pain Screening Questionnaire. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:584-592. [PMID: 28028688 DOI: 10.1007/s10926-016-9689-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose The aim of this study was to evaluate the reliability, construct validity and predictive validity of the Hong Kong Chinese version of the Orebro Musculoskeletal Pain Screening Questionnaire (COMPSQ-HK). Methods The COMPSQ-HK was developed using the forward-backward translation. Internal consistency was assessed using Cronbach's alpha and test-retest reliability was examined using intraclass correlation coefficient with one-way random-effects model (ICC1,1), minimum detectable change (MDC) and 95% limits of agreement (LoA). Construct validity was evaluated by correlating the COMPSQ-HK with the Numeric Pain Rating Scale, Roland-Morris Disability Questionnaire, Northwick Park Neck Pain Questionnaire, Tampa Scale for Kinesiophobia, and Medical Outcomes Study Short Form 12. The predictive validity was investigated using receiver operating characteristics (ROC) curve analyses with sick leave >60 days and return-to-work for ≥4 consecutive weeks as outcomes at 1 year follow-up. The areas under the curve (AUC) were calculated. Results The COMPSQ-HK was administered to 305 patients with acute/subacute low back pain and 160 patients with acute/subacute neck pain. The Cronbach's alphas and ICC1,1 ranged from 0.83 to 0.84 and 0.81 to 0.92 respectively. The MDC were 32.1 and 21.1. The 95% LoA were -32.4 to 31.8 and -15.4 to 26.7. The Pearson r ranged from 0.333 to 0.697 in absolute value. The AUC for the ROC curve analyses ranged from 0.59 to 0.71. Conclusions The COMPSQ-HK has good internal consistency, moderate test-retest reliability, satisfactory construct validity and predictive validity as a screening tool for patients with back and neck pain at risk of chronic disability.
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Affiliation(s)
- Raymond Tsang Chi Chung
- Physiotherapy Department, MacLehose Medical Rehabilitation Centre, Hospital Authority, 7 Sha Wan Drive, Sandy Bay, Hong Kong, Hong Kong SAR, People's Republic of China.
| | - Jamie Lau Sau Ying
- Physiotherapy Department, Prince of Wales Hospital, Hospital Authority, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Susane Kwong So Fong
- Physiotherapy Department, Tang Shiu Kin Hospital, Hospital Authority, 282 Queen's Road East, Wan Chai, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Eric So Ming Loi
- Physiotherapy Department, Princess Margaret Hospital, Hospital Authority, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Rainbow Law Ka Yee
- Department of Physical Medicine & Rehabilitation, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Thomas Wong Fu Yan
- Physiotherapy Department, Queen Elizabeth Hospital, Hospital Authority, 30 Gascoigne Road, Yau Ma Tei, Kowloon, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Edwin Lee Wai Chi
- Occupation Medicine Care Service, New Territories East Cluster, Hospital Authority, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, Hong Kong SAR, People's Republic of China
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Cross-Cultural Adaptation, Validity, and Reliability of the Persian Version of the Orebro Musculoskeletal Pain Screening Questionnaire. Asian Spine J 2017; 11:520-530. [PMID: 28874969 PMCID: PMC5573845 DOI: 10.4184/asj.2017.11.4.520] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/05/2017] [Accepted: 01/16/2017] [Indexed: 01/16/2023] Open
Abstract
STUDY DESIGN Observational study. PURPOSE To cross-culturally translate the Orebro Musculoskeletal Pain Screening Questionnaire (OMPQ) into Persian and then evaluate its psychometric properties (reliability, validity, ceiling, and flooring effects). OVERVIEW OF LITERATURE To the authors' knowledge, prior to this study there has been no validated instrument to screen the risk of chronicity in Persian-speaking patients with low back pain (LBP) in Iran. The OMPQ was specifically developed as a self-administered screening tool for assessing the risk of LBP chronicity. METHODS The forward-backward translation method was used for the translation and cross-cultural adaptation of the original questionnaire. In total, 202 patients with subacute LBP completed the OMPQ and the pain disability questionnaire (PDQ), which was used to assess convergent validity. 62 patients completed the OMPQ a week later as a retest. RESULTS Slight changes were made to the OMPQ during the translation/cultural adaptation process; face validity of the Persian version was obtained. The Persian OMPQ showed excellent test-retest reliability (intraclass correlation coefficient=0.89). Its internal consistency was 0.71, and its convergent validity was confirmed by good correlation coefficient between the OMPQ and PDQ total scores (r=0.72, p<0.05). No ceiling or floor effects were observed. CONCLUSIONS The Persian version of the OMPQ is acceptable for the target society in terms of face validity, construct validity, reliability, and consistency. It is therefore considered a useful instrument for screening Iranian patients with LBP.
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Chan AY, Ford JJ, Surkitt LD, Richards MC, Slater SL, Davidson M, Hahne AJ. Individualised functional restoration plus guideline-based advice vs advice alone for non-reducible discogenic low back pain: a randomised controlled trial. Physiotherapy 2017; 103:121-130. [DOI: 10.1016/j.physio.2016.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 08/03/2016] [Indexed: 11/16/2022]
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Factor analyses for the Örebro Musculoskeletal Pain Questionnaire for working and nonworking patients with chronic low back pain. Spine J 2017; 17:603-609. [PMID: 27916683 DOI: 10.1016/j.spinee.2016.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 10/26/2016] [Accepted: 11/28/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) has good psychometric properties to predict return to work in patients with acute low back pain. Although it is used in patients with chronic back pain and nonworkers, there is no evidence on the factor structure of the ÖMPQ in these populations. This is deemed an important prerequisite for future prediction studies. PURPOSE This study aimed to analyze the factor structure of the ÖMPQ in working and nonworking patients with chronic back pain. STUDY DESIGN/SETTING This is a cross-sectional study in a university-based spine center. PATIENT SAMPLE The patient sample consists two cohorts of working and nonworking adult patients (>18 years) with specific and nonspecific chronic back pain. OUTCOME MEASURES The Örebro Musculoskeletal Pain Questionnaire. METHODS Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed in working (N=557) and nonworking (N=266) patients for three, four, five, and six factors identified in literature. A goodness of fit index was calculated by a chi-square. Root mean square error of approximation (RMSEA) was calculated, and the number of factors identified was based on RMSEA values <.05. A Tucker-Lewis index (TLI) and a normed fit index (NFI) >0.90 are considered to indicate acceptable fit. RESULTS In working patients, a five-factor solution had the best fit (RMSEA<0.05; NFI and TLI >0.90), but substantial adaptations should be made to get proper fit (removal of the work-related items). In nonworking patients, a four-factor analysis had the best fit (RMSEA<0.05). For both samples, items related to duration could not fit in the overall model. CONCLUSIONS Factor structure of the ÖMPQ was not confirmed in working and nonworking patients with chronic back pain. Substantial adaptations should be made to obtain a factor structure with acceptable fit.
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Sharafi SE, Hafizi S, Shahi MHP, Kordi R, Noorbala AA, Arbabi M, Nejatisafa AA. The Persian Version of Örebro Musculoskeletal Pain Screening Questionnaire: Translation and Evaluation of its Psychometric Properties. Int J Prev Med 2017; 8:14. [PMID: 28348724 PMCID: PMC5353775 DOI: 10.4103/2008-7802.201658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/27/2016] [Indexed: 11/17/2022] Open
Abstract
Background: Screening of psychosocial risk factors for chronic low back pain (LBP) is essential. The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) is one of the most recognized and widely used instruments for this purpose. This study aimed to translate the ÖMPSQ into Persian, to adapt it for Iranian culture, and to investigate its psychometric properties. Methods: Using a linguistic methodology, the ÖMPSQ was translated into Persian according to the World Health Organization guideline. A total of 106 patients with LBP participated in the study. Internal consistency and test-retest reliability were evaluated. Concurrent validity was estimated with Pearson's correlation between the ÖMPSQ and short form health survey (SF-12), Hospital Anxiety and Depression Scale (HADS), and visual analog scale (VAS). Factor analysis was used to evaluate dimensionality. Results: The content validity index was 0.80. The instrument had a good test-retest reliability (intraclass correlation coefficient = 0.82) and internal consistency (Cronbach's α =0.82). Factor analysis indicates that factorial structure of Persian version was similar to original questionnaire. There was a significant correlation (r = 0.252–0.639, P < 0.01) between VAS score and all the ÖMPSQ domains. Physical component summary of SF-12 was positively correlated with miscellaneous domain (r = 384, P < 0.05) and negatively correlated with psychology domain of ÖMPSQ (r = −0.364, P < 0.05). A significant correlation between total score and anxiety component of HADS and psychology domain of ÖMPSQ was found (r = 0.49, P < 0.01 and r = 0.442, P < 0.05, respectively). Correlations between the ÖMPSQ and SF-12 and HADS and VAS indicate acceptable concurrent validity. Conclusions: The Persian version of ÖMPSQ was as a valid and reliable instrument and also a good cross-cultural equivalent for original English version.
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Affiliation(s)
- S Elham Sharafi
- Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Hafizi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ramin Kordi
- Sport Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Spine Division, Noorafshar Rehabilitation and Sport Medicine Hospital, Tehran, Iran
| | - Ahmad Ali Noorbala
- Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arbabi
- Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Nejatisafa
- Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Hahne AJ, Ford JJ, Hinman RS, Richards MC, Surkitt LD, Chan AYP, Slater SL, Taylor NF. Individualized functional restoration as an adjunct to advice for lumbar disc herniation with associated radiculopathy. A preplanned subgroup analysis of a randomized controlled trial. Spine J 2017; 17:346-359. [PMID: 27765714 DOI: 10.1016/j.spinee.2016.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/04/2016] [Accepted: 10/12/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Physical therapy is commonly sought by people with lumbar disc herniation and associated radiculopathy. It is unclear whether physical therapy is effective for this population. PURPOSE To determine the effectiveness of physical therapist-delivered individualized functional restoration as an adjunct to guideline-based advice in people with lumbar disc herniation and associated radiculopathy. STUDY DESIGN This is a preplanned subgroup analysis of a multicenter parallel group randomized controlled trial. PATIENT SAMPLE The study included 54 participants with clinical features of radiculopathy (6-week to 6-month duration) and imaging showing a lumbar disc herniation. OUTCOME MEASURES Primary outcomes were activity limitation (Oswestry Disability Index) and separate 0-10 numerical pain rating scales for leg pain and back pain. Measures were taken at baseline and at 5, 10, 26, and 52 weeks. METHODS The participants were randomly allocated to receive either individualized functional restoration incorporating advice (10 sessions) or guideline-based advice alone (2 sessions) over a 10-week period. Treatment was administered by 11 physical therapists at private clinics in Melbourne, Australia. RESULTS Between-group differences for activity limitation favored the addition of individualized functional restoration to advice alone at 10 weeks (7.7, 95% confidence interval [CI] 0.3-15.1) and 52 weeks (8.2, 95% CI 0.7-15.6), as well as back pain at 10 weeks (1.4, 95% CI 0.2-2.7). There were no significant differences between groups for leg pain at any follow-up. Several secondary outcomes also favored individualized functional restoration over advice. CONCLUSIONS In participants with lumbar disc herniation and associated radiculopathy, an individualized functional restoration program incorporating advice led to greater reduction in activity limitation at 10- and 52-week follow-ups compared with guideline-based advice alone. Although back pain was significantly reduced at 10 weeks with individualized functional restoration, this effect was not maintained at later timepoints, and there were no significant effects on leg pain, relative to guideline-based advice.
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Affiliation(s)
- Andrew J Hahne
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia.
| | - Jon J Ford
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia
| | - Rana S Hinman
- Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, The University of Melbourne, Parkville, Melbourne, Victoria 3010, Australia
| | - Matthew C Richards
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia
| | - Luke D Surkitt
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia
| | - Alexander Y P Chan
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia
| | - Sarah L Slater
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia
| | - Nicholas F Taylor
- Low Back Research Team, School of Allied Health, La Trobe University, Kingsbury Drive, Melbourne, Victoria 3086, Australia
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Can screening instruments accurately determine poor outcome risk in adults with recent onset low back pain? A systematic review and meta-analysis. BMC Med 2017; 15:13. [PMID: 28100231 PMCID: PMC5244583 DOI: 10.1186/s12916-016-0774-4] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 12/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Delivering efficient and effective healthcare is crucial for a condition as burdensome as low back pain (LBP). Stratified care strategies may be worthwhile, but rely on early and accurate patient screening using a valid and reliable instrument. The purpose of this study was to evaluate the performance of LBP screening instruments for determining risk of poor outcome in adults with LBP of less than 3 months duration. METHODS Medline, Embase, CINAHL, PsycINFO, PEDro, Web of Science, SciVerse SCOPUS, and Cochrane Central Register of Controlled Trials were searched from June 2014 to March 2016. Prospective cohort studies involving patients with acute and subacute LBP were included. Studies administered a prognostic screening instrument at inception and reported outcomes at least 12 weeks after screening. Two independent reviewers extracted relevant data using a standardised spreadsheet. We defined poor outcome for pain to be ≥ 3 on an 11-point numeric rating scale and poor outcome for disability to be scores of ≥ 30% disabled (on the study authors' chosen disability outcome measure). RESULTS We identified 18 eligible studies investigating seven instruments. Five studies investigated the STarT Back Tool: performance for discriminating pain outcomes at follow-up was 'non-informative' (pooled AUC = 0.59 (0.55-0.63), n = 1153) and 'acceptable' for discriminating disability outcomes (pooled AUC = 0.74 (0.66-0.82), n = 821). Seven studies investigated the Orebro Musculoskeletal Pain Screening Questionnaire: performance was 'poor' for discriminating pain outcomes (pooled AUC = 0.69 (0.62-0.76), n = 360), 'acceptable' for disability outcomes (pooled AUC = 0.75 (0.69-0.82), n = 512), and 'excellent' for absenteeism outcomes (pooled AUC = 0.83 (0.75-0.90), n = 243). Two studies investigated the Vermont Disability Prediction Questionnaire and four further instruments were investigated in single studies only. CONCLUSIONS LBP screening instruments administered in primary care perform poorly at assigning higher risk scores to individuals who develop chronic pain than to those who do not. Risks of a poor disability outcome and prolonged absenteeism are likely to be estimated with greater accuracy. It is important that clinicians who use screening tools to obtain prognostic information consider the potential for misclassification of patient risk and its consequences for care decisions based on screening. However, it needs to be acknowledged that the outcomes on which we evaluated these screening instruments in some cases had a different threshold, outcome, and time period than those they were designed to predict. SYSTEMATIC REVIEW REGISTRATION PROSPERO international prospective register of systematic reviews registration number CRD42015015778 .
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Construct validity and reliability of Finnish version of Örebro Musculoskeletal Pain Screening Questionnaire. Scand J Pain 2016; 13:148-153. [PMID: 28850521 DOI: 10.1016/j.sjpain.2016.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Chronic pain causes suffering for affected individuals and incurs costs to society through work disability. Interventions based on early screening of psychological risk factors for chronic pain using screening tools such as the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) have been found to reduce work absenteeism and health care visits and increase perceived health. The aim of the current study was to translate the ÖMPSQ into Finnish and test its validity and reliability in a patient sample. METHODS The ÖMPSQ was forward-backward translated and cross-culturally adapted, and applied to our study population (n=69), the members of which had been referred to the Department of Physical and Rehabilitation Medicine of Oulu University Hospital from primary health care centres in Northern Finland due to chronic low back pain. The patients answered the ÖMPSQ two weeks before the hospital visit, and the follow-up questionnaire either during the hospital visit, or after by mail. The reliability of the ÖMPSQ was evaluated using intraclass correlation coefficients (ICC). Factor analysis was used to group items of the ÖMPSQ, and internal consistency between the items was determined by calculating Cronbach's alphas. RESULTS The cross-cultural adaptation revealed only minor semantic and cultural differences. Measurements showed reliability as moderate to nearly perfect for all of the ÖMPSQ items (ICC values ranged from 0.59 to 0.96). Items loaded into five different factors: disability, psychological symptoms, pain, fear avoidance, and work. All except one (work) showed acceptable internal consistency. The ÖMPSQ score was positively associated with both intensity of pain and the Oswestry Disability Index. CONCLUSIONS AND IMPLICATIONS The reliability and construct validity of the Finnish version of the ÖMPSQ were good. The predictive ability of the ÖMPSQ in the Finnish population should be evaluated in further studies.
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Association between the 10 item Örebro Musculoskeletal Pain Screening Questionnaire and physiotherapists' perception of the contribution of biopsychosocial factors in patients with musculoskeletal pain. ACTA ACUST UNITED AC 2016; 23:48-55. [DOI: 10.1016/j.math.2016.03.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 02/28/2016] [Accepted: 03/18/2016] [Indexed: 11/24/2022]
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Traeger AC, Henschke N, Hübscher M, Williams CM, Kamper SJ, Maher CG, Moseley GL, McAuley JH. Estimating the Risk of Chronic Pain: Development and Validation of a Prognostic Model (PICKUP) for Patients with Acute Low Back Pain. PLoS Med 2016; 13:e1002019. [PMID: 27187782 PMCID: PMC4871494 DOI: 10.1371/journal.pmed.1002019] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 04/01/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Low back pain (LBP) is a major health problem. Globally it is responsible for the most years lived with disability. The most problematic type of LBP is chronic LBP (pain lasting longer than 3 mo); it has a poor prognosis and is costly, and interventions are only moderately effective. Targeting interventions according to risk profile is a promising approach to prevent the onset of chronic LBP. Developing accurate prognostic models is the first step. No validated prognostic models are available to accurately predict the onset of chronic LBP. The primary aim of this study was to develop and validate a prognostic model to estimate the risk of chronic LBP. METHODS AND FINDINGS We used the PROGRESS framework to specify a priori methods, which we published in a study protocol. Data from 2,758 patients with acute LBP attending primary care in Australia between 5 November 2003 and 15 July 2005 (development sample, n = 1,230) and between 10 November 2009 and 5 February 2013 (external validation sample, n = 1,528) were used to develop and externally validate the model. The primary outcome was chronic LBP (ongoing pain at 3 mo). In all, 30% of the development sample and 19% of the external validation sample developed chronic LBP. In the external validation sample, the primary model (PICKUP) discriminated between those who did and did not develop chronic LBP with acceptable performance (area under the receiver operating characteristic curve 0.66 [95% CI 0.63 to 0.69]). Although model calibration was also acceptable in the external validation sample (intercept = -0.55, slope = 0.89), some miscalibration was observed for high-risk groups. The decision curve analysis estimated that, if decisions to recommend further intervention were based on risk scores, screening could lead to a net reduction of 40 unnecessary interventions for every 100 patients presenting to primary care compared to a "treat all" approach. Limitations of the method include the model being restricted to using prognostic factors measured in existing studies and using stepwise methods to specify the model. Limitations of the model include modest discrimination performance. The model also requires recalibration for local settings. CONCLUSIONS Based on its performance in these cohorts, this five-item prognostic model for patients with acute LBP may be a useful tool for estimating risk of chronic LBP. Further validation is required to determine whether screening with this model leads to a net reduction in unnecessary interventions provided to low-risk patients.
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Affiliation(s)
- Adrian C. Traeger
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- * E-mail: (AT); (MH)
| | - Nicholas Henschke
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Markus Hübscher
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- * E-mail: (AT); (MH)
| | - Christopher M. Williams
- Hunter Medical Research Institute and School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Steven J. Kamper
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Christopher G. Maher
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - G. Lorimer Moseley
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - James H. McAuley
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
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Ford JJ, Hahne AJ, Surkitt LD, Chan AYP, Richards MC, Slater SL, Hinman RS, Pizzari T, Davidson M, Taylor NF. Individualised physiotherapy as an adjunct to guideline-based advice for low back disorders in primary care: a randomised controlled trial. Br J Sports Med 2015; 50:237-45. [PMID: 26486585 DOI: 10.1136/bjsports-2015-095058] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Many patients with low-back disorders persisting beyond 6 weeks do not recover. This study investigates whether individualised physiotherapy plus guideline-based advice results in superior outcomes to advice alone in participants with low-back disorders. METHODS This prospective parallel group multicentre randomised controlled trial was set in 16 primary care physiotherapy practices in Melbourne, Australia. Random assignment resulted in 156 participants receiving 10 sessions of physiotherapy that was individualised based on pathoanatomical, psychosocial and neurophysiological barriers to recovery combined with guideline-based advice, and 144 participants receiving 2 sessions of physiotherapist-delivered advice alone. Primary outcomes were activity limitation (Oswestry Disability Index) and numerical rating scales for back and leg pain at 5, 10, 26 and 52 weeks postbaseline. Analyses were by intention-to-treat using linear mixed models. RESULTS Between-group differences showed significant effects favouring individualised physiotherapy for back and leg pain at 10 weeks (back: 1.3, 95% CI 0.8 to 1.8; leg: 1.1, 95% CI 0.5 to 1.7) and 26 weeks (back: 0.9, 95% CI 0.4 to 1.4; leg: 1.0, 95% CI 0.4 to 1.6). Oswestry favoured individualised physiotherapy at 10 weeks (4.7; 95% CI 2.0 to 7.5), 26 weeks (5.4; 95% CI 2.6 to 8.2) and 52 weeks (4.3; 95% CI 1.4 to 7.1). Responder analysis at 52 weeks showed participants receiving individualised physiotherapy were more likely to improve by a clinically important amount of 50% from baseline for Oswestry (relative risk (RR=1.3) 1.5; 95% CI 1.2 to 1.8) and back pain (RR 1.3; 95% CI 1.2 to 1.8) than participants receiving advice alone. CONCLUSIONS 10 sessions of individualised physiotherapy was more effective than 2 sessions of advice alone in participants with low-back disorders of ≥6 weeks and ≤6 months duration. Between-group changes were sustained at 12 months for activity limitation and 6 months for back and leg pain and were likely to be clinically significant. CLINICAL TRIAL REGISTRATION ACTRN12609000834257.
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Affiliation(s)
- Jon J Ford
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Andrew J Hahne
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Luke D Surkitt
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Alexander Y P Chan
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Matthew C Richards
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Sarah L Slater
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Rana S Hinman
- School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tania Pizzari
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Megan Davidson
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Nicholas F Taylor
- Low Back Research Team, College of Science, Health & Engineering, La Trobe University, Bundoora, Victoria, Australia
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Traeger A, Henschke N, Hübscher M, Williams CM, Kamper SJ, Maher CG, Moseley GL, McAuley JH. Development and validation of a screening tool to predict the risk of chronic low back pain in patients presenting with acute low back pain: a study protocol. BMJ Open 2015; 5:e007916. [PMID: 26179647 PMCID: PMC4513486 DOI: 10.1136/bmjopen-2015-007916] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Around 40% of people presenting to primary care with an episode of acute low back pain develop chronic low back pain. In order to reduce the risk of developing chronic low back pain, effective secondary prevention strategies are needed. Early identification of at-risk patients allows clinicians to make informed decisions based on prognostic profile, and researchers to select appropriate participants for secondary prevention trials. The aim of this study is to develop and validate a prognostic screening tool that identifies patients with acute low back pain in primary care who are at risk of developing chronic low back pain. This paper describes the methods and analysis plan for the development and validation of the tool. METHODS/ANALYSIS The prognostic screening tool will be developed using methods recommended by the Prognosis Research Strategy (PROGRESS) Group and reported using the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement. In the development stage, we will use data from 1248 patients recruited for a prospective cohort study of acute low back pain in primary care. We will construct 3 logistic regression models to predict chronic low back pain according to 3 definitions: any pain, high pain and disability at 3 months. In the validation stage, we will use data from a separate sample of 1643 patients with acute low back pain to assess the performance of each prognostic model. We will produce validation plots showing Nagelkerke R(2) and Brier score (overall performance), area under the curve statistic (discrimination) and the calibration slope and intercept (calibration). ETHICS AND DISSEMINATION Ethical approval from the University of Sydney Ethics Committee was obtained for both of the original studies that we plan to analyse using the methods outlined in this protocol (Henschke et al, ref 11-2002/3/3144; Williams et al, ref 11638).
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Affiliation(s)
- Adrian Traeger
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Nicholas Henschke
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Markus Hübscher
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Christopher M Williams
- Hunter Medical Research Institute and School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Steven J Kamper
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Chris G Maher
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - G Lorimer Moseley
- Neuroscience Research Australia, Sydney, New South Wales, Australia Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - James H McAuley
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
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Fagundes FRC, Costa LOP, Fuhro FF, Manzoni ACT, de Oliveira NTB, Cabral CMN. Örebro Questionnaire: short and long forms of the Brazilian-Portuguese version. Qual Life Res 2015; 24:2777-88. [PMID: 26038226 DOI: 10.1007/s11136-015-0998-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE To translate, cross-culturally adapt and test the measurement properties of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) short and long versions in Brazilian-Portuguese. METHODS The ÖMPSQ versions were translated, cross-culturally adapted and pretested in 30 patients with acute and subacute non-specific low back pain. Internal consistency, reproducibility (reliability and agreement), construct validity, and ceiling and floor effects were tested in 100 patients. Construct validity was assessed using the Roland-Morris Disability Questionnaire (RMDQ), the Tampa Scale for Kinesiophobia (TSK), and the Pain Numerical Rating Scale. RESULTS Internal consistency was adequate (ÖMPSQ: Cronbach's alpha = 0.83; ÖMPSQ-short: Cronbach's alpha = 0.72). Reliability was substantial (ÖMPSQ: ICC2,1 0.76; ÖMPSQ-short: 0.78). Standard error of measurement was very good for the ÖMPSQ (5 %) and good for the ÖMPSQ-short (6.7 %); limits of agreement were 13.07 for the ÖMPSQ and 1.37 for the ÖMPSQ-short; and the minimum detectable change was 25.12 for the ÖMPSQ and 15.51 for the ÖMPSQ-short. The ÖMPSQ total score showed a good correlation with the RMDQ (r = 0.73) and the TSK (r = 0.64) and a moderate correlation with pain intensity (current pain: r = 0.36; last 2 weeks: r = 0.37; last episode: r = 0.46). Moreover, ÖMPSQ-short showed a good correlation with RMDQ (r = 0.69) and a moderate correlation with TSK (r = 0.57) and pain (current pain: r = 0.34; last 2 weeks: r = 0.36; last episode: r = 0.54). No ceiling or floor effects were detected in both versions. CONCLUSION The Brazilian-Portuguese ÖMPSQ and ÖMPSQ-short showed acceptable measurement properties and provide evidence that the Brazilian-Portuguese versions of ÖMPSQ and ÖMPSQ-short are similar to the original versions.
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Affiliation(s)
- Felipe Ribeiro Cabral Fagundes
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 448/475, Tatuapé, São Paulo, SP, CEP 03071-000, Brazil.
| | - Leonardo Oliveira Pena Costa
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 448/475, Tatuapé, São Paulo, SP, CEP 03071-000, Brazil.,Musculoskeletal Division, The George Institute for Global Health, Sydney, Australia
| | - Fernanda Ferreira Fuhro
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 448/475, Tatuapé, São Paulo, SP, CEP 03071-000, Brazil
| | - Ana Carolina Tacollini Manzoni
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 448/475, Tatuapé, São Paulo, SP, CEP 03071-000, Brazil
| | - Naiane Teixeira Bastos de Oliveira
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 448/475, Tatuapé, São Paulo, SP, CEP 03071-000, Brazil
| | - Cristina Maria Nunes Cabral
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 448/475, Tatuapé, São Paulo, SP, CEP 03071-000, Brazil
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Cuesta-Vargas AI, González-Sánchez M. Spanish version of the screening Örebro musculoskeletal pain questionnaire: a cross-cultural adaptation and validation. Health Qual Life Outcomes 2014; 12:157. [PMID: 25358630 PMCID: PMC4219048 DOI: 10.1186/s12955-014-0157-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/09/2014] [Indexed: 11/24/2022] Open
Abstract
Background Spanish is one of the five most spoken languages in the world. There is currently no published Spanish version of the Örebro Musculoskeletal Pain Questionnaire (OMPQ). The aim of the present study is to describe the process of translating the OMPQ into Spanish and to perform an analysis of reliability, internal structure, internal consistency and concurrent criterion-related validity. Methods Design: Translation and psychometric testing. Procedure: Two independent translators translated the OMPQ into Spanish. From both translations a consensus version was achieved. A backward translation was made to verify and resolve any semantic or conceptual problems. A total of 104 patients (67 men/37 women) with a mean age of 53.48 (±11.63), suffering from chronic musculoskeletal disorders, twice completed a Spanish version of the OMPQ. Statistical analysis was performed to evaluate the reliability, the internal structure, internal consistency and concurrent criterion-related validity with reference to the gold standard questionnaire SF-12v2. Results All variables except “Coping” showed a rate above 0.85 on reliability. The internal structure calculation through exploratory factor analysis indicated that 75.2% of the variance can be explained with six components with an eigenvalue higher than 1 and 52.1% with only three components higher than 10% of variance explained. In the concurrent criterion-related validity, several significant correlations were seen close to 0.6, exceeding that value in the correlation between general health and total value of the OMPQ. Conclusions The Spanish version of the screening questionnaire OMPQ can be used to identify Spanish patients with musculoskeletal pain at risk of developing a chronic disability. Electronic supplementary material The online version of this article (doi:10.1186/s12955-014-0157-5) contains supplementary material, which is available to authorized users.
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Bergström G, Hagberg J, Busch H, Jensen I, Björklund C. Prediction of sickness absenteeism, disability pension and sickness presenteeism among employees with back pain. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:278-86. [PMID: 23771777 PMCID: PMC4000420 DOI: 10.1007/s10926-013-9454-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE The primary aim of this study was to evaluate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) concerning long-term sick leave, sickness presenteeism and disability pension during a follow-up period of 2 years. METHODS The study group consisted of 195 employees visiting the occupational health service (OHS) due to back pain. RESULTS Using receiver operating characteristic (ROC) curves, the area under the curve (AUC) varied from 0.67 to 0.93, which was from less accurate for sickness presenteeism to highly accurate for the prediction of disability pension. For registered sick leave during 6 months following the baseline the AUC from the ROC analyses was moderately accurate (0.81) and a cut off score of 90 rendered a high sensitivity of 0.89 but a low specificity of 0.46 whereas a cut off score of 105 improves the specificity substantially but at the cost of some sensitivity. The predictive ability appears to decrease with time. Several workplace factors beyond those included in the ÖMPSQ were considered but only social support at the workplace was significantly related to future long-term sick leave besides the total score of the ÖMPSQ. CONCLUSIONS The results of this study extend and confirm the findings of earlier research on the ÖMPSQ. Assessment of psychosocial risk factors among employees seeking help for back pain at the OHS could be helpful in the prevention of work disabling problems.
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Affiliation(s)
- Gunnar Bergström
- Division of Implementation and Intervention Research, The Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, 171 77, Stockholm, Sweden,
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Testing a new 10-item scale (Pind's LBP Test) for prediction of sick leave lasting more than three days or more than two weeks after a general practitioner visit for acute low back pain. Spine (Phila Pa 1976) 2014; 39:E581-6. [PMID: 24480937 DOI: 10.1097/brs.0000000000000248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A study on acute low back pain (LBP) in consecutive working patients in a multicenter study in general practice. OBJECTIVE LBP costs are enormous in all countries. New guidelines are difficult to introduce. On the basis of a new, specially developed LBP scale, the aims were to predict the duration of sick leave (SL), and to examine if the guidelines concerning bed rest (BR) and referral to radiographical examination were followed. SUMMARY OF BACKGROUND DATA Pain intensity and heavy work influence the course of SL. A finger-to-floor distance test assesses the mobility of the spine, and both the finger-to-floor distance test and the straight leg raising test (SLRT) can be used to predict the course of LBP. BR or waiting time for treatment or referral will prolong SL. The expectations of patients and general practitioners are strong outcome predictors as is information about the prognosis. METHODS A user-friendly 10-item questionnaire was specifically developed. The scale included the background date. From a predefined scale the patients were subgrouped into 3 categories in relation to SL: (1) "no SL" or "a few days of SL," (2) "1 week of SL," and (3) "more than 2 weeks of SL." The Fisher exact test was used to compare categorical variables. RESULTS Twenty-three doctors examined 207 working patients. A total of 114 patients (56%) completed the follow-up questionnaire. The 10-item scale showed a good correlation between the total score at the first general practitioner visit and predictable time of SL according to the 3 periods.The frequency of BR and referral to radiographical examination was low, and perhaps this was a consequence of using the scale. CONCLUSION The specially developed short and user-friendly 10-item LBP scale was a good predictor of the duration of SL. A low rate of BR and radiographical examination may even be the result of using the scale. LEVEL OF EVIDENCE N/A.
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Chou R, McCarberg B. Managing acute back pain patients to avoid the transition to chronic pain. Pain Manag 2014; 1:69-79. [PMID: 24654586 DOI: 10.2217/pmt.10.7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chronic back pain is a major source of disability, decreased quality of life and healthcare costs. Treating chronic back pain is difficult, with even effective therapies only being modestly effective. Helping patients avoid the transition from acute to chronic low back pain is a promising strategy for preventing suffering and reducing healthcare utilization. The biopsychosocial model provides a useful framework for understanding factors that contribute to chronicity in low back pain, and are important targets for interventions. This article reviews recent research on predictors of chronicity and treatment strategies in higher risk patients that may be helpful for preventing chronicity.
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Affiliation(s)
- Roger Chou
- Chronic Pain Management Program Kaiser Permamente, San Diego, CA, USA
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Ford JJ, Richards MC, Hahne AJ. A classification and treatment protocol for low back disorders. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x12y.0000000034] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Smits N, Finkelman MD. Variable length testing using the ordinal regression model. Stat Med 2013; 33:488-99. [DOI: 10.1002/sim.5936] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 06/24/2013] [Accepted: 07/11/2013] [Indexed: 11/09/2022]
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