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Channak S, Speklé EM, van der Beek AJ, Janwantanakul P. Effect of two dynamic seat cushions on postural shift, trunk muscle activation and spinal discomfort in office workers. APPLIED ERGONOMICS 2024; 120:104337. [PMID: 38885573 DOI: 10.1016/j.apergo.2024.104337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/31/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
We investigated the effect of two dynamic seat cushions on postural shift, trunk muscle activation and spinal discomfort. In this repeated-measures study, 30 healthy office workers were randomly assigned to a sequence of three conditions: sitting on a dynamic seat cushion-A, cushion-B and control (no seat cushion). The two dynamic seat cushions had different inflation levels. Participants typed a standard text for an hour and were monitored for postural shift by using a seat pressure mat, transversus abdominis/internal oblique and lumbar multifidus muscles activity by using surface EMG, spinal discomfort by using Borg's CR-10 scale. Two-way repeated ANOVAs showed no statistically significant interaction effects between condition and time on postural shift and muscle activation. Post hoc Bonferroni tests showed that postural shifts and lumbar multifidus activation during sitting on cushion-A were significantly higher (p < 0.01) than in the control and cushion-B conditions. Both cushions reduced spinal discomfort, compared to the control condition (p < 0.05).
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Affiliation(s)
- Sirinant Channak
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Erwin M Speklé
- Arbo Unie B.V., Occupational Health Service, Nieuwegein, the Netherlands; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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Roynarin N, Channak S, Janwantanakul P. Postural shifts and body perceived discomfort during 1-hour sitting when leaning and sitting on an air-filled seat cushion among healthy office workers. ERGONOMICS 2024:1-12. [PMID: 38932623 DOI: 10.1080/00140139.2024.2372006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
This study compared the number of postural shifts and perceived discomfort while leaning and sitting on an air-filled seat cushion for 1 hour. Sixty office workers typed a standard text while leaning on a cushion placed behind the low back, sitting on a cushion placed under the buttocks, and sitting without a cushion (a control condition). The number of postural shifts was collected using a seat pressure mat device. Low back discomfort was assessed using the Borg CR-10 scale. Leaning on a seat cushion (22 shifts/h) led to a significantly higher number of postural shifts than sitting on a seat cushion (18 shifts/h) and the control condition (20 shifts/h). Leaning or sitting on a seat cushion significantly decreased low back discomfort compared to the control condition (p < 0.05). Leaning on a seat cushion placed behind the low back may be an effective means of preventing low back pain among office workers.
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Affiliation(s)
- Narumon Roynarin
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sirinant Channak
- Faculty of Physical Therapy, Huachiew Chalermprakiet University, Samutprakarn, Thailand
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Meguro T, Takayama F, Hammarlund H, Honjo M. Effects of a mobile health intervention on health-related outcomes in Japanese office workers: a pilot study. Int J Occup Med Environ Health 2024; 37:153-164. [PMID: 38375630 PMCID: PMC11142403 DOI: 10.13075/ijomeh.1896.02317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The purpose of the current study was to explore the effects of a mobile health (mHealth) intervention based on the Persuasive System Design (PSD) model on health-related outcomes among office workers. MATERIAL AND METHODS The authors conducted a trial that consisted of a 4-week baseline and an 8-week intervention period by reference to 23 office workers in a private research company. The mHealth application was developed to improve these workers' daily step count, decrease their sedentary time, and increase their sleep duration in accordance with the PSD model. The app features included at least 1 principal factor from each of the 4 main categories of the PSD model (primary task support, dialogue support, system credibility support, and social support). The objective health-related variables were measured using a smartwatch (Fitbit Luxe) that was synchronized with the application using the Fitbit Web Application Programming Interface. Subjects used the app, which included self-monitoring, personalized messages, education, and a competition system for users, during the intervention period. RESULTS Sedentary time exhibited a significant decrease (a median reduction of 14 min/day, p < 0.05) during the intervention period. No significant differences in daily step count and sleep duration were observed between the baseline and intervention periods. CONCLUSIONS This study suggests that the mHealth intervention based on the PSD model was useful for reducing sedentary time among office workers. Given that many previous studies on this topic have not been based on any theories, future studies should investigate the impact of structured selection behavior change theories on health-related outcomes among office workers. Int J Occup Med Environ Health. 2024;37(2):153-64.
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Affiliation(s)
- Takumi Meguro
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
| | | | | | - Masaru Honjo
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
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Ahmad I, Sharma A, Zaidi S, Alshahrani MS, Gautam AP, Raizah A, Reddy RS, Verma S, Tanwar T, Hussain ME, Malhotra D, Uddin S, Mukhtar EM. Establishing Responsiveness and Minimal Clinically Important Difference of Quebec Back Pain Disability Scale (Hindi Version) in Chronic Low Back Pain Patients Undergoing Multimodal Physical Therapy. Healthcare (Basel) 2023; 11:healthcare11040621. [PMID: 36833155 PMCID: PMC9957059 DOI: 10.3390/healthcare11040621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Increasing emphasis is placed on physical functional measures to examine treatments for chronic low back pain (CLBP). The Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) has never been evaluated for responsiveness. The objectives of this study were to (1) examine the internal and external responsiveness of the Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) and (2) find out the minimal clinically important difference (MCID) and minimal detectable change (MDC) in the functional ability of patients with chronic low back pain (CLBP) undergoing multimodal physical therapy treatment. In this prospective cohort study, QBPDS-H responses were recorded at the baseline and after eight weeks from 156 CLBP patients undergoing multimodal physiotherapy treatment. To differentiate between the clinically unimproved (n = 65, age: 44.16 ± 11.8 years) and clinically improved (n = 91, age: 43.28 ± 10.7 years) scores of patients from the initial assessment to the last follow-up, the Hindi version of the Patient's Global Impression of Change (H-PGIC) scale was utilized. Internal responsiveness was large (E.S. (pooled S.D.) (n = 91): 0.98 (95% CI = 1.14-0.85) and Standardized Response Mean (S.R.M.) (n = 91): 2.57 (95% CI = 3.05-2.17)). In addition, the correlation coefficient and receiver operative characteristics (R.O.C.) curve were used to assess the QBPDS-H external responsiveness. MCID and MDC were detected by the R.O.C. curve and standard error of measurements (S.E.M.), respectively. The H-PGIC scale showed moderate responsiveness (ρ = 0.514 and area under the curve (A.U.C.) = 0.658; 95% CI, 0.596-0.874), while the MDC achieved 13.68 points, and the MCID was found have 6 points (A.U.C. = 0.82; 95% CI: 0.74-0.88, sensitivity = 90%, specificity = 61%). This study shows that QBPDS-H has moderate levels of responsiveness in CLBP patients receiving multimodal physical therapy treatment, so it can be used to measure the changes in disability scores. MCID and MDC changes were also reported with QBPDS-H.
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Affiliation(s)
- Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Akhil Sharma
- St. Stephens Hospital, Tis Hazari, New Delhi 110054, India
| | - Sahar Zaidi
- Department of Physiotherapy, Jamia Hamdard, New Delhi 110062, India
- Correspondence: ; Tel.: +91-97-3986-4312
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Abdullah Raizah
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
| | - Shalini Verma
- Department of Physiotherapy, Jamia Hamdard, New Delhi 110062, India
| | - Tarushi Tanwar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mohammad Ejaz Hussain
- Faculty of Allied Health Sciences and Physiotherapy, SGT University, Gurugram 122505, India
| | - Deepak Malhotra
- Department of Physiotherapy, Jamia Hamdard, New Delhi 110062, India
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan 82911, Saudi Arabia
| | - Emadeldin Mohammed Mukhtar
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia
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Waongenngarm P, van der Beek AJ, Janwantanakul P, Akkarakittichoke N, Coenen P. Can the Borg CR-10 scale for neck and low back discomfort predict future neck and low back pain among high-risk office workers? Int Arch Occup Environ Health 2022; 95:1881-1889. [PMID: 35650349 PMCID: PMC9630392 DOI: 10.1007/s00420-022-01883-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
Purpose Perceived discomfort could indicate an early sign of pain, for example, as a result of a biomechanical load on the musculoskeletal system. Assessing discomfort can, therefore, help to identify workers at increased risk of musculoskeletal disorders for targeted intervention development. We aimed: (1) to identify the optimal cut-off value of neck and low back discomfort among office workers and (2) to evaluate its predictive validity with future neck and low back pain, respectively. Methods At baseline healthy participants (n = 100) completed questionnaires, including the Borg CR-10 discomfort scale (on a 0–10 scale), and were followed for six months, during which musculoskeletal pain was assessed monthly. Logistic regression analyses were performed to assess the associations of baseline discomfort with the onset of future neck or low back pain. Sensitivity, specificity, and the area under the receiver operating characteristics curve were estimated to identify the optimal discomfort cut-off value predicting future pain. Results Borg CR-10 scores ≥ 3.5 for perceived neck and low back discomfort had acceptable sensitivity and specificity to predict future neck and low back pain, respectively. Perceived discomfort at baseline as a dichotomous measure (using the ≥ 3.5 cut-off) was a statistically significant predictor of future neck pain (OR = 10.33) and low back pain (OR = 11.81). Conclusion We identified the optimal cut-off value of the Borg CR-10 discomfort scale to identify office workers at increased risk of developing neck and low back pain. These findings might benefit ergonomists, primary health care providers, and occupational health researchers in developing targeted interventions.
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Affiliation(s)
- Pooriput Waongenngarm
- Faculty of Health Science Technology, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Nipaporn Akkarakittichoke
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
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Sihawong R, Waongenngarm P, Janwantanakul P. Efficacy of risk factor education on pain intensity and disability in office workers with nonspecific neck or low back pain: A pilot cluster randomized clinical trial. J Back Musculoskelet Rehabil 2021; 34:251-259. [PMID: 33185585 DOI: 10.3233/bmr-191716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Musculoskeletal disorders are of multi-factorial origin, including individual, physical, and psychosocial factors. An effective education program for musculoskeletal disorders should include predisposing factors. OBJECTIVE This study aimed to examine the effect of risk factor education on pain intensity and disability levels compared to a home-based exercise program in office workers with nonspecific neck or low back pain. METHODS A pilot cluster randomized clinical trial was conducted in 46 workers with neck or low back pain. The education group received checklists of risk factors and handbooks providing information on how to manage them. The exercise group received a home-based exercise program to manage their neck or low back pain. The primary outcome measures were pain intensity and disability levels. RESULTS There was no significant difference in pain intensity or disability level between groups at baseline and follow-ups. However, neck and low back pain intensity, but not disability level, at the 3-month and 6-month follow-ups was significantly lower than those at baseline in both groups. CONCLUSION Risk factor education was not more effective than the home-based exercise program in terms of pain intensity or disability reduction in workers with nonspecific neck or low back pain.
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Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Effects of an active break and postural shift intervention on preventing neck and low-back pain among high-risk office workers: a 3-arm cluster-randomized controlled trial. Scand J Work Environ Health 2021; 47:306-317. [PMID: 33906239 PMCID: PMC8091075 DOI: 10.5271/sjweh.3949] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study evaluated the effects of the promotion of active breaks and postural shifts on new onset of neck and low-back pain during a 6-month follow-up among high-risk office workers. METHODS A 3-arm cluster-randomized controlled trial with 6-month follow-up was conducted among healthy but high-risk office workers. Participants were recruited from six organizations in Bangkok, Thailand (N=193) and randomly assigned at cluster level into active break intervention (N=47), postural shift intervention (N=46), and control (N=100) groups. Participants in the intervention groups received a custom-designed apparatus to facilitate designated active breaks and postural shifts during work. Participants in the control group received a placebo seat pad. The primary outcome measure was new onset of neck and low-back pain during 6-month follow-up. Analyses were performed using Cox proportional hazard models. RESULTS One-hundred and eighty-six (96%) predominantly female participants were successfully followed up over six months. New onset of neck pain during the 6-month follow-up occurred in 17%, 17%, and 44% of the participants in the active break, postural shift, and control groups, respectively. For new onset of low-back pain, these percentages were 9%, 7%, and 33%, respectively. Hazard rate (HR) ratios after adjusting for biopsychosocial factors indicated a protective effect of the active break and postural shift interventions for neck pain [HRadj 0.45, 95% confidence interval (CI) 0.20-0.98 for active break and HRadj 0.41, 95% CI 0.18-0.94 for postural shift] and low-back pain (HRadj 0.34, 95% CI 0.12-0.98 for active break and HRadj 0.19, 95% CI 0.06-0.66 for postural shift). CONCLUSION Interventions to increase either active breaks or postural shifts reduced new onset of neck and low-back pain among high-risk office workers.
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Affiliation(s)
- Pooriput Waongenngarm
- Prawit Janwantanakul, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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Ali M, Ahsan GU, Hossain A. Prevalence and associated occupational factors of low back pain among the bank employees in Dhaka City. J Occup Health 2020; 62:e12131. [PMID: 32715531 PMCID: PMC7383126 DOI: 10.1002/1348-9585.12131] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 04/01/2020] [Accepted: 04/23/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Low back pain (LBP) is one of the common health problems among full-time office employees that causes absenteeism from work. The aim of the study is to identify the association between occupational factors and LBP among full-time bank employees in Dhaka City. MATERIALS AND METHODS We conducted a cross-sectional study involving 593 full-time bank employees who were engaged in sedentary works. The 1-month complaint of LBP was measured using a subscale of subjective health complaints inventory. Multivariable logistic models were performed to identify variables related to LBP, and a random forest technique was performed to determine the top five important variables. RESULTS The 1-month prevalence for LBP was found to be 36.6% among the bank employees, and the prevalence was the highest (64.3%) for the 51- to 59-year-old age group. The regression analysis indicates that respondents from both agegroups, 41-50 years (OR = 2.00, 95% confidence interval [CI] = 1.10-3.69) and 51-59 years age groups (OR = 5.14, 95% CI = 2.05-13.64), are significantly associated with LBP. Furthermore, obesity (OR = 2.06, 95% CI = 1.01-4.21), and prolong working hours (>9 hours) (OR = 1.42, 95% CI = 1.01-2.0) are positively associated with LBP. The top five important variables for LBP identified by random forest technique are: age, length of employment, prolong office hours, presence of chronic illness, and physical activity. CONCLUSION LBP is highly prevalent in full-time bank employees. The occupational factors, including the length of employment (>10 years) and long working hours, play a significant role in developing LBP among bank employees. Moreover, several factors, including age, chronic illness, obesity, and physical activity, should be taken into account in the prevention of LBP in bank employees.
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Affiliation(s)
- Mohammad Ali
- Department of PhysiotherapyUttara Adhunik Medical College HospitalDhakaBangladesh
- Centre for Higher Studies and ResearchBangladesh University of ProfessionalsDhakaBangladesh
| | - Gias U. Ahsan
- Department of Public HealthNorth South UniversityDhakaBangladesh
| | - Ahmed Hossain
- Department of Public HealthNorth South UniversityDhakaBangladesh
- Health Management BD FoundationDhakaBangladesh
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Wang K, Zhang JW, Min SX, Xu XY, An SL. Development and validation of a pre-scoring system for nonspecific low back pain among general population in Guangzhou: a cross-sectional study. BMC Public Health 2019; 19:1262. [PMID: 31510992 PMCID: PMC6739945 DOI: 10.1186/s12889-019-7564-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background Nonspecific Low Back Pain (NLBP) is a common disease with a low cure rate and significant impact on the population. This study aimed to develop and validate a pre-scoring system for identifying the risk of suffering from NLBP among the general population in Guangzhou. Methods A total of 1439 eligible subjects were surveyed in Guangzhou by stratified random sampling and was divided randomly into the development dataset (69.6%) and validation dataset (30.4%) subsequently. Based on the development dataset, potential associated factors (average exercise times weekly, the intensity of daily work, etc.) with NLBP were tested by the sequential logistic regression, and a pre-scoring system was formulated with Sullivan’s method and graded afterward. The internal validity of the system was assessed by AUC and calibration plot, and the external validation was performed in the validation dataset. Results The prevalence rates of NLBP in the development dataset and the validation dataset were 12.97 and 13.27%, respectively. Age, BMI, average exercise times weekly, gender, educational level, the intensity of daily work, place of residence, monthly income, overall evaluation of health condition and physiology health were identified as significant factors. The total risk score ranged from 0 to 38, which was split into three risk grades: low risk (0 to 18), intermediate risk (19 to 22) and high risk (23 to 38). The pre-scoring system had an adequate calibration and a good discriminating ability with bootstrap-corrected AUC equaling 0.861 in the development dataset and 0.821 in the validation dataset. Conclusions A pre-scoring system that could help clinicians to assess the risk of NLBP in the general population was validated. Further validation of the system in a new population or prospective cohort study is suggested. Electronic supplementary material The online version of this article (10.1186/s12889-019-7564-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kai Wang
- Department of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, People's Republic of China
| | - Jing-Wen Zhang
- Department of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, People's Republic of China
| | - Shao-Xiong Min
- Orthopaedic Center, Zhujiang Hospital, Southern Medical University, No. 253 Gongye Avenue, Guangzhou, 510282, People's Republic of China
| | - Xin-Yi Xu
- Orthopaedic Center, Zhujiang Hospital, Southern Medical University, No. 253 Gongye Avenue, Guangzhou, 510282, People's Republic of China
| | - Sheng-Li An
- Department of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, People's Republic of China.
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Froud R, Fawkes C, Foss J, Underwood M, Carnes D. Responsiveness, Reliability, and Minimally Important and Minimal Detectable Changes of 3 Electronic Patient-Reported Outcome Measures for Low Back Pain: Validation Study. J Med Internet Res 2018; 20:e272. [PMID: 30355556 PMCID: PMC6231814 DOI: 10.2196/jmir.9828] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/18/2018] [Accepted: 06/18/2018] [Indexed: 01/19/2023] Open
Abstract
Background The Roland Morris Disability Questionnaire (RMDQ), visual analog scale (VAS) of pain intensity, and numerical rating scale (NRS) are among the most commonly used outcome measures in trials of interventions for low back pain. Their use in paper form is well established. Few data are available on the metric properties of electronic counterparts. Objective The goal of our research was to establish responsiveness, minimally important change (MIC) thresholds, reliability, and minimal detectable change at a 95% level (MDC95) for electronic versions of the RMDQ, VAS, and NRS as delivered via iOS and Android apps and Web browser. Methods We recruited adults with low back pain who visited osteopaths. We invited participants to complete the eRMDQ, eVAS, and eNRS at baseline, 1 week, and 6 weeks along with a health transition question at 1 and 6 weeks. Data from participants reporting recovery were used in MIC and responsiveness analyses using receiver operator characteristic (ROC) curves and areas under the ROC curves (AUCs). Data from participants reporting stability were used for analyses of reliability (intraclass correlation coefficient [ICC] agreement) and MDC95. Results We included 442 participants. At 1 and 6 weeks, ROC AUCs were 0.69 (95% CI 0.59 to 0.80) and 0.67 (95% CI 0.46 to 0.87) for the eRMDQ, 0.69 (95% CI 0.58 to 0.80) and 0.74 (95% CI 0.53 to 0.95) for the eVAS, and 0.73 (95% CI 0.66 to 0.80) and 0.81 (95% CI 0.69 to 0.92) for the eNRS, respectively. Associated MIC thresholds were estimated as 1 (0 to 2) and 2 (–1 to 5), 13 (9 to 17) and 7 (–12 to 26), and 2 (1 to 3) and 1 (0 to 2) points, respectively. Over a 1-week period in participants categorized as “stable” and “about the same” using the transition question, ICCs were 0.87 (95% CI 0.66 to 0.95) and 0.84 (95% CI 0.73 to 0.91) for the eRMDQ with MDC95 of 4 and 5, 0.31 (95% CI –0.25 to 0.71) and 0.61 (95% CI 0.36 to 0.77) for the eVAS with MDC95 of 39 and 34, and 0.52 (95% CI 0.14 to 0.77) to 0.67 (95% CI 0.51 to 0.78) with MDC95 of 4 and 3 for the eNRS. Conclusions The eRMDQ was reliable with borderline adequate responsiveness. The eNRS was responsive with borderline reliability. While the eVAS had adequate responsiveness, it did not have an attractive reliability profile. Thus, the eNRS might be preferred over the eVAS for measuring pain intensity. The observed electronic outcome measures’ metric properties are within the ranges of values reported in the literature for their paper counterparts and are adequate for measuring changes in a low back pain population.
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Affiliation(s)
- Robert Froud
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Institute of Health Sciences, Kristiania University College, Oslo, Norway
| | - Carol Fawkes
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jonathan Foss
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Department of Computer Science, University of Warwick, Coventry, United Kingdom
| | - Martin Underwood
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Dawn Carnes
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Faculty of Health, University of Applied Sciences and the Arts, Western Switzerland, Switzerland
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