Measures for low back pain: a proposal for clinical use

Bournemouth questionnaire Arabic version: Cross-cultural adaptation, validity, and reliability for patients with low back pain

OBJECTIVE

To translate, culturally adapt, validate, and investigate the reliability of Arabic version of Bournemouth questionnaire (BQ) for patients with low back pain.

METHOD

Thirty experts (three panels) and 70 low back pain patients (37.5 ± 13.9 years) were involved in this study. Test-retest as well as internal consistency analyses were used to assess reliability. Intraclass correlation coefficient (95% confidence interval) was used to assess test-retest analysis, whereas Cronbach alpha value was calculated to assess the internal consistency. BQ Arabic version validity was evaluated in forms of face, content, internal, and external construct validity. Internal construct validity was evaluated with factor analysis, and external construct validity was tested by the correlation between the Arabic version of BQ and short-form (36) health survey (SF-36) questionnaire.

RESULTS

Factor analysis revealed that BQ had a single factor. BQ has a very good correlation with SF-36 questionnaire (r = .74). Arabic version of BQ has a high internal consistency reliability where Cronbach alpha value was 0.889 at baseline and 0.911 after 1 week. The test-retest analysis was between 0.87 and 0.96 and for the BQ total score was 0.95 (p < .0001) indicating that test-retest results are highly correlated.

CONCLUSION

The Arabic version of BQ is a valid, reliable, and feasible scale for assessment of low back patients. It is short, easy-to-apply, need short time to complete and comprehensive scale. So it may be considered as a preferable scale for clinical assessment of Arabic speaking patients with low back pain.

Cultural adaptation, reliability and validity of Japanese Orthopaedic Association Back Pain Evaluation Questionnaire to Brazilian Portuguese

OBJECTIVE

To describe the translation and cultural adaptation of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire into Brazilian Portuguese, and verifies the reliability and validity of this new version.

METHODS

A cross-cultural adaptation of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire was performed using the following steps: translation, back-translation, committee review, and pre-testing phase (50 subjects). The psychometric properties were evaluated by application of the questionnaire to 102 patients. Reliability was assessed by homogeneity and stability of measures. The criterion-related validity was tested by comparing scores of Japanese Orthopaedic Association Back Pain Evaluation Questionnaire to Oswestry and Medical Outcomes Study 36 - Item Short questionnaires.

RESULTS

Excellent internal consistency was found in both test (Cronbach's α of 0.90) and re-test (Cronbach's α of 0.91). The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire showed good reliability and the correlations ranged from reasonable (0.64) to very good (r=0.91).

CONCLUSION

The Brazilian Portuguese version of Medical Outcomes Study 36 - Item Short was easy to apply and understand. The questionnaire had a great impact on assessment and multidimensional care of patients with low back pain.

Análise dos sintomas osteomusculares de professores do ensino fundamental em Matinhos (PR)

INTRODUÇÃO: Com a finalidade de investigar a etiologia dos sintomas osteomusculares em professores, estudos tem abordado a relação entre o trabalho docente e as possíveis particularidades da profissão que podem levar ao adoecimento físico dos professores. OBJETIVO: Analisar os sintomas osteomusculares de professores do ensino fundamental da cidade de Matinhos (PR). MATERIAIS E MÉTODOS: Foram avaliados 126 professores (120 mulheres e seis homens, 38,6 ± 9 anos) por meio de um questionário contendo dados gerais e ocupacionais e pelo questionário nórdico. Análises estatísticas univariadas desses questionários foram realizadas com o teste qui-quadrado. Um modelo linear logístico múltiplo foi estabelecido para predizer as variáveis respostas do questionário nórdico a partir das variáveis independentes do questionário de dados gerais e ocupacionais. RESULTADOS: A presença de dor não indicou associação significativa com a idade, realização de atividade física, número de alunos por classe e tempo de profissão (p > 0,05), relacionou-se apenas com o número de classes que lecionavam (p = 0,02). Porém, a presença de dor nos últimos 12 meses teve relação com o impedimento de realizar atividade nos últimos 12 meses e a procura por algum profissional da saúde (p > 0,05). Dos participantes, 95,2% apresentaram algum sintoma osteomuscular. As áreas mais atingidas foram lombar (51,5%), região dorsal (49,2%), ombro (49,2%) e pescoço (47,6%). CONCLUSÕES: Os professores apresentaram elevada prevalência de sintomas osteomusculares, especialmente na lombar, nos ombros e na região dorsal, os quais, por sua vez, provocaram o impedimento de realizar atividades cotidianas.

The Pain Disability Questionnaire: a reliability and validity study

The goal of this study was to translate and adapt The Pain Disability Questionnaire (PDQ) to Brazilian Portuguese, as well as to assess its psychometric properties and practicability. The following methodological steps were followed: translation, synthesis, back-translation, expert committee assessment and pre-test. The psychometric properties were assessed through the application of a questionnaire to 119 patients with chronic musculoskeletal disorders. The results indicated the reliability of the instrument, with a Cronbach's alpha coefficient of 0.86, and high stability in the test-retest. A moderate correlation was found between the PDQ scores and the numerical pain scale. Negative correlations were found between the Spitzer Quality of Life Index and the functional condition, psychosocial component and total PDQ score. Construct validity demonstrated significant difference in PDQ scores between symptomatic and asymptomatic individuals. The PDQ revealed fast application and easy understanding. The results indicated a successful cultural adaptation and reliable psychometric properties.

Qualidade de vida no trabalho e distúrbios osteomusculares relacionados ao trabalho entre profissionais de enfermagem

OBJETIVO: Avaliar a associação de Qualidade de Vida no Trabalho (QVT) com os distúrbios osteomusculares (DORT) entre profissionais de enfermagem que trabalham em bloco cirúrgico. MÉTODOS: Estudo de abordagem quantitativa, descritivo, transversal e correlacional, do qual participaram 211 trabalhadores de Enfermagem de 11 hospitais de Londrina-PR, Brasil. Para coleta de dados, foram utilizados três instrumentos: caracterização sociodemográfica e profissional, Escala Visual Analógica e o Questionário Nórdico. RESULTADOS: A maioria dos participantes era de auxiliares de enfermagem (62,6%), do sexo feminino (87,1%), casados (54,5%), com idade média de 40 anos. Dentre os participantes, 38,9% apresentavam queixas osteomusculares na região inferior das costas e 37,9%, na região dos ombros. Neste estudo, a QVT obteve associação estatisticamente significante com os distúrbios osteomusculares na região lombar e dos ombros nos últimos 12 meses (p=0,00). CONCLUSÃO: A ausência de lombalgia contribuiu significativamente para elevar a medida de QVT (p=0,010), embora o modelo final de regressão tenha explicado, apenas 22,6% da variância da medida de QVT.

Psychometric evaluation of a brazilian portuguese version of the spitzer quality of life index in patients with low back pain

The purpose of this study was to adapt the Spitzer Quality of Life Index and evaluate its reliability in patients with low back pain. The following steps were followed: translation, back-translation, evaluation by a committee, and pretest. The reliability was estimated through stability and homogeneity assessment. The validity was tested comparing scores of the Spitzer (QLI) with the SF-36 and the Roland-Morris. The psychometric properties were evaluated by the self-application on 120 patients. Results showed that the Cronbach's Alpha was 0.77. Intraclass correlation coefficient for test-retest reliability was 0.960 (p<0.001; IC95%: 0.943; 0.972). Spearman´s correlation coefficient for test-retest reliability was 0.937 (p<0.001). There was significant correlation between the Spitzer (QLI) scores and the dimensions of the SF-36. A significant negative correlation was found between the Spitzer (QLI) and the Roland-Morris scores (r = - 0.730). The adaptation process was conducted successfully and the questionnaire presented reliable psychometric measures.

Percepção sobre qualidade de vida de mulheres participantes de oficinas educativas para dor na coluna

O objetivo deste estudo foi analisar a percepção da qualidade de vida de mulheres com dor nas costas, após terem participado de oficinas educativas para o autocuidado e prevenção desta sintomatologia. A pesquisa do tipo qualitativa foi realizada em uma instituição de ensino superior situada em Fortaleza, Ceará, Brasil, nos meses de abril e maio de 2005, com a participação de nove mulheres que haviam concluído oito oficinas. Para coleta de dados, usamos o grupo focal, o qual foi gravado e filmado. Os dados foram agrupados por categoria e analisados de forma seqüencial. Todas acharam que tinham boa qualidade de vida, mesmo apresentando pouca saúde, pouco dinheiro e sem emprego, mas isto era superado pela fé em Deus. Referiram que, antes das oficinas, a dor interferia nas atividades da vida diária e social e que, depois da intervenção, a dor havia diminuído ou desaparecido em todas as mulheres. A conscientização sobre o autocuidado proporcionou bem-estar físico, emocional, intelectual, potencializou a mobilidade e a tomada de decisões, o retorno às atividades, além de eliminar ou diminuir a medicação para dor. Percebemos a importância de avaliar a qualidade de vida para guiar-nos quanto às atitudes e terapêuticas mais eficazes.

Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity

STUDY DESIGN

Translation, revision, back-translation, and 3-way validity were performed.

OBJECTIVE

The objective of this study was to translate a version of the Oswestry Disability Index (ODI) into Brazilian Portuguese and evaluate its reliability.

SUMMARY OF BACKGROUND DATA

Reports in the literature have identified a need for internationally standardized and reliable measurements to analyze back pain. The ODI has become one of the principal outcome measurements used in the management of spinal disorders.

METHODS

The cross-cultural adaptation was performed according to the internationally recommended methodology, using the following guidelines: translation, back-translation; revision by a committee, and pretesting. The psychometric properties were evaluated by administering the questionnaire to 120 subjects with back pain. Reliability was estimated through stability and homogeneity assessment. The validity was tested comparing ODI scores with the following measurements: Roland-Morris Disability Questionnaire, SF-36, and a Numerical Pain Scale.

RESULTS

Good internal consistency was found (Cronbach's alpha = 0.87). Intraclass correlation coefficient for test-retest reliability was 0.99. The ODI showed moderate correlation with pain measurement (r = 0.66). Relatively high correlation was also found between the ODI and the Roland-Morris scores (r = 0.81). There was significant correlation (P < 0.001) between ODI scores and the 8 scales of the SF-36.

CONCLUSIONS

The data showed that the cultural adaptation process was successful and that the adapted instrument demonstrated having excellent psychometric properties, reliable in the Brazilian culture.

Disability associated with low back pain in Mulago Hospital, Kampala Uganda

BACKGROUND

Low back pain is sufficiently disabling and a common cause of disability particularly during the productive middle years of adult life. Disability implies interference with daily activities.

OBJECTIVE

To assess and document the disability associated with low back pain in terms of sick leave days, interference with daily activities and some pain characteristics.

METHODS

This study was carried out in the Orthopaedic out patient clinic of Mulago Hospital, a tertiary national referral hospital in Kampala, Uganda. It was a descriptive cross sectional study over a period of seven months. 204 patients with mechanical back pain were enrolled in the study, after screening all consecutive new adult patients referred with low back pain as the major complaint. A validated modified Oswestry instrument was used to collect data. Nine daily activities: sleep, sex, lifting, traveling, social and recreational activities, dressing, sitting, walking and running activities were investigated. Data was analyzed using SPSS for windows version 10. Mean and Standard deviations were used to summarize continuous variables. P value was considered statistically significant if it was equal or less than 0.05.

RESULTS

87% of the respondents reported a mean of 14 days off work during the 4 weeks prior to the interview because of back problems. The mean duration of a current low back pain episode was 5 months. All activities were interfered with; with lifting as the most affected with a mean score of 4.5, walking and running was 3.6, standing was 3.3, sex life was 2.9, traveling was 2.9, sitting was 2.7, social and recreational activities was 2.7, getting dressed was 2.1 and sleeping was 1.8.

CONCLUSION

Our results confirm that low back pain is a significant cause of disability affecting the productive middle years of adult life and causes significant disruption of daily activities including sleep and sex. The cost of lost work time, compensation and treatment for our setting is a knowledge gap that should be filled by further study. There is need for a community-based study to ascertain extent of the problem in at a wider population level.