Functional status and disability questionnaires: what do they assess? A systematic review of back-specific outcome questionnaires.
ABSTRACT A systematic literature review of outcome questionnaires designed for assessing functional status or disability in patients with low back pain.
To provide a comprehensive overview of all functioning/disability questionnaires used in recent years and to explore how the main concept(s) was described or defined in the original paper, the content or the domains of disability, and the measurement properties of the questionnaires.
A number of clinical tools designed for evaluating the functional status of patients with low back pain have been developed. Only a few have been reviewed earlier, and there has been little focus on the content reflected in the questionnaires.
Papers including questionnaires for assessing disability, function, activity limitations, or participation restrictions in adult patients with low back pain were searched in the MEDLINE and CINAHL databases for the period from January 1996 to January 2002. Two independent and blinded researchers read and selected abstracts and questionnaires. The content of the included questionnaires was classified according to World Health Organization's International Classification of Functioning, Disability and Health. The measurement properties were analyzed according to recommended guidelines.
A total of 36 back-specific questionnaires were identified. When distinguishing among a bodily, personal, and social perspective of functioning, 4 main types of content were identified. Most of the outcome questionnaires had a mixed content reflecting various constructs such as pain and symptoms, sleep disturbances, psychological dysfunctions, physical impairments, and social functions. Nine questionnaires assessed solely activities of daily living. For one-third of the questionnaires, the measurement properties were reported in only the original study.
Although most questionnaires had their main focus on activity limitations, a considerable variation with respect to the main concept and content was found. Only a few of the questionnaires can be considered acceptably validated.
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ABSTRACT: It is often assumed that patients with pain-related disability due to low back pain (LBP) will have reduced physical activity levels, but recent studies have provided results that challenge this assumption. The aim of our systematic review was to examine the relationship between physical activity and disability in LBP. The literature search included 6 electronic databases and the reference list of relevant systematic reviews and studies to May 2010. To be included, studies had to measure both disability (eg, with the Roland Morris Disability Questionnaire) and physical activity (eg, by accelerometry) in patients with non-specific LBP. Two independent reviewers screened search results and extracted data, and authors were contacted for additional data. Correlation coefficients were pooled using the random-effects model. The search identified 3213 records and 18 studies were eligible for inclusion. The pooled results showed a weak relationship between physical activity and disability in acute or subacute (<3months) LBP (r=-0.08, 95% confidence interval=-0.17 to 0.002), and a moderate and negative relationship in chronic (>3months) LBP (r=-0.33, 95% confidence interval=-0.51 to -0.15). That is, persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability. Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity. Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability. Persons with chronic back pain with high levels of disability will likely have low levels of physical activity.Pain 03/2011; 152(3):607-13. DOI:10.1016/j.pain.2010.11.034 · 5.84 Impact Factor
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ABSTRACT: The assessment of work disability due to health problems is a difficult task because there is no straightforward relationship between disease and disability. As a result, there is wide inter-rater variability between physicians in assessing work disability. The aim of this paper is to discuss the sources of the inter-rater variability and to describe possibilities for its reduction. A model is presented in which the process of disability assessment, the instruments used and the role of the assessor is addressed. On the basis of this model, the causes of inter-rater variability and suggestions for improvement are discussed.Work 01/2010; 37(4):405-11. DOI:10.3233/WOR-2010-1094 · 0.52 Impact Factor
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ABSTRACT: This study aims to identify the needs, concerns and problems of pregnant women when using maternity support garments. Maternity support belt is regarded as helpful in reducing low back pain during pregnancy. However, several garment-related problems exist which might lead to poor adherence behaviour undermining the benefit of garment therapy. A qualitative exploratory study. METHODS. Semi-structured interviews were conducted with 10 pregnant Chinese women who experienced low back pain during pregnancy. All the interviews followed an interview guide and different maternity support garments were shown to the participants as a method of tangible objects to stimulate responses. Content analysis was used to analyse the data. The results showed that 60% of pregnant women discontinued using maternity support garments due to excessive heat, perceived ineffectiveness, itchiness, excessive pressure around the abdomen and inconvenience of adjustment. The content analysis generated five main themes of needs including effective function, safety, skin comfort, ease to put on and take off and aesthetics of maternity support garments. The findings of the five main themes of needs were largely consistent with previous studies examining medical garments for overall satisfaction and compliance. The results revealed that women's physiological and psychological changes during pregnancy influenced their clothing preferences on both functional and aesthetical values. Maternity support garments are convenient and easily-accessible therapy to manage LBP during pregnancy and are frequently recommended and worn by pregnant women. However, inappropriate choice of garment therapy not only led to ineffectiveness but also undesirable effects. The key findings of the five main themes of garment needs in pregnant women will facilitate healthcare professionals in providing evidence-based advice to assist patients in the selection of an appropriate and optimal maternity support garment. These recommendations in the clinical practice will assist patients in making well informed treatment decisions and ultimately improve the quality of care.Journal of Clinical Nursing 08/2009; 18(17):2426-35. DOI:10.1111/j.1365-2702.2009.02786.x · 1.23 Impact Factor