Ackelman BH, Lindgren U. Validity and reliability of a modified version of the neck disability index

Department of Physiotherapy, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.
Journal of Rehabilitation Medicine (Impact Factor: 1.68). 12/2002; 34(6):284-7. DOI: 10.1080/165019702760390383
Source: PubMed


The Neck Disability Index was tested for validity and reliability. Fifty-nine Swedish patients (28 men, 31 women) were included. Twenty patients were in the acute phase after a neck sprain, 19 had chronic neck pain and 20 had no neck pain but had other musculoskeletal symptoms. On 5 occasions, the patients completed the Neck Disability Index, the Disability Rating Index, the MOS 36-item short-form health survey, 2 visual analogue scales, for pain and overall activity and some complementary questions. Levels of sensitivity, test-retest reliability and validity were acceptable. In order to increase specificity, we modified the Neck Disability Index by clarifying that the items only referred to the pain in the neck in 9 of 10 items. Thirty-eight patients (16 men, 22 women) were included in a study of the modified version. Twenty patients with acute neck sprain and 18 with other musculoskeletal symptoms filled out the modified version of the Neck Disability Index, which provided a more specific measure of disability due to neck pain.

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    • "In addition, symptoms consistent with the clinical diagnosis of tension neck syndrome (Larsson et al., 2007) were required with a pain intensity of at least three on the Numeric Rating Scale (NRS; Ferreira-Valente et al., 2011) and/or a decrease in neck function scored as at least 10 measured by the Swedish version of the Neck Disability Index (Ackelman and Lindgren, 2002). The CNSP subjects also had to be willing to engage in an exercise intervention. "
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    ABSTRACT: Background In peripheral tissue, several substances influence pain and pain modulation. Exercise has been found to decrease pain and improve function for chronic pain conditions, but how and why exercise produces beneficial effects remains unclear. This study investigates whether aspects of pain and concentrations of substances with algesic, analgesic and metabolic functions differ between women with chronic neck shoulder pain (CNSP) and healthy women (CON) and whether changes are found after an exercise intervention for CNSP.Methods Forty-one women with CNSP and 24 CON subjects were included. The participants attended two microdialysis sessions with 4–6 months between the experiments. During this period, the CNSP subjects underwent an exercise intervention. Expression levels of substance P, beta-endorphin, cortisol, glutamate, lactate and pyruvate as well as pain intensity and pressure pain thresholds were analysed.ResultsAt baseline, higher concentrations of glutamate and beta-endorphin and lower concentrations of cortisol in CNSP than CON were found. After exercise, decreased levels of substance P and possibly of glutamate, increased levels of beta-endorphin and cortisol as well as decreased pain intensity and increased pain pressure thresholds were found for CNSP.Conclusions The findings at baseline indicated algesic and analgesic alterations in the painful trapezius muscles. The findings for CNSP after the exercise intervention, with changes in peripheral substances and decreased pain intensity and sensitivity, could reflect a long-term physiological effect of the exercise.
    Full-text · Article · Dec 2014 · European journal of pain (London, England)
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    • "Other evaluation methods contained neck disability index (NDI) assessment and 36-item short-form 36-item Medical Outcome Short Form Health Study Survey (SF-36) questionnaire. NDI assessment was performed according to a previous description [13]. There were 10 items in NDI assessment, such as pain intensity, personal care, driving, headaches, reading, work as well as personal care, lifting, driving, sleeping, and recreational activities. "
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    ABSTRACT: In this paper, we carried out a randomized controlled clinical trial to explore the effect of 12-words-for-life-nurturing exercise on patients presenting with cervical spondylosis. After exercise intervention, the mean VAS and NDI scores of the patients decreased significantly and the scores of BP, VT, and MH in SF-36 Health Questionnaire were significantly higher. Exercise therapy showed significant effect on relieving pain and improving vitality and mental health. The 12-words-for-life-nurturing exercise may be a potential effective therapy for patients with cervical spondylosis.
    Preview · Article · Mar 2014 · Evidence-based Complementary and Alternative Medicine
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    • "Inclusion criteria were female, 20 – 60 years old, and constantly or frequently occurring pain in the neck/shoulder area for more than six months. In addition, symptoms consistent with the clinical diagnosis of tension neck syndrome [27] was required with a pain intensity of at least 3 on the Numeric Rating Scale (NRS) [28] and/or a reduction in function scored as at least 10 (see “Neck function” for details) measured by the Swedish version of the NDI [24]. The participant also had to declare that they were motivated to follow the exercise protocol. "
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    ABSTRACT: Different types of exercises can help manage chronic neck pain. Supervised exercise interventions are widely used, but these protocols require substantial resources. The aim of this trial, which focused on adherence, was to evaluate two home exercise interventions. This parallel group randomized controlled trial included 57 women randomly allocated into two groups - a strength training group (STRENGTH, 34 subjects) and a stretching group (STRETCH, 23 subjects). The interventions focused on the neck and shoulder muscles and lasted for 12 months. The STRENGTH group performed weight training and ended each session with stretching exercises. These stretching exercises constituted the entirety of the STRETCH group's training session. Both groups were instructed to exercise three times per week. All the participants kept an exercise diary. In addition, all participants were offered support via phone and e-mail. The primary outcomes were pain intensity and function. The trial included a four- to six-month and a twelve-month follow-up. A completer in this study exercised at least 1,5 times per week during eight unbroken weeks. A responder in this study reported clinically significant improvements on pain and function. The statistical analyses used the Mann Whitney U-test, Wilcoxon signed-rank test, and X2 test. At four- to six-months, the numbers of completers were 19 in the STRENGTH group and 17 in the STRETCH group. At twelve months, the corresponding numbers were 11 (STRENGTH) and 10 (STRETCH). At four- to six-months, the proportions of subjects reporting clinically important changes (STRENGTH and STRETCH) were for neck pain: 47% and 41%, shoulder pain: 47% and 47%, function: 37% and 29%. At twelve months, the corresponding numbers were for neck pain: 45% and 40%, shoulder pain: 55% and 50%, function: 55% and 20%. No differences in the two primary outcomes between the two interventions were found, a finding that may be due to the insufficient statistical power of the study. Both interventions based on home exercises improved the two primary outcomes, but the adherences were relatively low. Future studies should investigate ways to improve adherence to home exercise treatments.Trial registration: Id: NCT01876680.
    Full-text · Article · Jan 2014 · BMC Musculoskeletal Disorders
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