Validity of the new backache index (bai) in patients with low back pain

  • A. Farasyn Fac. LO & Rehab., Free Univeristy Brussels (VUB)
  • R. Meeusen Fac. LO & Rehab., Free Univeristy Brussels (VUB)

Аннотация

Background context: The Backache-Index (BAI) is applied to patients with low back pain (LBP) in order to help the doctors/surgeons perform physical examinations easily and it is carried out within a short space of time (< 2 min.) without using inclinometric instruments. Purpose: To explore the reliability, validity and responsiveness of this new Backache-Index in patients with low back pain, which can fulfil the existing need for a reliable routine examination in the clinical environment. Study design/setting: Patients with LBP filled in disability questionnaires, pain rating scales and physical impairment tests were completed in function of construct validity and correlation studies. A subgroup was evaluated for inter-observer and test-retest reliability and a second group was reassessed after two active treatment sessions in order to verify the responsiveness compared with other examined variables. Patient sample: In total, 75 patients with subacute LBP (3-12 weeks) participated in a randomized controlled study. Outcome measures: The validity of the BAI was explored through a correlation with the standard Oswestry LBP Disability Index (ODI), the McGill LBP Questionnaire Index (MPQ), and the Visual Analogue Scale (VAS). Methods: The BAI consisted of a scoring system that includes pain factors and stiffness estimation at the end of a series offive different lumbar movements of a patient standing in an erect position. Results: The correlations between the separate outcomes and the BAI ranged from 0.61 to 0.76 (P < 0.001). The inter-observer reliability between two experienced observers for the 5 outcome scores was good (ICC > 0.86) and even perfect for the BAI (ICC = 0.96). A BAI change of one unit is able to exclude a measurement error. A significantly good correlation (P < 0.001) was found between the BAI at baseline, and the ODI (R = 0.62) and the MPQ-PRIT, as the total degree of pain rating index (R = 0.57), a moderate correlation with the MPQ-NWCT, as the total number of chosen adjectives from the whole list of adjectives (R = 0.48) and the VAS (R = 0.47), but a lower correlation was found with the MPQ-Quality of life index (R = 0.43). The effect size and discriminative ability of the measures were explored after two treatment sessions of deep transverse friction myotherapy by means of the study of the receiver operating characteristics curve (ROC) and the greatest area under the curve (AUC). The greatest level of distinction was found for the MPQ-PRI-T and the BAI (AUC > 0.93), followed by the ODI (AUC = 0.92). A lower level of distinction was found for the MPQ-NWC-T and the VAS (AUC > 0.82). Conclusions: The Backache Index or BAI appears to be a reliable and valid assessment of overall restricted spinal movements in case of LBP and discriminates between successful and unsuccessful treatment outcome.

Литература

Gracovetsky S, Newman N, Pawlowsky M, et al. A database for estimating normal spinal motion derived from noninvasive measurements. Spine 1995;20:1036-46.
King P, Tuckwell N, Barrett T. A critical review of functional capacity evaluations. Phys Ther 1998;78:852-66.
Diamond A, Coniam S. Assessment of the pain patient. In: - the management of chronic pain (2nd Ed.) 3:14-22. Oxford: Oxford University Press, 1997.
Main C, Burton R. The patient with low back pain: who or what are we assessing? An experimental investigation of a clinical puzzle. Pain reviews 1995;2:203-09
Marras W, Lavender S, Leurgans S et al. The role of dynamic 3- dimenstional trunk motion in occupationally-related low back disorders. The effects of workplace factors, trunk position, and trunk motion characteristics on risk of injury. Spine 1993;18:617-28.
Oostendorp R, Scholten-Peeters G, Swinkels R, Bekkering G, Heijmans M et al. Evidence-based practice in physical and manual therapy: development and content of Dutch National Practice Guidelines for patients with non-specific low back pain. J Manual & Manip Ther 2004;12:21-31.
Panjabi M. The stabilizing system of the spine. Part II: neutral zone and instability hypothesis. Journal of Spinal Disorders 1992;5:390-96.
Zanoli G, Stromqvist B, Jonsson B, Padua R, Romanini E. Pain in low-back pain. Problems in measuring outcomes in musculoskeletal disorders. Acta Orthop Scand (Suppl 305): 2002;54- 57.
Natrass C, Nitschke J, Disler P, Chou M, Ooi K. Lumbar spine range of motion as a measure of physical and functional impairment: an investigation of validity. Clinic Rehabil 1999:211-18.
Spratt K, Keller T, Szpalski M, Vandeputte K, Gunsburg R. A predictive model for outcome after conservative decompression
surgery for lumbar spinal stenosis. Eur Spine J 2004;13:14-21.
Waddell G, Sommerville D, Hendersson I, Newton M. Objective clinical evaluation of physical impairment in chronic low back pain. Spine 1992:17:617-28.
Borenstein M. Chronic low back pain. Musculoskel Med 1996;22:439-56.
Muller G. Problems of diagnostic assessment in low back patients. Schmertz 2001;15:435-41.
Szpalski M, Gunzburg R. Methods of trunk testing. Semin Spine Surg 1998;10:104-11
Van Zundert J, Raj Perdine S, van Kleef M. Application of radiofrequency treatment in practical pain management: state of art. Pain Practice 2002;2: 267-78.
Bogduk N, McGuirk B. Medical management of acute and chronic low back pain. An evidence-based approach. Amsterdam: Elsevier, 2002.
Tstujii Y. Myotherapy, treatment of muscle hardenings. Nagoya (Japan): Ed. Nagoya University College of Medical Technology, 1993.
Fairbank J, Davies J et al. The Oswestry low back pain disability questionnaire. Physiother 1980;66:271-27.
Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain 1975;1:277-99.
Van der Kloot W., Vertommen H. De MPQ-DLV. Een standaard Nederlandstalige versie van de McGill Pain Questionnaire. Netherlands: Eds. Swets & Zeitlinger, Lisse B.V., 1989.
Streiner D, Norman G. Health Measuremndent Scales: A practical guide to their development and use (2nd ed.) Oxford: Oxford University Press, 1995.
Vincent W. Statistics in kinesiology. Champaign (USA): Ed. Human Kinetics, 1994.
Altman D, Bland J. Statistics notes: Diagnostic tests 3: receiver operating characteristic plots. BMJ 1994;309:188.
Petrie A, Sabin C Medical Statistics at a Glance. Oxford: Blackwell Science Ltd, 2000.
Beaton D (2000) Understanding the relevance of measured change through studies of responsiveness. Spine 2000;25: 319299.
Middel B, Stewart R, Bouma J, van Onderen E, van den Heuvel W. How to validate clinically important change in health-related functional status. Is the magnitude of the effect size consistently to magnitude of change as indicated by a global question rating? J Eval Clin Pract 2001;7: 399.
Patrick D, Wild D, Johnson E et al. Quality of life Assessment: International Perspectives. Berlin: Springer-Verlag, 1994.
Strand L, Moe-Nilssen R, Ljunggren A. Back performance Scale for the Assessment of Mobility-Related Activities in People with Back Pain. Phys Ther 2002;82:1213-23.
Fritz J, Piva S. Physical Impairment Index: reliability, validity and responsiveness of patients with acute low back pain. Spine 2003;28:1189-94.
Haas M, Nyiendo J. Diagnostic utility of the MPQ Questionnaire and the OLBPQ Disability Questionnaire for classification of low back pain syndromes. Journal of Manip Physiol Ther 1992;15:90-98.
Scrimshaw S, Maher C. Responsiveness of visual analogue scale and mcgill painscale measures. J Manip Physiol Ther 2001;24:501-04.
Опубликован
2018-05-31
Как цитировать
Farasyn, A., & Meeusen, R. (2018). Validity of the new backache index (bai) in patients with low back pain. Bulletin of the International Scientific Surgical Association, 1(3), 20-24. извлечено от http://surgjournal.ru/index.php/BISSA/article/view/105
Раздел
Оригинальные статьи