The back pain functional scale: Features and applications

BackgroundThe evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.ObjectiveThe purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.DesignThis was a randomized, placebo-controlled trial.SettingThe study was conducted in an outpatient physical therapy department in Australia.PatientsThe participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.InterventionTwelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.MeasurementsPrimary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.ResultsThe exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=−0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.LimitationClinicians could not be blinded to the intervention they provided.ConclusionsMotor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.

Download Full-text

Are stabilisation exercises different to other treatments in improving physical activity or reducing disability for people with persistent low back pain? A systematic literature review

International Journal of Therapy and Rehabilitation ◽

10.12968/ijtr.2019.0109 ◽

2020 ◽

Vol 27 (11) ◽

pp. 1-16

Author(s):

Sara Gardiner ◽

Helena Daniell ◽

Benjamin Smith ◽

Rachel Chester

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Confidence Interval ◽

Patient Specific ◽

Low Back ◽

Fear Avoidance ◽

Functional Scale ◽

Disability Questionnaire ◽

Randomised Controlled

Background/Aims Stabilisation exercises are commonly prescribed for people with persistent low back pain. However, for some patients, it has been hypothesised that stabilisation exercises could draw attention to protecting the core, promote hypervigilance and inhibit volitional movement. The aim of this study was to compare the effectiveness and reported adverse events, in particular fear avoidance, of stabilisation exercises compared with placebo or other treatments offered by physiotherapists on the outcome of disability and activity at 12- and 24-months' follow-up. Methods The following electronic databases were searched: Embase, Medline, AMED, CINAHL, from inception to June 2019. Only randomised controlled trails were included. Study selection, data extraction and appraisal of quality criteria using PEDro, were undertaken by two independent assessors. Results Seven studies (n=1820) were eligible. Of six studies that reported adverse effects in the group receiving stabilisation exercises, four reported none and two reported mild exacerbation of pain locally or elsewhere. Fear avoidance was not investigated in any of the studies. Across the studies, 12 analyses were reported and included seven different comparator groups and three outcome measures: Oswestry Disability Index (n=1), Roland Morris Disability Questionnaire (n=5), Patient Specific Functional Scale (n=4). Two studies included a 24-month follow up in addition to a 12-month follow up. Of the 12 studies, nine reported no significant differences between the effectiveness of stabilisation exercises and comparator groups. Stabilisation exercises were more effective than comparator groups for the following three analyses: compared to manual therapy or education at 12 but not 24 months for the Oswestry Disability Index (15.71, 95% confidence interval 19.3–10.01); compared to placebo for the Patient Specific Functional Scale (1.5, 95% confidence interval 0.7–2.2) but not the Roland Morris Disability Questionnaire; and compared to high load lifting for the Patient Specific Functional Scale (1.8 95% confidence interval 2.8–0.7). Conclusions Stabilisation exercises are safe and equally effective to other treatments, and possibly superior for some outcomes at some time points. No or only mild adverse effects were reported. However, none of the studies measured fear avoidance as an outcome and we recommend this be included in future randomised controlled trials measuring the effectiveness of stabilisation exercises.

Download Full-text

Single vertebral manipulative therapy (Kitchener’s Technique): a new technique for treatment of acute and subacute spinal root compression

Journal of Neurology & Stroke ◽

10.15406/jnsk.2021.11.00451 ◽

2021 ◽

Vol 11 (2) ◽

pp. 31-35

Author(s):

Nabil Kitchener

Keyword(s):

Back Pain ◽

Physical Functioning ◽

Rating Scale ◽

Numerical Rating Scale ◽

Roland Morris Disability Questionnaire ◽

Spinal Root ◽

Functional Scale ◽

Manipulative Therapy ◽

Numerical Rating ◽

Disability Questionnaire

Introduction: Spinal Root Compression Syndromes (SRCS) are common, costly, and significant cause of long-term sick leave and work loss. There is No consensus on the best approach. One intervention often used is manipulative therapy. Objective: The aim of this study was to determine if Single Vertebral Manipulative Therapy (Kitchener’s Technique) (SVMT) is effective in alleviating pain levels and regaining physical functioning in comparison to standard medical care (SMC), among 18-55-year-old active working personnel. Methods: Prospective, longitudinal, 2-arm controlled study comparing SMC plus SVMT (32 patients) with only SMC (21 patients). The primary outcome measures were changes in root-related pain on the numerical rating scale and physical functioning at 6 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS). Results: Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus SVMT group than in the SMC group at both week 2 (P<0.001) and week 6 (P=0.001). Mean numerical rating scale pain scores were also significantly better in the group that received SVMT. Adjusted mean back pain functional scale scores were significantly higher (improved) in the SMC plus SVMT group than in the SMC group at both week 2 (P<0.001) and week 6 (P=0.001). Conclusion: Results suggest that SVMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only SMC, for patients aged 18-55 years with SRCS.

Download Full-text

Evaluation of the correlation between the Istanbul Low Back Pain Disability Index, Back Pain Functional Scale and other back pain disability scales in Turkish patients with low back pain

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191824 ◽

2021 ◽

pp. 1-5

Author(s):

Ahmet Karadağ ◽

Muhammet Canbaş

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Strong Correlation ◽

Low Back ◽

Functional Scale ◽

Pain Disability Index ◽

Pain Disability ◽

Important Health ◽

Disability Questionnaire ◽

Turkish Patients

BACKGROUND: Low back pain is an important health problem that may cause functional loss. Several back pain disability scales have been developed in different languages. OBJECTIVE: The present study evaluates the correlation between the Istanbul Low Back Pain Disability Index (ILBPDI) the Back Pain Functional Scale (BPFS) and other back pain disability scales in patients with mechanical low back pain. METHODS: Included in the study were 105 patients who presented to our outpatient clinics and who were diagnosed with mechanical low back pain. The ILBPDI, BPFS, Quebec back pain disability scale (QBPDS) and Oswestry low back pain disability questionnaire (ODI) were administered to all participants, and Visual analogue scale (VAS) scores were recorded. RESULTS: A strongly negative correlation was identified between ILBPDI and BPFS (p< 0.05), and a strongly positive correlation was noted between ILBPDI and QBPDS, ODI and VAS. CONCLUSION: A strong correlation exists between ILBPDI and BPFS, and a further strong correlation between ILBPDI ODI and QBPDS. These questionnaires can be used interchangeably to evaluate disability associated with chronic mechanical low back pain.

Download Full-text

Persian translation and validation of the Back Pain Functional Scale

Physiotherapy Theory and Practice ◽

10.1080/09593985.2017.1390804 ◽

2017 ◽

Vol 34 (3) ◽

pp. 223-230 ◽

Cited By ~ 2

Author(s):

Noureddin Nakhostin Ansari ◽

Soofia Naghdi ◽

Fatemeh Habibzadeh ◽

Nasser Salsabili ◽

Safoora Ebadi

Keyword(s):

Back Pain ◽

Functional Scale ◽

Persian Translation ◽

Translation And Validation

Download Full-text

Cross-cultural Adaption and Validity of the “Patient Specific Functional Scale” / Kulturelle Adaption und Validierung der deutschen Version der “Patient Specific Functional Scale”

International Journal of Health Professions ◽

10.1515/ijhp-2015-0002 ◽

2015 ◽

Vol 2 (1) ◽

pp. 73-82 ◽

Cited By ~ 4

Author(s):

Patrick Heldmann ◽

Thomas Schöttker-Königer ◽

Axel Schäfer

Keyword(s):

Back Pain ◽

High Sensitivity ◽

Patient Specific ◽

German Version ◽

Measurement Instruments ◽

Functional Scale ◽

Measuring Point ◽

Lumbar Back Pain ◽

Cultural Adaption ◽

External Responsiveness

Abstract Objective: Measurement of activity and participation related outcomes play an important role in rehabilitation of low back pain. Therefore the „Patient Specific Functional Scale»(PSFS) was developed to assess individual, patient related activities. The aim of this study is the cultural adaptation and validation of the PSFS for German speaking countries.Method: A cultural translation and adaptation process was carried out in accordance with standardized guidelines. The internal and external responsiveness and the construct validity adjustment to the German version pertaining to patients with lumbar back pain was examined in comparison to the «Oswestry Disability Index»(ODI).Results: In both groups the PSFS proved itself to be more sensitive in comparison to the ODI. The internal responsiveness of ODI improved ES= -0.75), (non-improved ES= -0.38). PSFS (improved ES= 1.96), (non-improved ES 0.77). The external responsiveness of ODI (AUC= 0.59), of PSFS (AUC= 0.83) (P= 0.0068). Constructs of both measurement instruments have a weak and a moderate correlation on measuring point 1 (r= -0.28) and 2 (r= -0.58).Conclusion: The German version of PSFS proves itself to be a feasible model and a method of high sensitivity in evaluating changes in the functional ability of patients with lumbar back pain. The instrument can be recommended to be used in clinical practice.

Download Full-text

Construct Validity and Validity to Change of the Patient-Specific Functional Scale in Patients with Shoulder and Low Back Pain: A Clinimetric Study

Physical Medicine and Rehabilitation - International ◽

10.26420/physmedrehabilint.2021.1181 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Kromer TO ◽

◽

Saner J ◽

Sieben JM ◽

Bastiaenen CHG ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Construct Validity ◽

Shoulder Pain ◽

Outcome Measures ◽

Patient Specific ◽

Low Back ◽

Group Level ◽

Functional Scale ◽

Specific Outcome

Background: Patient-specific and condition-specific measures are widely used in clinical practice and research to measure disability or change over time. While condition-specific outcome measures comprise a range of restrictions generally relevant for all patients, the Patient-Specific Functional Scale measures restrictions chosen by the individual patient. Objectives: Based on the hypothesis that patient-specific and conditionspecific scales deliver comparable results when used on group level. The aim of this study was to test for floor and ceiling effects, to evaluate construct validity and validity to change of the Patient-Specific Functional Scale when compared to condition-specific outcome measures. For this purpose, two datasets from patients with shoulder pain and low back pain were analyzed. Methods: Patient-Specific Functional Scale scores were compared to the Shoulder Pain and Disability Index and the Roland Morris Disability Questionnaire at 4 time-points using stem-and-leaf-plots and correlations using Pearson’s r. Hypothesis-driven correlation levels for data interpretation were predefined, with r ≥0.75=high, r ≥0.5=moderate, r ≥0.25=low. Results: Patient-Specific Functional Scale floor effects were comparable to condition-specific outcome measures in both samples. At none of the timepoints did the Patient-Specific Functional Scale correlate with the conditionspecific outcome measures in the expected manner. Conclusion: Hypotheses regarding expected ranges of correlation between the Patient-Specific Functional Scale and the condition-specific outcome measures for construct validity and validity to change were not met. While the use of the Patient-Specific Functional Scale in a clinical context has its advantages, the measure is not recommended for group-level evaluations.

Download Full-text

Psychometric Properties of the Patient-Specific Functional Scale in Patients with Low-Back Pathology: A Systematic Review and Meta-Analysis

Physiotherapy Canada ◽

10.3138/ptc-2020-0042 ◽

2021 ◽

pp. e20200042

Author(s):

Goris Nazari ◽

Pavlos Bobos ◽

Steve Lu ◽

Stephanie Reischl ◽

Pedro H. Almeida ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Psychometric Properties ◽

Meta Analysis ◽

Measurement Properties ◽

Patient Specific ◽

Low Back ◽

Functional Scale ◽

Patient Reported

Purpose: This systematic review and meta-analysis identifies, critically appraises, synthesizes, and meta-analyses the reported psychometric properties of the Patient-Specific Functional Scale (PSFS) in patients with low back pain or pathology. Method: The MEDLINE, Embase, PubMed, and Google Scholar databases were searched from their inception to September 2019. We included prospective measurement studies that reported on the psychometric properties (reliability, validity, responsiveness) of the PSFS in people with low back pain or pathology. We followed the COnsensus-based Standards for the selection of health Measurement INstruments 2018 guideline for systematic reviews. We performed both quantitative and qualitative syntheses in which the results were summarized on the basis of the reported measurement properties and study quality. Results: Ten eligible studies were included. The pooled PSFS reliability measure was excellent (intra-class correlation coefficient = 0.89; 95% CI: 0.75, 0.95). Validity measures displayed correlations that ranged from −0.47 to 0.69 when compared with other patient-reported outcome measures (PROMs) or other tests. Eight studies had assessed the responsiveness of the PSFS. Effect sizes reported were large (≥ 0.91). Conclusions: The PSFS is a reliable, valid, and responsive PROM for patients with low back pain or pathology.

Download Full-text