A comparison of five low back disability questionnaires: reliability and responsiveness

Area of Science:

• Rehabilitation Medicine
• Clinical Assessment
• Low Back Pain Research

Background:

• Low back pain (LBP) is a prevalent condition causing significant disability.
• Accurate assessment of disability is crucial for effective LBP management.
• Several questionnaires exist to measure LBP-related disability.

Purpose of the Study:

• To compare the test-retest reliability and responsiveness of five commonly used disability questionnaires in LBP patients undergoing physical therapy.
• To evaluate the suitability of these scales for clinical application in LBP assessment.

Main Methods:

• Five questionnaires (Oswestry, Quebec, Roland-Morris, Waddell, SF-36) were administered to 106 LBP patients at baseline and 6 weeks.
• Test-retest reliability was assessed in stable patients.
• Responsiveness was evaluated using standardized response means and ROC curves.
• Scale width was assessed to ensure reliable detection of change.

Main Results:

• The modified Oswestry Disability Questionnaire, Quebec Back Pain Disability Scale, and SF-36 Physical Functioning scale demonstrated high reliability (ICC > 0.80).
• The Waddell Disability Index and Roland-Morris Disability Questionnaire showed lower reliability (< 0.80).
• No significant differences in responsiveness were found between the scales.

Conclusions:

• The modified Oswestry, Quebec, and SF-36 Physical Functioning scales are recommended for reliable disability assessment in LBP.
• The Waddell Disability Index has moderate reliability but insufficient scale width for clinical use.
• The Roland-Morris Disability Questionnaire and SF-36 Role-Physical/Bodily Pain scales lack sufficient reliability and scale width for clinical application.