LOW-BACK-PAIN OUTCOME MEASUREMENT ASSESSMENT IN CHIROPRACTIC TEACHING-CLINICS - RESPONSIVENESS AND APPLICABILITY OF 2 FUNCTIONAL DISABILITYQUESTIONNAIRES
M. Haas et al., LOW-BACK-PAIN OUTCOME MEASUREMENT ASSESSMENT IN CHIROPRACTIC TEACHING-CLINICS - RESPONSIVENESS AND APPLICABILITY OF 2 FUNCTIONAL DISABILITYQUESTIONNAIRES, Journal of manipulative and physiological therapeutics, 18(2), 1995, pp. 79-87
Objective: The major aims were to evaluate responsiveness and clinical
/research applicability of the Revised Oswestry Disability Questionnai
re (ODQ) and the Dallas Pain Questionnaire (DPQ). Construct and conten
t validity were assessed. Patient characteristics and outcomes were al
so documented. Design: Longitudinal observational study. Setting: Coll
ege outpatient clinics. Participants: Six hundred sixty-three consecut
ive new patients accepted for treatment of low back pain (LBP) at the
clinics over a 1-yr period, age 18 or older. Interventions: Treatment
of low back pain by senior interns under the supervision of staff clin
icians. Main Outcome Measures: ODQ and DPQ administered at baseline, 2
wk, 1 month, and monthly up to 6 months. Responsive ness: mean standa
rdized change score (Delta' = mu(dif)/sigma(dif)), relative efficiency
([RE = Delta'(ODQ)/Delta(DPQ)](2)), and improvement rates (IR). Appli
cability: instrument completion rates. Construct validity: correlation
with VAS for pain intensity. Results: ODQ responsiveness was generall
y consistent over time (Delta' =.70-.83) and negligibly better than th
e DPQ activities of daily living scale (RE = 1.00-1.35); most patients
self-reporting improvement showed positive outcomes (IR = 97%). For l
arge samples (n > 100): Delta' =.47-.63 and IR = 81% for the DPQ work/
leisure scale; Delta' =.17-.40 and IR = 54% for the DPQ anxiety/depres
sion and social dimensions. Completion rates: 65%-78% of all instrumen
ts; 81%-100% of individual scales. Construct validity: r = .44-.68 for
the ODQ, DPQ activities of daily living, and DPQ work/leisure scales;
r = .20-.40 for the anxiety/depression scale. Conclusions: The ODQ an
d the activities of daily living and work/leisure scales from the DPQ
appear appropriate for monitoring LBP patients returning for care to c
hiropractic teaching clinics. The social and anxiety/depression dimens
ions of the DPQ do not appear to be responsive in this population. The
latter scale may be unsuitable on the grounds of misinterpretations.