Assessing change over time in patients with low back pain.
OBJECTIVE
This study compared the ability of the Roland-Morris (RM), Oswestry (OSW), and Jan van Breemen Institute (JVB) pain and function questionnaires to detect change over time.


METHODS
The sample consisted of 88 patients with mechanical low back pain who were referred by physicians to the outpatient physical therapy department of a teaching hospital.


METHODS
Questionnaires were completed by the subjects at their initial visit and 4 to 6 weeks later. Clinically important change was estimated by having the subject and the clinician independently complete two rating scales. Sensitivity to change was assessed using receiver operating characteristic (ROC) curve analysis.


RESULTS
The ROC curve areas for the RM (0.79), OSW (0.78), and JVB pain (0.79) questionnaires were significantly greater than for the JVB function questionnaire (0.66). Blank and multiple responses per item were present on approximately 20% of the OSW questionnaires and 14% of the JVB questionnaires. Words rather than checks were evident on 3% of the RM questionnaires.


CONCLUSIONS
Based on the latter finding, we believe the RM questionnaire may be the preferred instrument for assessing change over time in patients with low back pain.
Stratford
P W
PW
School of Occupational Therapy and Physiotherapy, McMaster University, Hamilton, Ontario, Canada.
Binkley
J
J
Solomon
P
P
Gill
C
C
Finch
E
E
D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000150:complications* / Q000503:physiopathology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D010147:Pain Measurement / Q000592:standards*; D026741:Physical Therapy Modalities; D012372:ROC Curve; D012017:Referral and Consultation; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome