title: An outcome measure of functionality and pain in patients with lumbar disc herniation: a validation study of the Japanese Orthopedic Association (JOA) score.
abstract: BACKGROUND
  Lumbar disc hernia (LDH) is a common cause of low back pain and radicular leg pain. The Japanese Orthopedic Association (JOA) score is a very short instrument for measuring functionality and pain in these patients. This study aimed to translate and validate the JOA score for use in Iran.
  
  
  METHODS
  This was a prospective clinical validation study. Translation of the English version of the questionnaire was performed in accordance with published guidelines. A sample of patients with LDH was asked to respond to the questionnaire at two points in time--at preoperative and postoperative (6 months follow-up) assessments. To test reliability, the internal consistency was assessed by use of Cronbach's alpha coefficient. Validity was evaluated by use of known-groups comparison.
  
  
  RESULTS
  A total of 117 patients with LDH were entered into the study. The mean age of patients was 45 (SD = 11) and Cronbach's alpha coefficients for the JOA score at the preoperative and postoperative assessments were 0.67 and 0.81, respectively. Validity as performed by known-groups analysis also showed the result was satisfactory. The instrument discriminated well between sub-groups of patients who differed in age and in a standard predictive measure of lumbar disc surgery (the Finneson-Cooper score).
  
  
  CONCLUSIONS
  In general, the Iranian version of the JOA score performed well and the findings suggest that it is a reliable and valid measure of functionality and pain among LDH patients.
authors.affiliation: Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran, parisa.azimi@gmail.com
authors.forename: Parisa
authors.initials: P
authors.lastname: Azimi
authors.forename: Hasan Reza
authors.initials: HR
authors.lastname: Mohammadi
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
mesh_terms: D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000503:physiopathology* / Q000534:rehabilitation; D007492:Iran; D007564:Japan; D017116:Low Back Pain / Q000503:physiopathology*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D020127:Recovery of Function; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014177:Translations