Clinimetric Testing of the Lumbar Spine Instability Questionnaire

Abstract

Study Design Clinical measurement study. Background The Lumbar Spine Instability Questionnaire (LSIQ) is a self-report measure of 15 items. Previous studies have used the LSIQ as a measure of clinical instability; however, a comprehensive evaluation of its clinimetric properties has not been conducted. Objectives The aim of this study was to evaluate the clinimetric properties of the LSIQ in patients with chronic non-specific low back pain (LBP). Methods We included patients with non-specific LBP presenting to primary care clinicians in Australia. Rasch analysis was conducted to assess item hierarchy, targeting, unidimensionality, person fit, internal consistency and differential item functioning. We also tested test-retest reliability for total scores and each item, and convergent and divergent validity. Results A total of 107 participants with LBP were recruited (60 men and 47 women). The results were variable. The LSIQ appeared to constitute a unidimensional measure, targeted the sample well and showed adequate test-retest reliability. However, the scale had poor internal consistency, did not appear to function as an interval-level measure and had unclear construct validity. Although no items appeared to be redundant, several items were biased by factors other than the proposed construct of the measure. Conclusions The LSIQ does not seem ready to be implemented in clinical practice. We suggest a theoretical reconsideration of this questionnaire. Although the LSIQ provided satisfactory estimates for some clinimetric features, we cannot consider it as an internal-level measure but rather an index. Future studies are needed to investigate whether the LSIQ measures clinical instability or some other construct. J Orthop Sports Phys Ther, Epub 22 Jun 2018. doi:10.2519/jospt.2018.7866.

A Screening Tool for Patients With Lumbar Instability

“… 12 Subsequently, the questionnaire was translated into Thai and Brazilian Portuguese 13 , 14 and its reliability tested. 13 – 15 Chatprem et al 13 (in press) developed a Thai version of the lumbar instability screening tool for physical therapists to administer to patients with CLBP.…”

Sacroiliac Joint Hypermobility Biomechanics and What it Means for Health Care Providers and Patients

“…A recent summary of the CPGs recommends exercise as an intervention for primary management of patients with chronic LBP and for use in selected patients with acute LBP . Numerous forms of exercise are available for management of LBP, ranging from general physical activity (eg, walking) to core‐specific exercises (eg, motor control) . A Cochrane review reported that motor control exercises are not superior to other forms of exercise .…”

“…35 The Lumbar Spine Instability Questionnaire is a 15-item questionnaire that may be useful in assessing instability and guiding treatment approaches. 36,37 A thorough kinematic evaluation of bilateral lumbopelvic movement symmetry can provide important information for the management of patients with LBP. 15…”

“…41 Numerous forms of exercise are available for management of LBP, ranging from general physical activity (eg, walking) to corespecific exercises (eg, motor control). 37 A Cochrane review reported that motor control exercises are not superior to other forms of exercise. 37 Likewise, a systematic review found that back strengthening exercises are not superior to other forms of exercise.…”

“…37 A Cochrane review reported that motor control exercises are not superior to other forms of exercise. 37 Likewise, a systematic review found that back strengthening exercises are not superior to other forms of exercise. 47 Therefore, selection of specific exercises may depend on patient preferences as well as implementing exercises that foster adherence to achieve long-term muscular and functional gains.…”