Psychometric Properties of the Neck Disability Index and Numeric Pain Rating Scale in Patients With Mechanical Neck Pain

Cleland, Joshua A.; Childs, John D.; Whitman, Julie M.

doi:10.1016/j.apmr.2007.08.126

Cited by 589 publications

(471 citation statements)

References 38 publications

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“…As far as superiority is concerned, interpretation of the results-both ours and those of the previous RCTsdemands that attention is paid to the clinical relevance, and not just statistical significance, of the group differences observed. The minimum clinically important difference for the primary outcome used in most of the RCTs, the NDI (0-100 scale), is 15-19 points [5,11], yet in most of the trials the group difference for the improvement in NDI score after 2 years was just a fraction of this, between two and seven points [25,45,46]. Similarly, differences between the groups in the improvement of arm and neck pain scores of just 6-15 points (on the 0-100-point scale) were recorded after 2 years [45,46], yet the minimum clinically important difference for such scales is reported to be 13-20 points [11,24,39].…”

Section: Discussionmentioning

confidence: 99%

“…The minimum clinically important difference for the primary outcome used in most of the RCTs, the NDI (0-100 scale), is 15-19 points [5,11], yet in most of the trials the group difference for the improvement in NDI score after 2 years was just a fraction of this, between two and seven points [25,45,46]. Similarly, differences between the groups in the improvement of arm and neck pain scores of just 6-15 points (on the 0-100-point scale) were recorded after 2 years [45,46], yet the minimum clinically important difference for such scales is reported to be 13-20 points [11,24,39]. In our own study, the adjusted group difference in the reduction in COMI score after either 12 months or 24 months was approximately one point (on the 0-10 scale), again failing to reach the minimal clinically important difference of approximately two …”

Section: Discussionmentioning

confidence: 99%

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A comparison of outcomes of cervical disc arthroplasty and fusion in everyday clinical practice: surgical and methodological aspects

et al. 2009

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Randomised controlled trials (RCTs) of cervical disc arthroplasty vs fusion generally show slightly more favourable results for arthroplasty. However, RCTs in surgery often have limited external validity, since they involve a select group of patients who fit very rigid admission criteria and who are prepared to subject themselves to randomisation. The aim of this study was to examine whether the findings of RCTs are verified by observational data recorded in our Spine Center in association with the Spine Society of Europe Spine Tango surgical registry. Patients undergoing fusion/stabilisation or disc arthroplasty for degenerative cervical spinal disease were selected for inclusion. They completed a questionnaire pre-operatively and at 12 and 24 months follow-up (FU). The questionnaire comprised the multidimensional Core Outcome Measures Index (COMI; 0-10 scale) and, at FU, questions on global outcome and satisfaction with treatment (5-point scales, dichotomised to ''good'' and ''poor''), re-operation and patient-rated complications. The surgeon completed a Spine Tango Surgery form. The outcome data from 266 (208 fusion, 58 arthroplasty) out of 284 eligible patients who had reached 12 months FU, and 169 (139 fusion, 30 arthroplasty) out of 178 who had reached 24 months FU, were included. Patients with cervical disc arthroplasty were younger [46 (SD 8) years vs 56 (SD 11) years for fusion; P \ 0.05], had less comorbidity (P \ 0.05), more often had only mono-segmental pathology (69% arthroplasty, 47% fusion) and only one type of degenerative pathology (69% arthroplasty, 46% fusion). Surgical complication rates were similar in each group (arthroplasty, 1.5%; fusion, 2.6%). The reduction in the COMI score was significantly greater in the arthroplasty group (at 12 months, 4.8 (SD 3.0) vs 3.7 (SD 2.9) points for fusion, and at 24 months 5.1 (SD 2.8) vs 3.8 (SD 2.9) points; each P \ 0.05). In the arthroplasty group, a ''good'' global outcome was recorded in 90% patients (at 12 months) and 93% (at 24 months); in the fusion group the figures were 80 and 82%, respectively (group differences at each timepoint, P [ 0.09). Satisfaction with treatment was similar in both groups (89-93%), at each timepoint. In multiple regression analysis, treatment group was of borderline significance as a unique predictor of the change in COMI at FU (P = 0.059 at 12 months, P = 0.055 at 24 months) in a model in which known confounders (age, comorbidity, number of affected levels) were controlled for. Being in the arthroplasty group was associated with an approximately 1-point greater reduction in the COMI score at FU. The results of this observational study appear to support those of the RCTs and suggest that, in patients with degenerative pathology of the cervical spine, disc arthroplasty is associated with a slightly better outcome than fusion. However, given the small size of the difference, its clinical relevance is questionable, especially in view of the a priori more favourable outcome expected in the arthroplasty group due to ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparison of outcomes of cervical disc arthroplasty and fusion in everyday clinical practice: surgical and methodological aspects

et al. 2009

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“…The NDI has documented reliability, validity, and responsiveness as a measure of disability due to neck pain. 11,41 A secondary outcome was the intensity of neck pain, evaluated with an 11-point numeric pain rating scale, on which patients rated their current pain intensity and the best and worst pain intensity over the past 24 hours. The mean of the 3 ratings was used as the measure of neck pain intensity.…”

Section: Methodsmentioning

confidence: 99%

Exercise Only, Exercise With Mechanical Traction, or Exercise With Over-Door Traction for Patients With Cervical Radiculopathy, With or Without Consideration of Status on a Previously Described Subgrouping Rule: A Randomized Clinical Trial

Fritz¹,

Thackeray²,

Brennan³

et al. 2014

J Orthop Sports Phys Ther

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“…The NPRS exhibits fair to moderate test-retest reliability in patients with mechanical neck pain and shows adequate responsiveness in this patient population. 16,23 The minimal clinically important difference for the NDI has been reported as a 19-percentage-point change (9.5 raw score), and the minimal clinically important difference for the NPRS has been reported as a 1.3-point change in this population. 23 …”

Section: Outcome Measuresmentioning

confidence: 99%

Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain

Horn

Brennan

George

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Neck pain is the second most common musculoskeletal disorder in population surveys and is associated with high injury and disability claims. 1,2 It is generally accepted that neck pain has a favorable course of care, 3 but there is variation in short-term outcomes in patients with neck pain. 3,4 Certain factors are known to be prognostic for the course of neck pain, and several interventions, including those provided by physical therapists, are likely to produce a favorable outcome. [5][6][7][8][9] Approximately 35% of persons with neck pain reported being seen by a physical therapist, the most frequently visited provider, 10 and evidence suggests that physical therapy can be an effective secondary prevention strategy for neck pain. 11 In recent years, organized efforts have been made to improve clinical outcomes and standardize physical therapy treatment, including using classification system approaches. Fritz and Brennan 12 supported that subgrouping patients with neck pain and providing interventions matched to the patient classification improves shortterm outcomes of pain and disability from physical therapy, but this approach has not been validated nor have other classification systems published in the literature been validated. 13,14 Therefore in this study, rather than introduce a new classification system, we wished to pragmatically examine a large cohort of patients with common clinical presentations of neck pain. The purposes of this study were to describe the demographics and Disclosures: none.

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Psychometric Properties of the Neck Disability Index and Numeric Pain Rating Scale in Patients With Mechanical Neck Pain

Cited by 589 publications

References 38 publications

A comparison of outcomes of cervical disc arthroplasty and fusion in everyday clinical practice: surgical and methodological aspects

A comparison of outcomes of cervical disc arthroplasty and fusion in everyday clinical practice: surgical and methodological aspects

Exercise Only, Exercise With Mechanical Traction, or Exercise With Over-Door Traction for Patients With Cervical Radiculopathy, With or Without Consideration of Status on a Previously Described Subgrouping Rule: A Randomized Clinical Trial

Description of Common Clinical Presentations and Associated Short-Term Physical Therapy Clinical Outcomes in Patients With Neck Pain

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