Farasyn Andre, Meeusen Romain
Faculty of Physical Education and Physical Therapy, Department of Physical Therapy, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090, Belgium.
Spine J. 2006 Sep-Oct;6(5):565-71. doi: 10.1016/j.spinee.2006.01.021.
The Backache Index (BAI) is applied to patients with low back pain (LBP) in order to help therapists, doctors, and surgeons perform physical examinations easily. It is carried out within a short space of time (<2 min) without using inclinometric instruments.
To explore the reliability, validity, and responsiveness of this new Backache Index in patients with LBP, which can fulfil the existing need for a reliable routine examination in the clinical environment.
STUDY DESIGN/SETTING: Patients with LBP filled in disability questionnaires; pain rating scales and physical impairment tests were completed in function of construct validity and correlation studies. A subgroup was evaluated for interobserver and test-retest reliability, and a second group was reassessed after two active treatment sessions to verify the responsiveness compared with other examined variables.
In total, 75 patients with subacute LBP (3-12 weeks) participated in a randomized controlled study.
The validity of the BAI was explored through a correlation with the standard Oswestry LBP Disability Index (ODI), the McGill LBP Questionnaire Index (MPQ), and the Visual Analogue Scale (VAS).
The BAI consisted of a scoring system that includes pain factors and stiffness estimation at the end of a series of five different lumbar movements of a patient standing in an erect position.
The correlations between the separate outcomes and the BAI ranged from 0.61 to 0.76 (p<.001). The interobserver reliability between two experienced observers for the five outcome scores was good (intraclass correlation coefficient [ICC]>0.86) and even perfect for the BAI (ICC=0.96). A BAI change of one unit is able to exclude a measurement error. A significantly good correlation (p<.001) was found between the BAI at baseline, the ODI (R=0.62), and the total degree of pain rating index (MPQ-PRI-T) (R=0.57), a moderate correlation with the total number of chosen adjectives from the whole list of adjectives (MPQ-NWC-T) (R=0.48), and the VAS (R=0.47), but a lower correlation was found with the MPQ-Quality of life index (R=0.43). The effect size and discriminative ability of the measures were explored after two treatment sessions of deep transverse friction myotherapy by means of study of the receiver operating characteristics curve (ROC) and the greatest area under the curve (AUC). The greatest level of distinction was found for the MPQ-PRI-T and the BAI (AUC>0.93), followed by the ODI (AUC=0.92). A lower level of distinction was found for the MPQ-NWC-T and the VAS (AUC>0.82).
The BAI appears to be a reliable and valid assessment of overall restricted spinal movements in case of LBP and discriminates between successful and unsuccessful treatment outcome.
背痛指数（BAI）应用于腰痛（LBP）患者，以帮助治疗师、医生和外科医生轻松进行体格检查。它在短时间内（<2分钟）完成，无需使用测斜仪。
探讨这种新的背痛指数在LBP患者中的可靠性、有效性和反应性，以满足临床环境中对可靠常规检查的现有需求。
研究设计/地点：LBP患者填写残疾问卷；根据结构效度和相关性研究完成疼痛评分量表和身体损伤测试。对一个亚组进行观察者间和重测信度评估，对另一组在两次积极治疗后重新评估，以验证与其他检查变量相比的反应性。
总共75例亚急性LBP（3 - 12周）患者参与了一项随机对照研究。
通过与标准奥斯维斯特腰痛残疾指数（ODI）、麦吉尔腰痛问卷指数（MPQ）和视觉模拟量表（VAS）的相关性来探讨BAI的有效性。
BAI由一个评分系统组成，该系统包括患者直立位进行一系列五种不同腰椎运动结束时的疼痛因素和僵硬程度估计。
各单独结局与BAI之间的相关性范围为0.61至0.76（p<0.001）。两位经验丰富的观察者对五个结局评分的观察者间信度良好（组内相关系数[ICC]>0.86），而BAI的观察者间信度甚至完美（ICC = 0.96）。BAI变化一个单位能够排除测量误差。在基线时，BAI与ODI（R = 0.62）、疼痛评分指数总分（MPQ - PRI - T）（R = 0.57）之间发现显著良好的相关性，与从整个形容词列表中选择的形容词总数（MPQ - NWC - T）（R = 0.48）以及VAS（R = 0.47）有中等相关性，但与MPQ生活质量指数（R = 不适合的内容，文档中此处疑似有误，推测应该是R = 0.43）相关性较低。通过研究受试者工作特征曲线（ROC）和曲线下最大面积（AUC），在两次深层横向摩擦肌疗法治疗后探讨了这些测量指标效应大小和区分能力。发现MPQ - PRI - T和BAI的区分水平最高（AUC>0.93），其次是ODI（AUC = 0.92）。MPQ - NWC - T和VAS的区分水平较低（AUC>0.82）。
BAI似乎是对LBP患者脊柱整体活动受限的可靠有效评估，并且能够区分治疗成功和失败的结果。
