School Clinical Science at Queensland University of Technology, Brisbane, Australia.
BMC Musculoskelet Disord. 2014 Jan 9;15:12. doi: 10.1186/1471-2474-15-12.
The purpose of this study was the development of a valid and reliable "Mechanical and Inflammatory Low Back Pain Index" (MIL) for assessment of non-specific low back pain (NSLBP). This 7-item tool assists practitioners in determining whether symptoms are predominantly mechanical or inflammatory.
Participants (n = 170, 96 females, age = 38 ± 14 years-old) with NSLP were referred to two Spanish physiotherapy clinics and completed the MIL and the following measures: the Roland Morris Questionnaire (RMQ), SF-12 and "Backache Index" (BAI) physical assessment test. For test-retest reliability, 37 consecutive patients were assessed at baseline and three days later during a non-treatment period. Face and content validity, practical characteristics, factor analysis, internal consistency, discriminant validity and convergent validity were assessed from the full sample.
A total of 27 potential items that had been identified for inclusion were subsequently reduced to 11 by an expert panel. Four items were then removed due to cross-loading under confirmatory factor analysis where a two-factor model yielded a good fit to the data (χ2 = 14.80, df = 13, p = 0.37, CFI = 0.98, and RMSEA = 0.029). The internal consistency was moderate (α = 0.68 for MLBP; 0.72 for ILBP), test-retest reliability high (ICC = 0.91; 95%CI = 0.88-0.93) and discriminant validity good for either MLBP (AUC = 0.74) and ILBP (AUC = 0.92). Convergent validity was demonstrated through similar but weak correlations between the ILBP and both the RMQ and BAI (r = 0.34, p < 0.001) and the MLBP and BAI (r = 0.38, p < 0.001).
The MIL is a valid and reliable clinical tool for patients with NSLBP that discriminates between mechanical and inflammatory LBP.
本研究旨在开发一种有效的、可靠的“机械性和炎症性下背痛指数”（MIL），用于评估非特异性下背痛（NSLBP）。这个 7 项工具可以帮助医生确定症状主要是机械性还是炎症性。
参与者（n=170，96 名女性，年龄=38±14 岁）患有 NSLP，被转诊到两家西班牙物理治疗诊所，并完成了 MIL 以及以下评估：罗伦兹·莫里斯问卷（Roland Morris Questionnaire，RMQ）、SF-12 和“背痛指数”（Backache Index，BAI）物理评估测试。为了测试重测信度，37 名连续患者在非治疗期内进行了基线和三天后的评估。从整个样本中评估了表面和内容有效性、实用性特征、因子分析、内部一致性、判别有效性和收敛有效性。
一个专家小组确定了总共 27 个潜在的纳入项目，随后通过专家小组确定了 11 个项目。由于验证性因子分析中的交叉负荷，有 4 个项目被删除，其中，两因素模型对数据有较好的拟合（χ2=14.80，df=13，p=0.37，CFI=0.98，和 RMSEA=0.029）。内部一致性中等（MILBP 的α=0.68；ILBP 的α=0.72），重测信度高（ICC=0.91；95%CI=0.88-0.93），对于机械性或炎症性下背痛（MILBP 和 ILBP）的判别有效性都很好（AUC=0.74 和 AUC=0.92）。通过 ILBP 与 RMQ 和 BAI（r=0.34，p<0.001）以及 MILBP 与 BAI（r=0.38，p<0.001）之间的相似但较弱的相关性，证明了其收敛有效性。
MIL 是一种针对非特异性下背痛患者的有效、可靠的临床工具，可区分机械性和炎症性下背痛。
