J Orthop Sports Phys Ther. 2018 Dec;48(12):915-922. doi: 10.2519/jospt.2018.7866. Epub 2018 Jun 22.
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.
The aim of this study was to evaluate the clinimetric properties of the LSIQ in patients with chronic nonspecific low back pain (LBP).
In this clinical measurement study, the authors included patients with nonspecific 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. The researchers assessed test-retest reliability of total scores and individual item scores, as well as convergent and divergent validity.
A total of 107 participants with LBP (60 men and 47 women) were recruited. 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.
The LSIQ does not seem to be ready to be implemented in clinical practice and may require theoretical reconsideration. Although the LSIQ provided satisfactory estimates for some clinimetric features, the authors do not consider the instrument to be useful as an interval-level measure but rather as an index. Future studies are needed to investigate whether the LSIQ could measure clinical instability or some other construct. J Orthop Sports Phys Ther 2018;48(12):915-922. Epub 22 Jun 2018. doi:10.2519/jospt.2018.7866.
腰椎不稳定问卷（LSIQ）是一个包含 15 个项目的自我报告式测量工具。既往研究曾将 LSIQ 作为临床不稳定的测量指标，但尚未对其临床测量学特性进行全面评估。
本研究旨在评估慢性非特异性下腰痛（LBP）患者使用 LSIQ 的临床测量学特性。
在本临床测量学研究中，作者纳入了在澳大利亚初级保健临床医生处就诊的非特异性 LBP 患者。采用 Rasch 分析评估条目层级、目标性、单维性、个体拟合、内部一致性和区别性项目功能。作者评估了总分和各条目得分的重测信度以及聚合和离散效度。
共纳入 107 例 LBP 患者（60 名男性，47 名女性）。结果存在差异。LSIQ 似乎构成一个单维测量工具，对样本的目标性良好，重测信度尚可。但该量表的内部一致性较差，似乎不能作为等距测量工具，结构效度也不明确。虽然没有条目显得多余，但几个条目受到的影响并非来自测量工具的预期结构。
LSIQ 似乎尚未准备好在临床实践中应用，可能需要进行理论上的重新考虑。尽管 LSIQ 对某些临床测量学特征提供了令人满意的评估，但作者认为该工具不能作为等距测量工具使用，而只能作为指标。未来需要研究 LSIQ 是否能测量临床不稳定或其他某种结构。
美国运动医学杂志 2018 年；48（12）：915-922. 2018 年 6 月 22 日在线发表。doi：10.2519/jospt.2018.7866.
