Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy -
Unit of Neurorehabilitation, Department of Neuroscience and Rehabilitation, G. Brotzu Hospital, Cagliari, Italy -
Eur J Phys Rehabil Med. 2022 Feb;58(1):68-75. doi: 10.23736/S1973-9087.21.06729-0. Epub 2021 May 27.
The Pain Catastrophizing Scale (PCS), a widely used tool to assess catastrophizing related to spinal disorders, shows valid psychometric properties in general but the minimal important change (MIC) is still not determined.
The aim of this study was to assess responsiveness and MIC of the PCS in individuals with chronic low back pain (LBP) undergoing multidisciplinary rehabilitation.
Prospective observational study.
The setting was outpatient rehabilitation hospital.
Two hundred and five patients with chronic LBP.
Before and after an 8-week multidisciplinary rehabilitation program, 205 patients completed the Italian version of the PCS (PCS-I). We calculated the PCS-I responsiveness by distribution-based methods (effect size [ES], standardized response mean [SRM], and minimum detectable change [MDC]) and anchor-based methods [receiver operating characteristic (ROC) curves]. After the program, participants completed a 7-point global perceived effect scale (GPE), based on which they were classified as "improved" vs. "stable." ROC curves computed the best cut-off level (taken as the MIC) between the two groups. ROC analysis was also performed on subgroups according to patients' baseline PCS scores.
ES, SRM and MDC were 0.71, 0.67 and 7.73, respectively. ROC analysis yielded an MIC of 8 points (95% confidence interval [CI]: 6-10; area under the curve [AUC]: 0.88). ROC analysis of the PCS subgroups confirmed an MIC of 8 points (95%CI: 6-10) for no/low catastrophizers (score <30, N.=159; AUC: 0.90) and indicated an MIC of 11 points (95%CI: 8-14) for catastrophizers (score >30, N.=33; AUC: 0.84).
The PCS-I showed good ability to detect patient-perceived clinical changes in chronic LBP postrehabilitation. The MIC values we determined provide a benchmark for assessing individual improvement in this clinical context.
The present study calculated - in a sample of people with chronic LBP - the responsiveness and MIC of the PCS. These values increase confidence in interpreting score changes, enhancing their meaningfulness for both research and clinical contexts.
疼痛灾难化量表（PCS）是一种广泛用于评估与脊柱疾病相关灾难化的工具，其具有有效的心理测量学特性，但最小临床重要变化（MIC）仍未确定。
本研究旨在评估接受多学科康复治疗的慢性下腰痛（CLBP）患者中 PCS 的反应性和 MIC。
前瞻性观察性研究。
门诊康复医院。
205 例慢性 LBP 患者。
在 8 周多学科康复计划前后，205 例患者完成了意大利语版 PCS（PCS-I）。我们通过基于分布的方法（效应量[ES]、标准化反应均值[SRM]和最小可检测变化[MDC]）和基于锚定的方法[受试者工作特征（ROC）曲线]来计算 PCS-I 的反应性。在计划结束后，参与者根据自身情况完成了 7 分制的总体感知疗效量表（GPE），根据量表结果，他们被分为“改善”和“稳定”两类。ROC 曲线计算出两组之间的最佳截断值（视为 MIC）。还根据患者的基线 PCS 评分对亚组进行了 ROC 分析。
ES、SRM 和 MDC 分别为 0.71、0.67 和 7.73。ROC 分析得出 MIC 为 8 分（95%置信区间[CI]：6-10；曲线下面积[AUC]：0.88）。对 PCS 亚组的 ROC 分析证实，无/低灾难化者（评分<30，N.=159；AUC：0.90）的 MIC 为 8 分（95%CI：6-10），而灾难化者（评分>30，N.=33；AUC：0.84）的 MIC 为 11 分（95%CI：8-14）。
PCS-I 能够很好地检测慢性 LBP 患者康复后的患者感知临床变化。我们确定的 MIC 值为评估该临床环境下个体改善情况提供了基准。
本研究在慢性 LBP 人群中计算了 PCS 的反应性和 MIC。这些值增加了对评分变化的解释信心，提高了其在研究和临床环境下的意义。
