Ahmad Irshad, Sharma Akhil, Zaidi Sahar, Alshahrani Mastour Saeed, Gautam Ajay Prashad, Raizah Abdullah, Reddy Ravi Shankar, Verma Shalini, Tanwar Tarushi, Hussain Mohammad Ejaz, Malhotra Deepak, Uddin Shadab, Mukhtar Emadeldin Mohammed
Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia.
St. Stephens Hospital, Tis Hazari, New Delhi 110054, India.
Healthcare (Basel). 2023 Feb 20;11(4):621. doi: 10.3390/healthcare11040621.
Increasing emphasis is placed on physical functional measures to examine treatments for chronic low back pain (CLBP). The Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) has never been evaluated for responsiveness. The objectives of this study were to (1) examine the internal and external responsiveness of the Quebec Back Pain Disability Scale (Hindi version) (QBPDS-H) and (2) find out the minimal clinically important difference (MCID) and minimal detectable change (MDC) in the functional ability of patients with chronic low back pain (CLBP) undergoing multimodal physical therapy treatment. In this prospective cohort study, QBPDS-H responses were recorded at the baseline and after eight weeks from 156 CLBP patients undergoing multimodal physiotherapy treatment. To differentiate between the clinically unimproved (n = 65, age: 44.16 ± 11.8 years) and clinically improved (n = 91, age: 43.28 ± 10.7 years) scores of patients from the initial assessment to the last follow-up, the Hindi version of the Patient's Global Impression of Change (H-PGIC) scale was utilized. Internal responsiveness was large (E.S. (pooled S.D.) (n = 91): 0.98 (95% CI = 1.14-0.85) and Standardized Response Mean (S.R.M.) (n = 91): 2.57 (95% CI = 3.05-2.17)). In addition, the correlation coefficient and receiver operative characteristics (R.O.C.) curve were used to assess the QBPDS-H external responsiveness. MCID and MDC were detected by the R.O.C. curve and standard error of measurements (S.E.M.), respectively. The H-PGIC scale showed moderate responsiveness (ρ = 0.514 and area under the curve (A.U.C.) = 0.658; 95% CI, 0.596-0.874), while the MDC achieved 13.68 points, and the MCID was found have 6 points (A.U.C. = 0.82; 95% CI: 0.74-0.88, sensitivity = 90%, specificity = 61%). This study shows that QBPDS-H has moderate levels of responsiveness in CLBP patients receiving multimodal physical therapy treatment, so it can be used to measure the changes in disability scores. MCID and MDC changes were also reported with QBPDS-H.
对于慢性下腰痛（CLBP）治疗效果的评估，越来越强调采用身体功能测量指标。魁北克腰痛残疾量表（印地语版）（QBPDS-H）从未进行过反应性评估。本研究的目的是：（1）检验魁北克腰痛残疾量表（印地语版）（QBPDS-H）的内部和外部反应性；（2）找出接受多模式物理治疗的慢性下腰痛（CLBP）患者功能能力的最小临床重要差异（MCID）和最小可检测变化（MDC）。在这项前瞻性队列研究中，记录了156例接受多模式物理治疗的CLBP患者在基线时和八周后的QBPDS-H反应。为了区分患者从初始评估到最后随访时临床未改善（n = 65，年龄：44.16±11.8岁）和临床改善（n = 91，年龄：43.28±10.7岁）的得分，采用了患者整体印象变化量表（印地语版）（H-PGIC）。内部反应性较大（效应量（合并标准差）（n = 91）：0.98（95%可信区间 = 1.14 - 0.85），标准化反应均值（S.R.M.）（n = 91）：2.57（95%可信区间 = 3.05 - 2.17））。此外，使用相关系数和受试者工作特征（R.O.C.）曲线来评估QBPDS-H的外部反应性。分别通过R.O.C.曲线和测量标准误（S.E.M.）检测MCID和MDC。H-PGIC量表显示出中等反应性（ρ = 0.514，曲线下面积（A.U.C.） = 0.658；95%可信区间，0.596 - 0.874），而MDC为13.68分，发现MCID为6分（A.U.C. = 0.82；95%可信区间：0.74 - 0.88，敏感性 = 90%，特异性 = 61%）。本研究表明，QBPDS-H在接受多模式物理治疗的CLBP患者中具有中等水平的反应性，因此可用于测量残疾评分的变化。还报告了QBPDS-H的MCID和MDC变化。
