Goniometry and fleximetry measurements to assess cervical range of motion in individuals with chronic neck pain: a validity and reliability study.

PURPOSE: To assess the test-retest and inter-rater reliability of goniometry and fleximetry in measuring cervical range of motion in individuals with chronic neck pain. METHODS: A reliability study. Thirty individuals with chronic neck pain were selected. Cervical range of motion was measured by goniometry and fleximetry at two time points 7 days apart. To characterize the sample, we used the numerical pain rating scale, Pain-Related Catastrophizing Thoughts Scale, and Neck Disability Index. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) were calculated. Correlations between goniometry and fleximetry measurements were performed using Spearman's correlation coefficient (rho). RESULTS: For goniometry, we found excellent test-retest reliability (ICC ≥ 0.986, SEM ≤ 1.89%, MDC ≤ 5.23%) and inter-rater reliability (ICC ≥ 0.947, SEM ≤ 3.91%, MDC ≤ 10.84%). Similarly, we found excellent test-retest reliability (ICC ≥ 0.969, SEM ≤ 2.71%, MDC ≤ 7.52%) and inter-rater reliability (ICC ≥ 0.981, SEM ≤ 1.88%, MDC ≤ 5.20%) for fleximetry. Finally, we observed a strong correlation between the goniometry and the fleximetry for all cervical movements (rho ≥ 0.993). CONCLUSION: Goniometry and fleximetry measurements are reliable for assessing cervical range of motion in individuals with chronic neck pain.

Translation, cross-cultural adaptation, and validation of the 10-item spine functional index (SFI-10) in the Brazilians with musculoskeletal spine disorders.

PURPOSE: To translate and cross-culturally adapt the Spine Functional Index (SFI) into Brazilian Portuguese (SFI-Br) in individuals with musculoskeletal spine disorders. METHODS: Participants (n=194) answered the Numerical Pain Rating Scale (NPRS), 36-item Short-Form Health Survey (SF-36), Roland-Morris Disability Questionnaire for General Pain (RMDQ-g), and SFI-25 incorporating the SFI-10. Structural validity, from confirmatory factor analysis (CFA), used comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). The best structure was considered from the lower values of the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Construct and criterion validity used Spearman's correlation coefficient (rho). Internal consistency used Cronbach's alpha, reliability used intraclass correlation coefficient (ICC2,1), with ceiling and floor effects determined. Error used the standard error of the measurement (SEM) and minimal detectable change, 90% level (MDC90). RESULTS: Adequate fit indices demonstrated an unequivocal one-factor structure only for the SFI-10 (chi-square/DF <3.00, CFI and TLI >0.90, RMSEA <0.08). The SFI-10-Br correlation was high with the SFI-Br (rho=0.914, p<0.001), moderate for the RMDQ-g (rho=-0.78), SF-36 functional capacity domain (rho=0.718) and NPRS (rho=-0.526); and adequate for the remaining SF-36 domains (rho>0.30). Test-retest reliability (ICC2,1=0.826) and internal consistency (alpha=0.864) were high. No ceiling or floor effects were observed, and error was satisfactory (SEM=9.08%, MDC90=25.15%). CONCLUSION: The SFI Brazilian version was successfully produced with the 10-item version showing an unequivocal one-factor structure, high construct and criterion validity, reliability, internal consistency, and satisfactory error. Further research on responsiveness is required.

Additional effect of transcutaneous electrical nerve stimulation in a therapeutic exercise program for sedentary with chronic neck pain: A double-blind randomized controlled trial.

PURPOSE: To evaluate the additional effect of high frequency (HF) or low frequency (LF) transcutaneous electrical nerve stimulation (TENS) in a specific therapeutic exercise program for the treatment of patients with chronic neck pain. METHODS: A randomized controlled trial. Sixty participants of both sexes and with chronic neck pain were randomized into three groups: therapeutic exercise group + placebo TENS (n = 20), therapeutic exercise group + HF TENS (n = 20) and therapeutic exercise group + low TENS frequency (n = 20). The following assessment instruments were used: Numerical Pain Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale and Tampa Scale for Kinesiophobia. Participants were evaluated before the interventions, after eight treatment sessions and 1 month after the end of treatment. Primary outcome was disability measured after the eight treatment sessions. Secondary outcomes were pain intensity, catastrophizing, and kinesiophobia after eight treatment sessions and pain intensity 4 weeks after the end of the treatment sessions. RESULTS: The three groups were similar at baseline for personal and clinical characteristics. Regarding the main study analyses, there were no significant (p > 0.05) or clinical (d < 0.80) differences between the groups for the main variable (disability), nor for the secondary variables (pain intensity, catastrophizing and kinesiophobia). CONCLUSION: HF or LF TENS, compared to placebo TENS, does not provide additional clinical benefits to an exercise program for patients with chronic neck pain.

Structural validity of the Japanese Orthopedic Association back pain evaluation questionnaire in individuals with chronic low back pain.

OBJECTIVE: The main aim of this study was to evaluate the structural validity of the Brazilian version of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). METHODS: Individuals with chronic low back pain were included. The data collection of the study occurred by means of online platform. Confirmatory factor analysis was performed. The theoretical version proposed for the JOABPEQ with five domains was tested. The following indices were considered to verify the fit of the model: comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). RESULTS: The final sample consisted of 175 volunteers, mostly women (68%), adults (mean age of 28.98 years), lean (mean body mass index of 25 kg/m2), with incomplete higher education, single, with mean of pain chronicity of 61.50 months and mean of pain intensity of 6.78 points on the Numeric Pain Scale. Regarding the structure of the JOABPEQ, the original version with five domains was adequate: chi-square/DF=1.52, CFI=0.954, TLI=0.948, and RMSEA=0.055. The factorial load ranges from 0.41 to 0.90. CONCLUSIONS: This study confirms the structure of JOABPEQ with 5 domains (low back pain, lumbar function, walking ability, social life function, and mental health) and 25 items in individuals with chronic low back pain.

Structural validity of the Japanese Orthopedic Association back pain evaluation questionnaire in individuals with chronic low back pain

SUMMARY OBJECTIVE: The main aim of this study was to evaluate the structural validity of the Brazilian version of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). METHODS: Individuals with chronic low back pain were included. The data collection of the study occurred by means of online platform. Confirmatory factor analysis was performed. The theoretical version proposed for the JOABPEQ with five domains was tested. The following indices were considered to verify the fit of the model: comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). RESULTS: The final sample consisted of 175 volunteers, mostly women (68%), adults (mean age of 28.98 years), lean (mean body mass index of 25 kg/m2), with incomplete higher education, single, with mean of pain chronicity of 61.50 months and mean of pain intensity of 6.78 points on the Numeric Pain Scale. Regarding the structure of the JOABPEQ, the original version with five domains was adequate: chi-square/DF=1.52, CFI=0.954, TLI=0.948, and RMSEA=0.055. The factorial load ranges from 0.41 to 0.90. CONCLUSIONS: This study confirms the structure of JOABPEQ with 5 domains (low back pain, lumbar function, walking ability, social life function, and mental health) and 25 items in individuals with chronic low back pain.

Brazilian version of the Neck Bournemouth Questionnaire does not have a well-defined internal structure in patients with chronic neck pain.

OBJECTIVE: To investigate the structural validity of the Brazilian version of the Neck Bournemouth Questionnaire in patients with chronic neck pain. DESIGN: Cross-sectional study. SETTING: Community participants collected via online platform. SUBJECTS: Participants with neck pain (minimal pain intensity of 3 points at rest on 11-point Numerical Rating Scale), both genders and aged ⩾18 years old. MAIN MEASURE: The Numerical Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia and the Neck Bournemouth Questionnaire were completed. Exploratory and confirmatory factor analyses were used to identify dimensionality and to compare different structures of the Neck Bournemouth Questionnaire. RESULTS: We included 103 participants. The sample consisted mostly of adults (mean age = 33.64 years, standard deviation = 10.48 years), females (n = 82, 79.6%), lean, single and with higher education. The exploratory factor analysis with implementation of the parallel analysis identified the one-dimensional structure of the Neck Bournemouth Questionnaire, with a Kaiser-Meyer-Olkin value of 0.80 and Bartlett's test significant (P < 0.05). We observed that all structures tested in this study presented a high amount of residues in confirmatory factor analysis, which were identified by the value of root mean square error of approximation > 0.08 and chi-square/degree of freedom > 3.00. CONCLUSION: The internal structure of the Brazilian version of the Neck Bournemouth Questionnaire is not clear and well-defined. It was not possible to identify the construct measured by the instrument in individuals with chronic neck pain.