The Responsiveness of Three Persian Outcome Measures Following Physiotherapy Intervention in Patients with Chronic Non-Specific Neck Pain

Document Type : RESEARCH PAPER


1 Orthopedic Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Orthopedic Research Centre, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran- Orthopedic Research Centre, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran


Objectives: A prospective cohort study to evaluate and compare the responsiveness of the Persian 
version of the neck disability index (NDI), neck pain & disability scale (NPDS), neck outcome score 
(NOOS), and to determine the minimal clinically important difference (MCID) and minimal detectable 
change (MDC). To date, no studies have made a direct comparison between the responsiveness of the 
Persian version of NPDS, NDI, and NOOS questionnaires.
Methods: At the end of the study, 55 patients with chronic non-specific neck pain completed the NPDS, NDI, and 
NOOS questionnaires at the beginning and end of three weeks of physiotherapy treatment. Additionally, patients 
completed the global rating of change scale to differentiate between improved and unimproved patients. Comparison 
of responsiveness was performed using anchor-based methods (receiver operating characteristic (ROC) curve and 
correlation analysis). MCID and MDC were assessed to investigate relevant changes for each questionnaire.
Results: ROC curves analysis showed areas under the curves of 0.70, 0.64, and 0.43 to 0.63 for the NPDS, NDI, 
and NOOS subscales, respectively. The correlation coefficients between the global rating of the change scale and 
the change scores of the NPDS and NDI were 0.38 (P<0.01) and 0.30 (P<0.05), respectively. There were no 
significant correlations between NOOS subscales and global rating of change score (r=0.001- 0.21, P>0.05). The 
MCID for the NPDS, NDI, and NOOS subscales were 28.09 (score 0-100), 7.5 (score 0-50), and 13.75 to 28.64 
(score 0-100), respectively. The MDCs were found to be in the following order: 47.1 points for NPDS, 36.1 for NDI, 
and 23.5 to 39.7 for NOOS subscales.
Conclusion: The Persian NPDS seems more responsive than the NDI and NOOS questionnaires. The level of 
clinically meaningful change in NDI, NPDS, and NOOS questionnaires is in the range of measurement error. 
 Level of evidence: IV


Main Subjects

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