Psychometric Properties of the Neck Disability Index and Numeric Pain Rating Scale in Patients With Mechanical Neck Pain
Abstract
Cleland JA, Childs JD, Whitman JM. Psychometric properties of the Neck Disability Index and numeric pain rating scale in patients with mechanical neck pain.
Objective
To examine the psychometric properties including test-retest reliability, construct validity, and minimum levels of detectable and clinically important change for the Neck Disability Index (NDI) and the numeric rating scale (NRS) for pain in a cohort of patients with neck pain.
Design
Single-group repeated-measures design.
Setting
Outpatient physical therapy (PT) clinics.
Participants
Patients (N=137) presenting to PT with a primary report of neck pain.
Interventions
Not applicable.
Main Outcome Measures
All patients completed the NDI and the NRS at the baseline examination and at a follow-up. At the time of the follow-up, all patients also completed the global rating of change, which was used to dichotomize patients as improved or stable. Baseline and follow-up scores were used to determine the test-retest reliability, construct validity, and minimal levels of detectable and clinically important change for both the NDI and NRS.
Results
Test-retest reliability was calculated using an intraclass correlation coefficient (ICC) (NDI ICC=.50; 95% confidence interval [CI], .25–.67; NRS ICC=.76; 95% CI, .51–.87). The area under the curve was .83 (95% CI, .75–.90) for the NDI score and .85 (95% CI, .78–.93) for the NRS score for determining between stable and improved patients. Thresholds for the minimum clinically important difference (MCID) for the NDI were 19-percentage points and 1.3 for the NRS.
Conclusions
Both the NDI and NRS exhibit fair to moderate test-retest reliability in patients with mechanical neck pain. Both instruments also showed adequate responsiveness in this patient population. However, the MCID required to be certain that the change in scores has surpassed a level that could be contributed to measurement error for the NDI was twice that which has previously been reported. Therefore the ongoing analyses of the properties of the NDI in a patient population with neck pain are warranted.
cManual Therapy Fellowship Program, Regis University, Denver, CO
dU.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX
eDepartment of Physical Therapy, Regis University, Denver, CO.
Reprint requests to Joshua A. Cleland, PT, PhD, OCS, Physical Therapy Program, Franklin Pierce College, 5 Chenell Dr, Concord, NH 03301
Supported by the Orthopaedic Section of the American Physical Therapy Association, the American Academy of Orthopaedic Manual Physical Therapists, and Steens Physical USA.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT