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- Cross-cultural Adaptation and Validation of the Quebec Back Pain Disability Scale to European Portuguese LanguagePublication . Cruz, Eduardo Brazete; Fernandes, Rita; Carnide, Filomena; Vieira, Ana; Moniz, Sara; Nunes, FilipaLow back pain (LBP) is an extremely commonly health condition. It is a musculoskeletal complaint affecting most people at some point in their lives and the consequent health care, community, and personal costs are considerable.The clinical course of acute LBP has been described as initially favorable; however, beyond 6 weeks,only very small reductions in mean pain and disability seem to occur. According to a recent meta-analysis 6 individuals with persistent LBP are expected to have moderate levels of pain and disability. In these individuals, pain can fl uctuate over time with recurrences or exacerbations and has a major impact on their functionality. In the majority of the situations (85%), chronic LBP (CLBP) could not be assigned to a recognizable, known,specifi c pathology 15 , 16 and it is most accurately labeled as nonspecific CLBP (NSCLBP). Individuals with NSCLBP are commonly referred to physiotherapy services, 17 where reducing pain and disability are the main treatment goals and outcomes.The Quebec Back Pain Disability Scale (QBPDS) is one of the most recommended questionnaires to assess functional disability associated with LBP. It was developed as a measure of “functional disability,” which was defined by the authors as “perceived difficulty associated with simple physical activities.” It is a self-administered, 20-item questionnaire where patients are asked to rate their degree of difficulty in performing a specifi c activity from 0 (“not diffi cult at all”) to 5 (“unable to do”) in each item. The QBPDS score ranges from 0 to 100, with high values indicating higher levels of disability. The QBPDS has been extensively tested and is generally acknowledged to have good validity, reliability, and responsiveness. It has been translated and culturally adapted into different languages, including Portuguese from Brazil. However, the cultural and linguistic differences between the European Portuguese and the Brazilian Portuguese languages inhibit the use of the Brazilian version among Portuguese people. Therefore, the aim of this study was to conduct the crosscultural adaptation of the Portuguese version of the QBPDS and investigate its reliability and validity in patients with CLBP. This article is part of a larger research project aiming to validate tools with clinical relevance.
- Responsiveness and Interpretability of the Portuguese Version of the Quebec Back Pain Disability Scale in Patients With Chronic Low Back PainPublication . Vieira, Ana C.; Moniz, Sara; Fernandes, Rita; Carnide, Filomena; Cruz, Eduardo BrazeteImproving functional capacity is a common goal when providing physiotherapy treatment to patients with chronic low back pain (CLBP). In a clinical setting, clinicians and researchers are often interested in measuring change in a patient’s condition as a result of an intervention or to distinguish individual differences in response to treatment. To address change accurately in health-related outcomes, such as functional disability, clinicians need measurement tools that show responsiveness and are able to detect minimal changes in performance over time.This change must be large enough to be considered a “real” change and precise enough to detect small but important clinical changes over time considered to be important by patients and/or clinicians.The concepts of “minimal detectable change” (MDC) and “minimal clinically important difference” (MCID) have been introduced to help clinicians and researchers in assessing and interpreting patient changes. The MDC has been defi ned as the minimal amount of change that can be considered above the threshold of error expected in the measurement, whereas the MCID has been defined as the smallest change in an outcome measure that is perceived as benefi cial by the patient and that would lead to a change in the patient’s management, assuming an absence of excessive side effects and costs. The Quebec Back Pain Disability Scale (QBPDS) is a well established functional self-report questionnaire to assess changes in function in patients with CLBP participating in rehabilitation programs. Several studies have evaluated its reliability and validity and have had good results. However, studies addressing its responsiveness are scarce, especially in samples of patients with CLBP, and there is little agreement in their fi ndings. In those studies the MDC was in the range 11.04 23 to 24.6 (95% confi dence interval [CI]: 19.9–32.4) 14 and the MCID was in the range from 5 9 to 8.5 points. Moreover, and in what concerns its interpretability, there are only a few studies that have considered the MCID in relation to the MDC. Therefore, the purpose of this study was to examine the responsiveness of the QBPDS Portuguese version (PT) and to determine the MCID, MDC, and the floor/ceiling effects, in patients with CLBP.