Original article
Comparison of the Neck Disability Index and the Neck Bournemouth Questionnaire in a sample of patients with chronic uncomplicated neck pain

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Abstract

Objective

This study compares the sensitivity to change of the Neck Disability Index (NDI) and the Neck Bournemouth Questionnaire (NBQ) in patients with chronic uncomplicated neck pain.

Methods

This prospective longitudinal study was completed in an outpatient physical therapy clinic. Subjects, with uncomplicated neck pain (no concurrent shoulder pain or nerve root symptoms) for more than a 3-month duration, participated in a 4-week course of therapy that included moist heat, neck exercises, and either mobilization or massage. Outcome measures included standardized response means (sensitivity to change), Cronbach α (internal consistency), and 2-way Spearman correlations between the 2 questionnaires and between a pain Visual Analog Scale and each questionnaire (convergent validity).

Results

Mean (SD) score change of the NDI was 6.22 (5.12), and of the NBQ, 14.00 (11.99). Standardized response means were 1.21 and 1.17, respectively. Both questionnaires were more sensitive to change than the pain Visual Analog Scale (0.68). There was moderate correlation between the change scores of all 3 outcome tools (Spearman 0.46-0.57). The NBQ had higher internal consistency than the NDI.

Conclusions

The NDI and the NBQ performed comparably in this group of patients with chronic uncomplicated neck pain. Both are sensitive to change and would be efficient outcome tools in studies of chronic neck pain. Both had acceptable internal consistency and are appropriate for use as single-outcome scales.

Section snippets

Methods

A prospective longitudinal study was carried out in conjunction with a feasibility study of manual therapy for chronic, uncomplicated neck pain during a 15-month period. It was approved by the institutional review board. Subjects were recruited from patients referred to an outpatient physical therapy clinic for treatment of neck pain. A screening evaluation to determine if subjects met study criteria (Fig 1) was performed by one of the authors. After providing informed consent subjects

Results

Of 34 subjects meeting inclusion criteria, 23 consented to be in the study (7 men, 16 women). All but 3 received 12 treatments over the 4 weeks; 2 subjects were allowed to discontinue treatment after 7 sessions and 1 after 9 because they were asymptomatic. All 23 completed the questionnaires before and after the treatment period. Mean age was 49.6 years (SD, 14.6). Pre and posttreatment scores (mean and SD) as well as mean change scores (pre minus post) and the resulting SRM and ES are shown in

Discussion

We compared the performance of the NDI and the NBQ in a sample of patients with chronic uncomplicated neck pain who were treated with physical therapy and massage or mobilization. We found the questionnaires to have similar sensitivity to change. Both had reasonable internal consistency based on Cronbach α. The NBQ had good convergent validity with the NDI (which is a more widely used and validated questionnaire). Both questionnaires appeared to have low respondent burden. To our knowledge, the

Conclusion

We found the NBQ and NDI to have similar ESs. Consequently each would require a about the same number of subjects if used as the primary outcome measure in a trial of manual therapy for chronic uncomplicated neck pain. Both were more sensitive to change than the pain VAS. The NBQ had good convergent validity with the NDI with strong correlation between them in regard to pretreatment and posttreatment scores. Although the NBQ had slightly higher internal consistency than the NDI, their overall

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