Abstract
BackgroundBack pain in childhood and adolescence increases the risk for back pain in adulthood, but validated assessment tools are scarce. The aim of this study was to validate the Young Spine Questionnaire (YSQ) in a German version (G-YSQ) in children and adolescents.MethodsChildren and adolescents between 10 and 16 years (N = 240, 166 females, mean age = 13.05 ± 1.70 years), recruited in chiropractic practices and schools, completed the G-YSQ (translated according to scientific guidelines) and the KIDSCREEN-10 (assessing health-related quality of life) at three time points. Test-retest reliability was determined calculating intraclass correlation coefficients [ICC(3,1)] using start and two week-data. Construct validity was investigated testing a priori hypotheses. To assess responsiveness, the patients additionally filled in the Patient Global Impression of Change (PGIC) after three months and the area under the curve (AUC) of receiver operating curves was calculated.ResultsThe ICC(3,1) was 0.88 for pain intensity and pain frequency, indicating good reliability, 0.68 for week prevalence and 0.60 for point prevalence, indicating moderate reliability. Pain intensity, frequency and prevalence differed between patients and controls (p < 0.001) and, except point prevalence, between older (> 12 years) and younger control participants (p < 0.01). Health-related quality of life of participants with severe pain (in one or several spinal regions) was lower (KIDSCREEN-10, total score: F(4,230) = 7.26, p < 0.001; KIDSCREEN-10, self-rated general health: H(4) = 51.94, p < 0.001) than that of participants without pain or with moderate pain in one spinal region. Thus, altogether these findings indicate construct validity of the G-YSQ. The AUC was 0.69 (95 % CI = 0.57–0.82) and 0.67 (95 % CI = 0.54–0.80) for week and point prevalence, respectively, indicating insufficient responsiveness of the G-YSQ.ConclusionsApart from the question on point prevalence, construct validity and sufficient test-retest reliability was shown for the G-YSQ. However, its responsiveness needs to be improved, possibly by asking for pain frequency during the last week instead of (dichotomous) week prevalence.Trial registrationClinicalTrials.gov, NCT02955342, registered 07/09/2016, https://clinicaltrials.gov/ct2/results?cond=&term=NCT02955342&cntry=CH&state=&city=Zurich&dist=.
Highlights
Back pain in childhood and adolescence increases the risk for back pain in adulthood, but validated assessment tools are scarce
Back pain in childhood and adolescence is a significant risk factor for developing back pain in adulthood: the number of days in a given year with low back pain (LBP) in adolescence was shown to be associated with the risk of developing LBP in adulthood [5]
In 2013, the Young Spine Questionnaire (YSQ) was developed in Denmark as an instrument to measure spinal pain in the young population [7], though it has so far only been tested for content validity in preliminary versions during the developmental process in a population of Danish schoolchildren in the age range of 9–11 years [7]
Summary
Back pain in childhood and adolescence increases the risk for back pain in adulthood, but validated assessment tools are scarce. The aim of this study was to validate the Young Spine Questionnaire (YSQ) in a German version (G-YSQ) in children and adolescents. Research on spinal pain in childhood and adolescence shows large heterogeneity in assessing pain prevalence, pain intensity and associated disability [3], and validated assessment tools are scarce [6]. In 2013, the Young Spine Questionnaire (YSQ) was developed in Denmark as an instrument to measure spinal pain in the young population [7], though it has so far only been tested for content validity in preliminary versions during the developmental process in a population of Danish schoolchildren in the age range of 9–11 years [7]. The assessment of instrument validity and reliability is essential [8, 9]
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