Abstract
BackgroundNeck pain is a highly prevalent condition resulting in major disability. Standard scales for measuring disability in patients with neck pain have a pivotal role in research and clinical settings. The Neck Disability Index (NDI) is a valid and reliable tool, designed to measure disability in activities of daily living due to neck pain. The purpose of our study was the translation and validation of the NDI in a Greek primary care population with neck complaints.MethodsThe original version of the questionnaire was used. Based on international standards, the translation strategy comprised forward translations, reconciliation, backward translation and pre-testing steps. The validation procedure concerned the exploration of internal consistency (Cronbach alpha), test-retest reliability (Intraclass Correlation Coefficient, Bland and Altman method), construct validity (exploratory factor analysis) and responsiveness (Spearman correlation coefficient, Standard Error of Measurement and Minimal Detectable Change) of the questionnaire. Data quality was also assessed through completeness of data and floor/ceiling effects.ResultsThe translation procedure resulted in the Greek modified version of the NDI. The latter was culturally adapted through the pre-testing phase. The validation procedure raised a large amount of missing data due to low applicability, which were assessed with two methods. Floor or ceiling effects were not observed. Cronbach alpha was calculated as 0.85, which was interpreted as good internal consistency. Intraclass correlation coefficient was found to be 0.93 (95% CI 0.84–0.97), which was considered as very good test-retest reliability. Factor analysis yielded one factor with Eigenvalue 4.48 explaining 44.77% of variance. The Spearman correlation coefficient (0.3; P = 0.02) revealed some relation between the change score in the NDI and Global Rating of Change (GROC). The SEM and MDC were calculated as 0.64 and 1.78 respectively.ConclusionThe Greek version of the NDI measures disability in patients with neck pain in a reliable, valid and responsive manner. It is considered a useful tool for research and clinical settings in Greek Primary Health Care.
Highlights
Neck pain is a highly prevalent condition resulting in major disability
Validation Setting, sampling and target population In order to explore the psychometric properties of the Greek version of the Neck Disability Index (NDI), the questionnaire was administered to patients with neck pain, seeking primary care from 3 rural health centers
Translation The developer comments on the translated tool concerned replacement of "pain" with "neck pain"
Summary
Neck pain is a highly prevalent condition resulting in major disability. Standard scales for measuring disability in patients with neck pain have a pivotal role in research and clinical settings. The Neck Disability Index (NDI) is a valid and reliable tool, designed to measure disability in activities of daily living due to neck pain. The purpose of our study was the translation and validation of the NDI in a Greek primary care population with neck complaints. Neck pain is a highly prevalent condition among the general population. In a vast number of cases, there is no link between specific pathology and neck complaints, resulting in the term non-specific neck pain. In a recent prospective study assessing patients with non-specific back and neck pain seeking primary care, half of the respondents reported pain and disability at the 5-year follow-up [4]. In clinical trials, standardized scales are being used to capture important differences in disability, offering evidence for the effectiveness of one or another therapeutic intervention
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