Copenhagen Neck Functional Disability Scale Research Articles

Psychometric validation of the simplified Chinese Copenhagen Neck Functional Disability Scale in patients with chronic nonspecific neck pain.

Reliable and valid measurement tools are crucial for clinical practice in chronic nonspecific neck pain (CNSNP). The Copenhagen Neck Functional Disability Scale (CNFDS) is a widely used scale in neck pain assessment and has its unique advantages, but it is not available for patients with CNSNP in southern China. To develop the simplified Chinese version of CNFDS (CNFDS-SC) cross-culturally and to investigate its measurement properties in patients with CNSNP. Cross-sectional study. Validation of neck pain measurement scale in southern China. One hundred five patients with CNSNP. Not applicable. Internal consistency and test-retest reliability were evaluated using Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. Construct validity and structural validity were validated by hypothesis testing and exploratory factor analysis, respectively. Internal and external responsiveness were validated. Interpretability was revealed by the standard error of measurement (SEM) and smallest detectable change (SDC). Internal consistency (Cronbach's alpha=0.77 for first test and 0.84 for retest) and test-retest reliability (ICC=0.95) were satisfactory. CNFDS-SC scores showed strong correlations with the numeric rating scale (NRS), the Neck Disability Index (NDI), and the Northwick Park Neck Pain Questionnaire (NPQ) scores (r=0.652, 0.763, and 0.719, respectively; p < .001). Factor analysis revealed a one-factor structure of the scale. Regarding responsiveness, the standardized response mean (SRM) and the Guyatt's responsiveness index (GRI) were 1.29 and 2.12, respectively. CNFDS-SC change scores showed good correlations with the anchoring question (r=0.619, p < .001), NDI (r=0.439, p=.001), and NPQ (r=0.438 p=.001) change scores; the area under the receiver-operating characteristic (ROC) curve was 0.89 (p < .001). The SEM and SDC were 0.93 and 2.57, respectively. No floor or ceiling effect and no missing items were observed. The CNFDS-SC was demonstrated with adequate reliability, validity, responsiveness, and interpretability. The CNFDS-SC could be an effective tool for the clinical assessment of patients with CNSNP in southern China.

The effect of McKenzie protocol vs. deep neck flexor and scapulothoracic exercises in subjects with chronic neck pain - a randomized controlled study.

This study investigated the impact of McKenzie exercises against deep neck flexor (DNF) combined with scapulothoracic exercises on improving pain severity, cervical mobility, and functional disability. Fifty-five subjects suffering from chronic neck pain participated in this randomized controlled study. They were randomly assigned to three groups; the DNF group, which was treated by traditional physical therapy (i.e., physical therapy agents, stretching, and isometric exercises), combined with DNF, and scapulothoracic exercises; the McKenzie group, treated by traditional physical therapy, combined with McKenzie exercises; and finally, a control group, treated by traditional physical therapy. Before and after 6 weeks of treatment, they were assessed for neck pain severity, cervical range of motion (ROM), and functional disability using a visual analog scale (VAS), a gravity-reference goniometer, and the Copenhagen neck functional disability scale (CNFDS), respectively. Compared to baseline, all groups showed a significant decrease in neck pain severity and disability (p <0.05), and there was a significant increase in neck flexion/extension, lateral right flexion/left flexion, and right/left rotation ROMs (p<0.05). The improvement of the McKenzie group was significantly higher than the DNF group, and control group. Moreover, the improvement of the DNF group was significantly higher than the control group (p<0.05). The McKenzie exercises were better than DNF combined with scapulothoracic exercises to treat neck pain, functional disability, and mobility.

Association of Smartphone Addiction with Neck Disability Among University Students of Lahore

Background:&#x0D; The use of smartphone is most commonly seen in youth or university students for entertainment rather than for knowledge. The use of smartphone has increased rapidly for many years and this has brought about addiction. The addiction of smartphone is a risk factor for neck problems. Poor work habits lead to early neck pain that load cervical region.&#x0D; Objective:&#x0D; The study objective was to determine the association of smartphone addiction with neck disability among university students of Lahore.&#x0D; Material and Methods:&#x0D; Analytical cross sectional study design was used. Sample size was 365 university students of Lahore. Short version of smartphone addiction scale and Copenhagen neck functional disability scale was used to find out the smartphone addiction and neck pain in students respectively. Convenient sampling technique was used to collect data from students. Data was analyzed by using SPSS 20.&#x0D; Results:&#x0D; Out of 365 subjects, mean addiction score of smartphones was 39.3 with 3.23 standard deviation and Mean Copenhagen neck functional disability scale score was found to be 8.38±2.23 SD. Majority of students were having mild to moderate neck disability.&#x0D; Conclusion:&#x0D; This study concludes that there is positive correlation between smartphone addiction and neck disability among university students with p value=0.000 and r= 0.299. Both male and female students are addicted to smartphone and majority of students are suffering from mild to moderate neck disability.

Measurement properties of the Brazilian version of the Copenhagen Neck Functional Disability Scale in patients with chronic neck pain.

To evaluate the measurement properties of the Brazilian version of the Copenhagen Neck Functional Disability Scale (CNFDS) in patients with chronic neck pain. One hundred and five patients were included in the study. The structural validity of the CNFDS was assessed by exploratory and confirmatory factor analysis with the following fit indices: chi-square divided by degrees of freedom (chi-square/df), root mean square error of approximation (RMSEA), comparative fit index (CFI), and Tucker-Lewis index (TLI). To test the construct validity, the CNFDS score was correlated with the Numerical Pain Rating Scale, the Tampa Scale of Kinesiophobia, the Pain-Related Catastrophizing Thoughts Scale, and Neck Disability Index (NDI). A subsample of 43 patients filled the CNFDS at two different times, and test-retest reliability was measured using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC). The internal consistency of the CNFDS was analyzed by Cronbach's alpha. CNFDS presented a unidimensional structure, with goodness of fit indices: chi-square/df = 1.37, CFI = 0.94, TLI = 0.93, RMSEA = 0.059. The CNFDS showed satisfactory results of reliability (ICC = 0.93) and internal consistency (Cronbach's alpha = 0.84). The SEM was 1.72 and the MDC was 4.76. The CNFDS showed a high correlation with the NDI (rho = 0.718) and a low correlation with the other instruments. There were no floor and ceiling effects. The Brazilian version of the CNFDS with a one-dimensional structure and 15 items has adequate measurement properties.

The Copenhagen Neck Functional Disability Scale: an analysis of singers with dysphonia and without vocal complaints.

To analyze and compare the degree of cervical disability in singers with dysphonia and in singers without self-reported vocal complaints. A cross-sectional observational analysis. Sixty-two singers participated in the study: Thirty-two singers without vocal complaints and 30 singers with a speech-language pathology and otorhinolaryngological diagnosis of dysphonia. For singers without vocal complaints, two questionnaires were applied via Google Forms: A three-question questionnaire regarding vocal complaints and how each singer perceived their speaking and singing voice, and the Copenhagen Neck Functional Disability Scale (CNFDS). Data on singers with dysphonia were extracted from a database previously collected by a team of researchers at the speech-language pathology department of the Federal University of Minas Gerais. The difference in data collection methodology between the two groups was due to restrictions presented by the coronavirus pandemic. The Mann-Whitney test was used to compare the two groups, at a significance level of 5%. There was a significant difference between the groups (p=0.0001), demonstrating that singers with dysphonia suffered more from cervical pain and discomfort than singers without vocal complaints. Singers with dysphonia have more cervical pain and discomfort than singers without vocal complaints, thus presenting with greater cervical disability.

Escala Funcional de Incapacidade do Pescoço de Copenhagen: análise em cantoras disfônicas e em cantoras sem queixas vocais

ABSTRACT Purpose To analyze and compare the degree of cervical disability in singers with dysphonia and in singers without self-reported vocal complaints. Methods A cross-sectional observational analysis. Sixty-two singers participated in the study: Thirty-two singers without vocal complaints and 30 singers with a speech-language pathology and otorhinolaryngological diagnosis of dysphonia. For singers without vocal complaints, two questionnaires were applied via Google Forms: A three-question questionnaire regarding vocal complaints and how each singer perceived their speaking and singing voice, and the Copenhagen Neck Functional Disability Scale (CNFDS). Data on singers with dysphonia were extracted from a database previously collected by a team of researchers at the speech-language pathology department of the Federal University of Minas Gerais. The difference in data collection methodology between the two groups was due to restrictions presented by the coronavirus pandemic. The Mann-Whitney test was used to compare the two groups, at a significance level of 5%. Results There was a significant difference between the groups (p=0.0001), demonstrating that singers with dysphonia suffered more from cervical pain and discomfort than singers without vocal complaints. Conclusion Singers with dysphonia have more cervical pain and discomfort than singers without vocal complaints, thus presenting with greater cervical disability.

Assessment of the responsiveness of four scales in geriatric patients with chronic neck pain.

The purpose of this study was to evaluate the responsiveness of Copenhagen Neck Functional Disability Scale (CNFDS), Neck Disability Index (NDI), Neck Bournemouth Questionnaire (NBQ), Neck Pain and Disability Scale (NPDS) in geriatric patients with non-specific chronic neck pain. A total of 52 geriatric patients with non-specific chronic neck pain were included in the present study. All participants were included in a physical therapy and rehabilitation program for five sessions per week that lasted 3 weeks. All participants were evaluated before and after the treatment. Pain and disability were assessed with the Visual Analog Scale-pain (VAS-pain), VAS-disability, muscle spasm, CNFDS, NDI, NBQ, NPDS scales. Additionally, patient satisfaction scores were questioned both before and after the treatment. Following the 3-week physical therapy and rehabilitation program, significant improvements were detected in the VAS-pain, VAS-disability, muscle spasm, CNFDS, NDI, NBQ, and NPDS scores (p < 0.05). Responsiveness values were found to be as follows: CNFDS [effect size (ES) = 0.78; standardized response mean (SRM) = 0.90], NDI (ES = 0.66; SRM = 1.18), NBQ (ES = 0.82; SRM = 0.97) and NPDS (ES = 0.87; SRM = 0.98). Our study demonstrated that CNFDS, NDI, NBQ, and NPDS are responsive scales in determining treatment-related changes in geriatric patients with non-specific neck pain. These results also suggest that all of these four scales can be used in the assessment of treatment induced changes in geriatric patients with chronic neck pain.

INFLUENCE OF TENSION AND FEAR OVER CERVICALGIA OF PATIENTS AWAITING ENDODONTIC TREATMENT - PARTIAL RESULTS

Dental treatment can trigger anxiety, apprehension, fear, and discomfort to the awaiting patient. The objective of this study was to identify the presence of cervicalgia and the influence of tension and fear of dental treatment in patients of a clinical dentistry school. This is an observational and cross-sectional study, approved by the Ethics Committee (No. 2.683.186). There were included patients with ages ranging from 21 and 62 years, treated by the endodontic service. Data for the research were selected from 23 questionnaires. The partial results revealed that the prevalence of cervicalgia was 60.8% corresponding to 14 individuals, where 9 (64.2%) were women and 5 (35.7%) are men, predominantly between 21 and 53 years of age. According to The Copenhagen Neck Functional Disability Scale (CNFDS), 3 people (21.4%) demonstrated minimal disability, 4 (28.5%) mild disability, 3 (21.4%) mild-to-moderate disability, 2 (14.2%) moderate disability, 1 (7.1%) moderate-to-severe disability, and 1 (7.1%) severe disability. By means of the methodology used, it was observed that up to the present moment, the highest prevalence of cervicalgia was among females with mild disability in a dental clinic, with greater reference to tension during the procedure. Dental treatment can trigger anxiety, apprehension, fear, and discomfort to the awaiting patient. The objective of this study was to identify the presence of cervicalgia and the influence of tension and fear of dental treatment in patients of a clinical dentistry school. This is an observational and cross-sectional study, approved by the Ethics Committee (No. 2.683.186). There were included patients with ages ranging from 21 and 62 years, treated by the endodontic service. Data for the research were selected from 23 questionnaires. The partial results revealed that the prevalence of cervicalgia was 60.8% corresponding to 14 individuals, where 9 (64.2%) were women and 5 (35.7%) are men, predominantly between 21 and 53 years of age. According to The Copenhagen Neck Functional Disability Scale (CNFDS), 3 people (21.4%) demonstrated minimal disability, 4 (28.5%) mild disability, 3 (21.4%) mild-to-moderate disability, 2 (14.2%) moderate disability, 1 (7.1%) moderate-to-severe disability, and 1 (7.1%) severe disability. By means of the methodology used, it was observed that up to the present moment, the highest prevalence of cervicalgia was among females with mild disability in a dental clinic, with greater reference to tension during the procedure.

Short-term effects of chiropractic application and dry needling treatment on chronic mechanical neck pain

The current study was designed to compare the short-term effects of chiropractic applications (diversified technique) and dry needling on chronic mechanical neck pain. Participants comprised 40 patients aged 20–60 years who presented to the Anadolu Health Center Medicine and Rehabilitation Polyclinic with neck pain between 2017 and 2018. Neck pain duration was at least 3 months and scored at least 5 points on the Neck Disability Index. Age, gender, body weight, height, and body mass index were initially recorded. A visual analog scale (VAS) was used to evaluate pain in the neck and head region during relaxation, activity, and at night. Data on joint range of motion were collected using the Joint Range of Motion Measurement Form prepared by the researchers. Cervical flexion–extension, right–left lateral flexion, and right–left rotation movements were evaluated with an inclinometer. The Copenhagen Neck Functional Disability Scale was used to assess disability caused by neck pain. After the initial measurements, the participants were randomly divided into two groups: group 1: chiropractic application; group 2: dry needling treatment. Both treatments were effective in reducing neck pain and neck disability levels and for increasing the joint range of motion (group 1: p < 0.01; group 2: p < 0.001). Dry needling was significantly more successful in reducing night pain (p < 0.05) and allowing patients to more comfortably turn their heads to the left (p < 0.05); chiropractic application was significantly more successful for allowing patients to tilt their head backwards (p < 0.05). Dry needling and chiropractic treatments were found to be effective in terms of pain relief, increasing the joint range of motion, and decreasing the degree of neck disability in patients with chronic mechanical pain (p < 0.01).

Development, validity and reliability of the Italian version of the Copenhagen neck functional disability scale

BackgroundValid and reliable patient-reported outcome measures support health professionals in evaluating the results of clinical research and practice. The Copenhagen Neck Functional Disability Scale (CNFDS) has shown promising measurement properties to measure disability in patients with neck pain, but an Italian version of this questionnaire is not available. The objective of this study was to cross-culturally adapt the CNFDS into Italian (CNFDS-I), and to assess its validity and reliability in patients with neck pain.MethodsThe CNFDS-I was developed according to well-established guidelines for cross-cultural adaptation of patient-reported outcome measures. A cross-sectional clinimetric study was conducted to evaluate its validity and reliability. Patients with chronic neck pain (pain > 3 months) participated in this study. The following measurement properties (defined by the COSMIN initiative) were assessed: structural validity (exploratory factor analysis), internal consistency (Cronbach’s α), construct validity [by testing hypotheses on expected correlations with the Neck Disability Index (NDI), the Neck Bournemouth Questionnaire (NBQ), and pain Visual Analogue Scale (VAS)]. Test-retest reliability [Intraclass Correlation Coefficient for agreement (ICCagreement)], and measurement error [Smallest Detectable Change (SDC)] were also assessed in 50 clinically stable patients. Floor/ceiling effects and acceptability were calculated.ResultsOne-hundred and sixty-two patients (mean age = 47.9 ± 14.5 years, 70% female) were included. The CNFDS-I exhibited sufficient unidimensionality (one factor explained 83% of the variability) and internal consistency (α = 0.83). Construct validity was sufficient as all correlations with the other questionnaires were as expected (r = 0.846 with NDI, r = 0.708 with NBQ, r = 0.570 with VAS). Test-retest reliability was excellent (ICCagreement = 0.99, 95% CI from 0.995 to 0.999), while measurement error was equal to 8.31 scale points (27% scale range). No floor/ceiling effects were detected. The average time for filling the questionnaire was two minutes.ConclusionsThe CNFDS-I proved to be a valid and reliable outcome measure to assess disability in patients with chronic neck pain. Head-to-head comparison studies on the CNFDS-I measurement properties against other disability measures for neck pain (e.g. NDI and NBQ) are required to determine the relative merits of these different measures.

Validity and Reliability of the Arabic Version of the Copenhagen Neck Functional Disability Scale in Neck Pain Patients.

Study DesignProspective observational study.PurposeTo test the face validity, content validity, feasibility, internal consistency, reliability, and test–retest reliability of the Arabic version of the Copenhagen Neck Functional Disability Scale (CNFDS).Overview of LiteratureCNFDS is a clinical evaluation tool that accurately reflects the patient’s perception regarding his/her functionality with existing cervical pain. This study aimed to investigate the validity and reliability of the Arabic version of the CNFDS in measuring the disability level in chronic neck pain patients.MethodSeventy-four patients with neck pain were recruited, and 135 sheets (test and retest sheets) were completed by patients; two expert panels (each comprising ten experts) participated in this study. Arabic translation (forward translation), development of the preliminary translated version, English translation (backward translation), development of the prefinal version, and testing of the prefinal version was performed by experts; thereafter, the final version was tested on patients. Index of clarity, expert proportion of clearance, index of content validity (CVI), expert proportion of relevance, descriptive statistics, missed item index, Cronbach’s alpha, and Spearman’s rank correlation coefficient were used for statistical analyses.ResultsThe study revealed that the scale index of clarity was 86.84%, scale CVI was 99.33%, scale-level content validity index (universal agreement method) was 99.33%, 99.15% of the scale items were filled in all sheets, the scale was answered in less than 3 minutes in about 75% cases, Cronbach’s alpha was 0.856 (0.796, 0.905), and all Spearman’s correlations between the test and retest results were statistically significant.ConclusionsThe Arabic version of the CNFDS has adequate validity and reliability for the measurement of the disability level in chronic neck pain patients.

Patient-Reported Outcome Measures Used for Neck Disorders: An Overview of Systematic Reviews.

The evaluation of patient-reported outcome measures for the neck from multiple systematic reviews will provide a broader view of, and may identify potential conflicting or consistent results for, their psychometric properties. The purpose of this study was to conduct an overview of systematic reviews and synthesize evidence to establish the current state of knowledge on psychometric properties of patient-reported outcome measures for patients with neck disorders. In this overview of systematic reviews, an electronic search of 6 databases (MEDLINE, Embase, CINAHL, ILC, the Cochrane Central Register of Controlled Trials, and LILACS) was conducted to identify reviews that addressed at least one measurement property of outcome measures for people with neck pain. Only systematic reviews with patient-reported outcome measures were included in the analysis. Risk of bias was assessed with A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Data on measurement properties were extracted from each systematic review. From 13 systematic reviews, 8 patient-reported outcome measures were evaluated in 2 or more reviews. Risk-of-bias scores ranged from moderate (5-7) to high (4 and lower). Findings on internal consistency, test-retest reliability, construct validity, responsiveness to change, and content and structural validity were synthesized for the Neck Disability Index (NDI) in 11 systematic reviews; the Northwick Park Neck Pain Questionnaire and Neck Pain and Disability scale (NPDS) in 6 systematic reviews; the Copenhagen Neck Functional Disability Scale in 5 systematic reviews; the Neck Bournemouth Questionnaire in 4 systematic reviews; the Core Neck Pain Questionnaire and Patient-Specific Functional Scale in 3 systematic reviews, and the Whiplash Disability Questionnaire in 2 systematic reviews. High-quality evidence was found of good to excellent internal consistency and moderate to excellent test-retest reliability for the NDI. Moderate-quality evidence was found of good to excellent internal consistency and good test-retest reliability for the Northwick Park Neck Pain Questionnaire. High-quality evidence was found of excellent test-retest reliability and good to strong construct validity with pain scales for the Copenhagen Neck Functional Disability Scale. Moderate-quality evidence was found of unclear to excellent internal consistency and moderate to strong concurrent associations with the NDI and global assessment of change for the Neck Pain and Disability scale. Moderate-quality evidence was found of excellent internal consistency for the Whiplash Disability Questionnaire and of high test-retest reliability for the Patient-Specific Functional Scale. J Orthop Sports Phys Ther 2018;48(10):775-788. Epub 22 Jun 2018. doi:10.2519/jospt.2018.8131.

Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace.

We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group–SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients’ follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23–35). Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0–27). A control group of 42 healthy females (healthy controls group—HG) matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI), the Rolland-Morris Questionnaire (RMQ), the Quebec Back Pain Disability Scale (QDS), the Neck Disability Index (NDI) and the Copenhagen Neck Functional Disability Scale (CNFDS). Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent, the chi-square test was used. The chi-square test was used to compare qualitative features between persons with scoliosis and healthy controls. In addition, a Mann-Whitney test was utilized to compare differences between both groups in regard to quantitative characteristics. To establish relations between quantitative data such as e.g. age, duration of brace application, apical translation, Cobb angle, and questionnaire results, we used Spearman's rank correlation (marked as rS). To determine dependency between quantitative and qualitative characteristics, e.g. between questionnaire numerical data and marital status, place of residence or curve type, ANOVA Kruskal-Wallis test was used. A p<0.05 indicates statistical significance. Statistical calculations were performed by Statistica software. In regards to RODI, RMQ, QDS, NDI and CNFDS (both for total scores and particular sub-sections), statistically significant differences (p <0.001) between both samples were found, indicating higher levels of pain and neck and lower back pain-related disability among persons with scoliosis. Associations exist between RODI and RMQ (rS = 0.76) QDS (rS = 0.70), NDI (rS = 0.69) and CNFDS (rS = 0.60). RMQ was associated with QDS (rS = 0.71) and NDI (rS = 0.69), whereas QDS correlated with NDI (rS = 0.80) and CNFDS (rS = 0.60). NDI was also associated with CNFDS (rS = 0.81). Persons with scoliosis treated in adolescence with a Milwaukee brace display significant restrictions in everyday activities, due to lower back pain (LBP) and neck-related disabilities, compared to healthy controls. In addition, back pain is associated with curve progression in long-term follow-up after conservative treatment. Moreover, LBP-related disability coexists with restrictions experienced due to neck pain.

Surgical Outcomes and Correlation of the Copenhagen Neck Functional Disability Scale and Modified Japanese Orthopedic Association Assessment Scales in Patients with Cervical Spondylotic Myelopathy.

Study DesignCross-sectional.PurposeClinical outcome study comparing the Copenhagen Neck Functional Disability Scale (CNFDS) and modified Japanese orthopedic association (mJOA) assessment scales in patients with cervical spondylotic myelopathy (CSM).Overview of LiteratureComparison of instruments that measure patient-reported outcomes is needed.MethodsA cross-sectional analysis was conducted. Ninety five patients with CSM were entered into the study and completed the CNFDS and the mJOA preoperatively and postoperatively. Correlation between the CNFDS and the mJOA was evaluated preoperatively and at the end of follow-up. Responsiveness to change of CNFDS and mJOA was also assessed. Clinical outcomes were also measured with the recovery rate of mJOA score at end of follow-up.ResultsThe mean age of patients was 58.2 (standard deviation, SD=8.7) years. Mean follow-up was 2.1 years (range, 1 to 4 years). The mJOA correlated strongly with the CNFDS score preoperatively and postoperatively (r=–0.81 and –0.82, respectively; p<0.001). The CNFDS and the mJOA were able to detect changes after the surgery (p<0.001). The mean mJOA recovery rate was 51.8% (SD=13.1%).ConclusionsSurgery for the treatment of patients with CSM is an efficacious procedure. CNFDS and mJOA scores have a strong correlation in measuring disability among CSM patients.

Outcome Measures of Functionality, Social Interaction, and Pain in Patients with Cervical Spondylotic Myelopathy: A Validation Study for the Iranian Version of the Copenhagen Neck Functional Disability Scale

Study DesignCross-sectional.PurposeTo translate and validate the Iranian version of the Copenhagen Neck Functional Disability Scale (CNFDS).Overview of LiteratureInstruments measuring patient-reported outcomes should satisfy certain psychometric properties.MethodsNinety-three cases of cervical spondylotic myelopathy were entered into the study and completed the CNFDS pre and postoperatively at the 6 month follow-up. The modified Japanese Orthopedic Association Score was also completed. The internal consistency, test-retest, convergent validity, construct validity (item scale correlation), and responsiveness to change were assessed.ResultsMean age of the patients was 54.3 years (standard deviation, 8.9). The Cronbach α coefficient was satisfactory (α=0.84). Test-retest reliability as assessed by the intraclass correlation coefficient analysis was 0.95 (95% confidence interval, 0.92-0.98). The modified Japanese Orthopedic Association score correlated strongly with the CNFDS score, lending support to its good convergent validity (r=-0.80; p<0.001). Additionally, the correlation of each item with its hypothesized domain on the CNFDS was acceptable, suggesting that the items had a substantial relationship with their own domains. These results also indicate that the instrument was responsive to change (p<0.0001).ConclusionsThe findings suggest that the Iranian version of the CNFDS is a valid measure to assess functionality, social interaction, and pain among patients with cervical spondylotic myelopathy.

THE COPENHAGEN NECK FUNCTIONAL DISABILITY SCALE - CNFDS: TRANSLATION AND CULTURAL ADAPTATION TO BRAZILIAN PORTUGUESE

Introduction : the Danish questionnaire entitled The Copenhagen Neck Functional Disability Scale(CNFDS) is a tool for self-assessment of cervical complaints,originally developed in English, of which there is, so far, no translation into Brazilian Portuguese. The process involvedin this researchproved to be relevant for the exploration of the questionnaire and the realization of adjustments necessary for it to be functiona l and applicable in Portuguese Language and Brazilian Culture settings. Thus, once this has been carried out, many health professionals will benefit from this version in their clinical practice. Objective : To perform the translation and cultural adaptation to Brazilian Portuguese of the Escala funcional de incapacidade do pescoco de Copenhagen (The Copenhagen Neck Functional Disability Scale – CNFDS). Methods : The questionnaire was translated into Brazilian Portuguese by two bilingual, Brazilian physiotherapists who were aware of the objective of this research. The back-translation was performed by a third person, a Brazilian, bilingual English teacher, who had not participated in the previous step. After comparing the resulting translations, a single translated version was produced named the Escala Funcional de Incapacidade do Pescoco de Copenhagen (EFIPC) and in each question the option “not applicable” was added to the answer key. During the translation and cultural adaptation process there were no changes and/or eliminations of any questions. Result: The composition of the Escala Funcional de Incapacidade do Pescoco de Copenhagen reflects the original English version, with a total of 15 questions, with the questions numbered 1 to 5 presenting a positive direction response (a “yes” answer indicates good cervical condition), and questions numbered 6 to 15 presenting a negative direction response (a “yes” answer indicates poor cervical condition). Conclusion : The process involved in this research allowed the achievement of thedesired goal, and thus it was possible totranslate and culturally adapt to Brazilian Portuguese the content of the CNFDS questionnaire, giving riseto the Escala funcional de incapacidade do pescoco de Copenhagen .

The Cross-Cultural Adaptation, Reliability, and Validity of the Copenhagen Neck Functional Disability Scale in Patients With Chronic Neck Pain

The study design was cross-cultural adaptation and investigation of reliability and validity of the Copenhagen Neck Functional Disability Scale (CNFDS). The aim of this study was to translate the CNFDS into Turkish language and assess its reliability and validity among patients with neck pain in Turkish population. The CNFDS is a reliable and valid evaluation instrument for disability, but there is no published the Turkish version of the CNFDS. One hundred one subjects who had chronic neck pain were included in this study. The CNFDS, Neck Pain and Disability Scale, and visual analogue scale were administered to all subjects. For investigating test-retest reliability, correlation between CNFDS scores, applied at 1-week interval, intraclass correlation coefficient score for test-retest reliability was 0.86 (95% confidence interval = 0.679-0.935). There was no difference between test-retest scores (P < 0.001). For investigating concurrent validity, correlation between total score of the CNFDS and the mean visual analogue scale was r = 0.73 (P < 0.001). Concurrent validity of the CNFDS was very good. For investigating construct validity, correlation between total score of the CNFDS and the Neck Pain and Disability Scale was r = 0.78 (P < 0.001). Construct validity of the CNFDS was also very good. Our results suggest that the Turkish version of the CNFDS is a reliable and valid instrument for Turkish people.

Cross-cultural adaptation of the Neck Disability Index and Copenhagen Neck Functional Disability Scale for patients with neck pain due to degenerative and discopathic disorders. Psychometric properties of the Polish versions.

BackgroundEven though there are several region-specific functional outcome questionnaires measuring neck disorders that have been developed in English-speaking countries, no Polish version has ever been validated. The purpose of our study was to translate, culturally adapt and validate the Neck Disability Index (NDI) and Copenhagen Neck Functional Disability Scale (CDS) for Polish-speaking patients with neck pain.MethodsThe translation was carried out according to the International Quality of Life Association (IQOLA) Project. Sixty patients were treated due to degenerative and discopathic disorders in the cervical spine filled out the NDI-PL and the CDS-PL. The pain level was evaluated using the Visual Analog Scale. The mean age of the assessed group was 47.1 years (SD 8.9). We used Cronbach's alpha to assess internal consistency. We assessed the test-retest reliability using the Intraclass Correlation Coefficients (ICCs). The Spearman's rank correlation coefficient (rS) was used to determine dependency between quantitative characteristics. The Mann-Whitney test was applied to determine dependency between quantitative and qualitative characteristics.ResultsThe Cronbach's alpha values were excellent for the NDI-PL in the test and in the retest (0.84, 0.85, respectively), and for the CDS-PL (0.90 in the test and in the retest). Intraclass Correlation Coefficients were excellent for the CDS-PL and NDI-PL and equalled 0.93 (95% CI from 0.89 to 0.95) and 0.87 (95% CI from 0.80 to 0.92), respectively The concurrent validity was good in the test and in the retest (rs = 0.42 p < 0.001; rs = 0.40 p = 0.002, respectively) for NDI-PL and for CDS-PL (rs = 0.42 p < 0.001; rs = 0.40 p = 0.001, respectively). The adapted questionnaires showed a strong inter-correlation both in the test (0.87 p < 0.001) and in the retest (0.79 p < 0.001).ConclusionsThe present versions of the NDI-PL and CDS-PL, the first to be published in Polish, have proven to be reliable and valid for patients with degenerative changes in the cervical spine. The NDI-PL and CDS-PL have excellent internal consistency and test-retest reliability, and good concurrent validity. The adapted questionnaires showed a strong inter-correlation both in the test and in the retest. No ceiling or floor effects were detected in the NDI-PL and CDS-PL. The NDI-PL and CDS-PL are comparable with other versions and can be recommended and used in international comparative studies.

An Examination of Outcome Measures for Pain and Dysfunction in the Cervical Spine

Cross-sectional design. To examine and compare the factorial structure of 4 validated neck pain and dysfunction scales. Neck pain and dysfunction is commonly measured using 1 of 4 validated self-reporting questionnaires: the Neck Disability Index (NDI), the Northwick Park Neck Pain Questionnaire (NPQ), the Copenhagen Neck Functional Disability Scale (CNFDS), and the Neck Pain and Disability Scale (NPDS). Although used interchangeably in the literature, recent studies suggest that the 4 scales differ in the number and type of factors that they examine and the weighting of these factors. To date, there have been no direct comparisons made of these scales when applied simultaneously to the same patient population. Data were collected from 88 patients with mechanical neck pain who completed all 4 questionnaires. Exploratory principal components factor analyses were conducted to expose the underlying factors within each of the scales. Identified factors were examined, characterized, and compared. Factor analysis revealed a single factor for the NDI, 2 factors for the NPQ, and 3 factors for both the CNFDS and NPDS. Factors identified include neck pain, dysfunction related to general activities, neck-specific function, cognition, emotion, and the influence of participation restriction on psychosocial functioning. The 3 NPDS factors appear to assess the multidimensional nature of neck pain and dysfunction most comprehensively. When selecting and interpreting a neck pain and dysfunction scale, clinicians and researchers are encouraged to take into account the factors measured by the NDI, NPQ, CNFDS, and NPDS and their applicability to the specific neck patient population under examination. The decision of which factors are of greatest interest will influence the selection of an appropriate outcome instrument.

Neck pain and disability due to neck pain: what is the relation?

Pain and disability are interrelated, but the relationship between pain and disability is not straightforward. The objective of this study was to investigate the relationship between neck pain (NP) intensity, NP duration, and disability based on the population-based 'Funen Neck and Chest Pain' study. Pain intensity was measured using 11-box numerical rating scales, pain duration was measured using the Standardized Nordic Questionnaire, and disability was measured by the Copenhagen Neck Functional Disability Scale. Spearman rank correlation coefficients and logistic regression analyses were used to measure correlations and strength of associations between pain intensity, pain duration, and disability given domain specific characteristics (socioeconomic, health and physical, comorbidity, and variables related to consequences of NP). Neck pain was very common, but mainly mild and did not result in major disability. The correlations between NP intensity and disability were moderate but strongly associated, whereas weaker correlations and almost no associations were found between NP duration and disability. Pain duration is a poor indicator of disability. Given these variations, pain intensity and disability should be considered as two distinct dimensions and measured separately. These results have implications for future clinical and epidemiological studies.