Musculoskeletal Pain Questionnaire Research Articles

Predictive ability of a modified Örebro Musculoskeletal Pain Questionnaire in an acute/subacute low back pain working population

The original 'Örebro Musculoskeletal Pain Questionnaire' (original-ÖMPQ) has been shown to have limitations in practicality, factor structure, face and content validity. This study addressed these concerns by modifying its content producing the 'Örebro Musculoskeletal Screening Questionnaire' (ÖMSQ). The ÖMSQ and original-ÖMPQ were tested concurrently in acute/subacute low back pain working populations (pilot n = 44, main n = 106). The ÖMSQ showed improved face and content validity, which broadened potential application, and improved practicality with two-thirds less missing responses. High reliability (0.975, p < 0.05, ICC: 2.1), criterion validity (Spearman's r = 0.97) and internal consistency (α = 0.84) were achieved, as were predictive ability cut-off scores from ROC curves (112-120 ÖMSQ-points), statistically different ÖMSQ scores (p < 0.001) for each outcome trait, and a strong correlation with recovery time (Spearman's, r = 0.71). The six-component factor structure reflected the constructs originally proposed. The ÖMSQ can be substituted for the original-ÖMPQ in this population. Further research will assess its applicability in broader populations.

Unspezifische Rückenschmerzen – Grundlagen und Interventionsmöglichkeiten aus psychologischer Sicht

Back pain is one of the most common and expensive health problems in Germany. Apart from somatic parameters, psychological factors are thought to influence the aetiology and, especially, the chronification of back pain. A literature search has been performed to establish which psychological procedures are used in the diagnosis, prevention and therapy for back pain, and how effective they are. The connection between back pain and psychological factors was investigated in English and German technical articles identified in a literature search in Medline (2000-2006) and in psyndex (2000-2006). 714 hits were identified for the key words "back pain and prevention", 61 hits for "back pain and psychological factors", 732 hits for "back pain and risk factors" and 4 hits for "back pain and chronification of pain". 75 technical articles or studies were selected from these hits and used as a basis for the evaluation of the above questions. The search was completed by a manual search in the literature lists of published articles, perusing monographs, searching the internet and evaluating congress and meeting reports (2000-2008). The results of various studies show that cognitive, emotional and behavioural aspects and the processes of respondent and operant learning are of great importance in processing and overcoming pain. Biopsychosocial procedures appear to be superior to biomedical procedures. There has been good research on the (psychological) risk factors which contribute to the chronification of pain. It seems to be sensible to use screening procedures, such as the "Orebro Musculoskeletal Pain Questionnaire (OMPQ)" for the identification of patients at increased risk of chronification. For patients with chronic symptoms, there are evidence-based psychological programme components; these are usually successful, especially as part of multimodal programmes. As yet, there have only been initial studies on the use of psychological intervention for prevention, particularly in occupational settings. In the high risk group of patients already suffering from back pain, relapses and chronification can best be prevented by multimodal programmes. A decisive condition for the success of these physiotherapeutic, ergotherapeutic, sports therapeutic and psychotherapeutic interventions is apparently that there should be a standardised procedure in accordance with the theoretical principles of behavioural therapy, complied with by all those involved in the process. However, the principle objective of all measures should be the avoidance of the transition from acute to chronic back pain and the protracted and expensive clinical course this can lead to. Psychological intervention appears to work here as well. Further studies are needed to clarify whether the psychological program components are effective in isolation or whether they must be embedded in a multimodal (preventive) concept. It must also be investigated which target groups benefit most from which type of preventive (psychological) intervention. Provision of specific information is an alternative preventive approach. This health psychological or educative procedure corresponds to demedicalisation of this condition. Although media campaigns have been successfully performed in Australia, it is as yet unclear whether these can be transferred to Germany and which structural changes these would require in our health care system.

A case controlled, cross-sectional survey of joint and muscle aches, pains and stiffness in women with primary breast cancer.

Abstract Abstract #1116 Background: The long term consequences of treatment for breast cancer are becoming increasingly important as both the incidence rises and survival improves. Joint and muscle aches, pains and stiffness are some of the most commonly described problems amongst women treated for breast cancer, yet there is little primary research focusing on this issue. Inevitably some of these symptoms will be caused by ageing, however there is some evidence to suggest that they are specific to or exacerbated by primary breast cancer treatment (Felson and Cummings, 2005). Clinical observations suggest that there may be specific patterns of pain with specific breast cancer treatments. No previous research has compared the prevalence and patterns of these symptoms to those in women of a similar age without cancer.&amp;#x2028; Aims: 1.To determine the prevalence of joint and muscle aches, pains and stiffness in women after treatment for primary breast cancer and to compare with age matched controls.&amp;#x2028; 2.To explore the patterns of these symptoms in different parts of the body.&amp;#x2028; Methods: We recruited 247 women with breast cancer following primary breast cancer treatment and 272 without breast cancer attending for mammographic screening and benign breast clinics. They completed the Nordic musculoskeletal pain questionnaire, the Brief Pain Inventory (BPI) and the SF-36 general health questionnaire. Medical and demographic details were collected as well as information about factors which might affect these symptoms, such as menopausal status and weight.&amp;#x2028; Results: Current pain was reported by 143(62%) women in the breast cancer group as opposed to 125(49%) in the non cancer group (p=.005). Current pain was significantly worse in the breast cancer group at a mean of 4.2 on a ten point scale (BPI) compared to 3.4 in women without breast cancer(p=.006), although interference to daily activities as a result of pain was not significantly increased. The hands (p=.02) and upper back (p=.003) were more likely to be reported as a site of pain in women with breast cancer, while neck pain was more common in women without breast cancer (p=.04). Hands (p=.02) and upper back pain (p=.008) also significantly affected women's activities in the last 12 months. Although pain in the feet was not reported as more common in women with breast cancer it was more likely to affect activity in the last 12 months (p=.01).&amp;#x2028; Discussion: This study provides evidence that joint pains are more prevalent and more severe in women with breast cancer than women of the same age without breast cancer. Patterns of pain showed specificity to the hands and upper back, which were also worse than in women without breast cancer. The fact that women reported that foot pain was more likely to affect their activity suggests that although it was not more common, it was more troublesome in women with breast cancer. Further analyses will explore the impact of symptoms on quality of life. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1116.

Temporal outcomes and prognostic indicators of outcome for a spinal stabilisation exercise regime in subjects with low back pain—A pilot study

Introduction: Despite evidence supporting the use of exercise in the treatment of chronic, non-specific low back pain, outcomes associated with specific exercise regimes for this condition have yet to be established. Accordingly, the aims of this study were to document temporal outcomes and prognostic indicators of outcome for a specific spinal stabilisation exercise regime (Bounce back classes) in subjects with chronic, non-specific low back pain. Methodology: Five physiotherapy clinics in Australia, that offered the 8-week exercise regime in its standardised form, agreed to participate in this study. Data were collected prospectively for all consenting subjects with a minimum 12-week history of low back pain. Demographic information was collected prior to regime commencement. Outcome evaluations for pain (VAS) and function (Roland Morris 24) were conducted on three occasions throughout the regime term (weeks 1, 5 and 8), and 6 months after regime completion. Evaluations for psychosocial function (Orebro Musculoskeletal Pain Questionnaire) and work performance (Work Limitations 25) were conducted prior to regime commencement and 6 months after regime completion. For the statistical analyses, t-tests and chi square tests were used to establish temporal outcomes for the exercise regime and regression analyses to determine prognostic indicators of outcome. Results and discussion: The preliminary study results for 70 subjects are expected to be available for dissemination by May 2008. This study has important implications for the management of chronic low back pain and represents a unique step towards the identification of those patients most likely to benefit from a spinal stabilisation rehabilitation approach.

Yellow flag scores in a compensable New Zealand cohort suffering acute low back pain

Despite its high prevalence, most acute low back pain (ALBP) is nonspecific, self-limiting with no definable pathology. Recurrence is prevalent, as is resultant chronicity. Psychosocial factors (yellow flags comprising depression and anxiety, negative pain beliefs, job dissatisfaction) are associated with the development of chronic LBP. A national insurer (Accident Compensation Corporation, New Zealand [NZ]), in conjunction with a NZ primary health organization, piloted a strategy for more effective management of patients with ALBP, by following the NZ ALBP Guideline. The guidelines recommend the use of a psychosocial screening instrument (Yellow Flags Screening Instrument, a derivative of Örebro Musculoskeletal Pain Questionnaire). This instrument was recommended for administration on the second visit to a general medical practitioner (GP). This paper tests whether published cut-points of yellow flag scores to predict LBP claims length and costs were valid in this cohort. Data was available for 902 claimants appropriately enrolled into the pilot. 25% claimants consulted the GP once only, and thus were not requested to provide a yellow flag score. Yellow flag scores were provided by 48% claimants who consumed two or more GP services. Approximately 60% LBP presentations resolved within five GP visits. Yellow flag scores were significantly and positively associated with treatment costs and service use, although the association was nonlinear. Claimants with moderate yellow flag scores were similarly likely to incur lengthy claims as claimants with at-risk scores. Capturing data on psychosocial factors for compensable patients with ALBP has merit in predicting lengthy claims. The validity of the published yellow flag cut-points requires further testing.

A Systematic Review of the Predictive Ability of the Orebro Musculoskeletal Pain Questionnaire

Systematic review. To establish the ability of the Orebro Musculoskeletal Pain Questionnaire (OMPQ) to predict outcome in patients with recent onset spinal pain. Psychosocial factors are believed to play a significant role in the development of a chronic pain problem. The OMPQ is a self-administered screening questionnaire that was developed to identify those patients with acute or subacute musculoskeletal pain who are at risk of delayed recovery. Clinical guidelines recommend its use, despite its predictive ability never having been systematically reviewed. Searches of electronic databases were undertaken. Eligible studies were those that enrolled subjects with acute or subacute spinal pain, administered the OMPQ at baseline and measured outcomes in terms of pain, disability, sick leave, and/or global recovery. Ratings of study quality and data extraction were conducted by 2 independent assessors. Seven publications (5 discreet data sets) of variable methodologic quality were included. Baseline OMPQ scores were shown to have moderate ability in predicting long-term pain, disability, and sick leave outcomes. For example, the area under the curve values for predicting persisting pain ranged from 0.62 to 0.75 and for persisting disability from 0.68 to 0.83. The OMPQ has moderate predictive ability in identifying patients with spinal pain at risk of persisting pain and disability. This evidence supports clinical guidelines recommending its use as an assessment tool for identifying psychosocial risk factors. Further research is needed to confirm the predictive ability of individual items in different populations and settings, to enhance its usefulness.

Can long-term impairment in general practitioner whiplash patients be predicted using screening and patient-reported outcomes?

The objective of this prospective pilot study was to investigate the predictors of outcome at 6 months for whiplash-associated disorder in a general practitioner primary care population. Psychosocial screening questionnaires, patient-reported outcomes of cervical functional impairment, demographic and accident-specific data have been indicated as predictive of future recovery status and treatment requirements. Participants (n=30, age=37+/-14 years, 77% females) from eight general practitioners were initially screened with a modified Orebro Musculoskeletal Pain Questionnaire, and had recovery status monitored and classified for 6 months using both patient-reported outcomes, quantitatively (Neck Disability Index) and qualitatively (patient status self-classification). Analysis at two separate cutoff levels showed 30% of participants nonrecovered and 17% with moderate/severe impairment. Nonrecovery status and increased treatment was predicted by a 109-point screening score cutoff while moderate/severe impairment was predicted by including the presence of cervical rotation at impact. Initial cervical functional impairment status measured with the Neck Disability Index was sensitive but not specific for prediction. A larger population study investigating these protocols is warranted.

Predicting Treatment Failure in the Subacute Injury Phase Using the ??rebro Musculoskeletal Pain Questionnaire: An Observational Prospective Study in a Workers??? Compensation System

The goal of the present study was to examine if patient scores on a brief biopsychosocial screening questionnaire--the Orebro Musculoskeletal Pain Questionnaire (OMPQ)--could predict clinical discharge status ("fit" vs "not fit" for return to work) after a standardized 6-week physical therapy-based work conditioning program. The OMPQ was administered to a derivation sample of 200 injured workers with soft tissue injuries before beginning treatment. A clinical cutoff score of 147 was subsequently tested in a second validation sample of 211 injured workers. The OMPQ was able to correctly predict the discharge status of 85% of claimants. These results suggest that the OMPQ can facilitate clinical decision-making through early identification of individuals likely to fail a unidisciplinary physical therapy program and who may benefit from more complete biopsychosocial treatment.

Does the ??rebro Musculoskeletal Pain Questionnaire predict outcomes following a work-related compensable injury?

The objective of this prospective study was to investigate the usefulness of the Orebro Musculoskeletal Pain Questionnaire (OMPQ) to predict return to work outcomes following a compensable musculoskeletal injury. Participants (n=196 injured workers, 66% male, 36% with back pain) were screened at 4-12 weeks, and followed up at 6 months, post-injury. Total scores on the OMPQ were able to differentiate between work status on both occasions, indicating the potential predictive validity of this instrument. This is the first study to evaluate the OMPQ in a compensable injury population, and although replication with a larger sample is required, the findings have significant relevance to the recommendation of routine screening for the early identification of injured workers at risk of long-term disability.

Aramid fibre pellets

The Örebro Musculoskeletal Screening Questionnaire (ÖMSQ) is a recently validated, 21-item instrument. It modified the original Örebro Musculoskeletal Pain Questionnaire (ÖMPainQ) providing broader focus and also improved development and practicality for identifying work-injured patients at-risk of persistent musculoskeletal problems. These instruments are critiqued for practicality and a shortened-version recommended. A 10-item ÖMPainQ was previously proposed for low-back-pain; however, general musculoskeletal populations require a broader validated instrument. To provide this, a two-stage retrospective study was performed. Stage 1 used three phases to: determined a minimum 12-item tool was required to ensure internal consistency (α > 0.70); subsequently developed two shortened ÖMSQ-12 versions from qualitative content-retention and quantitative factor analysis reductive methodologies; then calibrated both versions in a spine-cohort. Stage 2 validated and compared both versions' clinimetric properties in a general musculoskeletal-cohort to ascertain which was most appropriate. The ÖMPainQ-10 and a randomly-created ÖMPainQ-10 were compared post-hoc for criterion validity and factor structure. A physical therapy outpatients convenience sample (n = 279) was divided into developmental (spine = 136) and calibration (musculoskeletal = 143) cohorts. Primary outcomes were functional status, insurer-reported absenteeism and costs at six months. The qualitative-ÖMSQ-12 demonstrated preferred properties with higher 21-item-ÖMSQ correlation (r = 0.97; quantitative-ÖMSQ-12: r = 0.94; ÖMPainQ-10: r = 0.92; ÖMPainQ-10-random: r = 0.94) and improved predictive ability cut-offs for high-risk (72 ÖMSQ-12 points, 60%) and low-risk (57 ÖMSQ-12 points, 48%). The ÖMSQ-12 content-retention version is recommended. It demonstrated suitable internal consistency, a three-factor structure and high correlation with recovery time (r = 0.73). The ÖMSQ-12 will facilitate early identification and management of at-risk individuals and enable targeted intervention strategies through psychosocial informed management principles.