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A Comparative Study of Oswestry Back Pain Disability Questionnaire Versus Computer Adaptive Testing for Measuring Back Pain

  • Choi, Bong-Sam
    • Physical Therapy Korea
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    • v.20 no.4
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    • pp.22-31
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    • 2013
  • The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain ($n_1=42$) and non-back pain group ($n_2=42$). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.

A Comparison of Three Low Back Disability Questionnaires With Rasch Analysis (라쉬분석을 이용한 세 가지 요통 장애 설문지의 비교)

  • Kim, Gyoung-Mo;Park, So-Yeon;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.94-102
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    • 2011
  • The purpose of this study was to review existing assessment tools for patients with low back pain and improve them through combination. A total of 314 patients with low back pain participated. Their condition was assessed using the Oswestry Disability Questionnaire (ODQ), the Quebec Back Pain Disability Scale (QBPD), and the Back Pain Functional Scale (BPFS). Rasch analysis was applied to identify inappropriate items, item difficulties, and the separation index. In this study, the 'sex life' item of the ODQ (10 items) and the 'sleeping' item of the BPFS (12 items) showed misfit statistics, whereas all items of the QBPD (20 items) were appropriate. After combining the ODQ, QBPD and BPFS, Rasch analysis was applied. The 'pain intensity', and the 'sex life' item of the ODQ and the 'throw a ball' item of QBPD showed misfit statistics. These 3 items were retained for further analysis. The remaining 42 combined ODQ-QBPD-BPFS items were arranged according to difficulty. For all subjects, the most difficult item was 'pain intensity', whereas the easiest was 'take food out of the refrigerator'. As the separation index of 42 combined ODQ-QBPD-BPFS was higher than that of the three questionnaires separately, difficulty of items varied with some need for rearrangement. The results of this study confirmed the possibility and need for a new back pain disability assessment tool, and produced one. Further study is needed to refine the questionnaire in consideration of psychosocial and occupational factors.

Keyform Analysis of Rasch Measurement Accessible to Clinicians in Rehabilitation Clinics

  • Choi, Bong-Sam
    • Physical Therapy Korea
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    • v.21 no.2
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    • pp.74-81
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    • 2014
  • The versions of the Oswestry disability questionnaire (ODQ) is regarded as one of the most extensively used condition-specific instruments measuring disability resulting from low back pain. It has been shown to have adequate psychometrics, reliability, validity, and responsiveness as a whole, yet the summated total score of the instrument often provide little information to rehabilitation clinicians. A keyform analysis based on Rasch measurement model is an innovative way of illustrating the specific test items that an individual may or may not perform. By applying the keyform of the Rasch measurement model to the ODQ, rehabilitation clinicians may able to select more challenging ODQ items matching an individual's ability and document them as attainable treatment goals. The results demonstrated how a keyform analysis assist to setting possible goals for the treatment of individuals with low back pain. Forty-two individuals with low back pain were recruited from rehabilitation clinics in Gainesville, Florida. A series of Rasch analyses on the 10 items of the ODQ were performed using Winsteps software. The performance of two individuals on those 10 items was illustrated on the keyform. The keyform analysis of the Rasch measurement model may be translated into a useful tool for making clinical judgements.

Application of Rasch Analysis to the Modified Oswestry Low Back Pain Disability Questionnaire for Work-Related Low Back Pain Patients (수정된 오스웨스트리 허리기능 장애 설문지의 라쉬분석: 산업장에서의 업무관련 요통환자를 대상으로)

  • Park, So-Yeon;Oh, Jae-Seop;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.15 no.3
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    • pp.26-34
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    • 2008
  • The purposes of this study were to assess and modify the original classification categories of the modified Oswestry Low Back Pain Disability Questionnaire (ODQ) and to determine the unidimensionality of the modified ODQ applying Rasch Analysis. The data were obtained from 108 work-related low back pain patients by physical therapists. Construct validity of the scale using the Rasch model required the structure of the rating scale to be modified from 6 response levels to 4 response levels. Eight items from the modified ODQ fit the Rasch model. The items, "pain intensity" and "social life" showed misfit statistics. In general, the order of item difficulty of the remaining 8 items showed a logical item difficulty hierarchy with the "changing degree of pain" item being the most difficult and the "walk" item being the easiest. The results showed that further study is needed to expand the construct of ODQ including additional higher-level items related to work activities. This study may be useful for establishing a standard method to assess the functionality of low back pain patients.

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The Effect of Diathermy Treatment through Physiotherapist's Hand on the Pain and Disability Index in Chronic Lumbar Pain Patients (물리치료사 손을 통한 고주파치료가 만성요통 환자의 통증과 장애지수에 미치는 영향)

  • Kwon, Kung;Kim, Chan Mun;Park, Shin-Jun
    • Journal of the Korea Convergence Society
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    • v.9 no.2
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    • pp.289-294
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    • 2018
  • A test study was conducted to identify the effects of diathermy through therapist's hand on patients with chronic lumbar pain. The study assessed the effectiveness of Winback High Frequency TECAR Therapy on 21 patients suffering from chronic lumbar pain and the testing was held at H Hospital and began in April 2016 and concluded in September 2016. Assessment of pain relief was through a Visual Analogue Scale (VAS) and the Oswestry Disability Questionnaire (ODQ). The results showed a VAS score decrease from $6.67{\pm}1.76$ to $5.52{\pm}2.03$ (p<0.05) and the ODQ results also showed an decrease from $41.19{\pm}2.56$ to $35.14{\pm}5.11$ (p<0.05). Both of these results are indicative of the positive effects that diathermy through therapist's hand has in the treatment of chronic pain, and the necessity for further studies in this field.

Phospholipase C-mediated vasorelaxing action of melatonin in rat isolated aorta (흰쥐 대동맥에서 phospholipase C를 경유한 melatonin의 혈관 이완 작용)

  • Kim, Shang-Jin;Baek, Sung-Soo;Kang, Hyung-Sub;Kim, Jin-Shang
    • Korean Journal of Veterinary Research
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    • v.45 no.4
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    • pp.507-515
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    • 2005
  • Melatonin, the principal hormone of the vertebral pineal gland, participates in the regulation of cardiovascular system in vitro and in vivo. However, the effects of melatonin on vascular tissues are still vague. The aim of this study was to assess the relationship between phospholipase C (PLC) and nitric oxide synthase (NOS)/cyclic guanosine 3',5'-monophosphate (cGMP) signaling cascade in the relaxatory action of melatonin in isolated rat aorta. Melatonin induced a concentration-dependent relaxation in phenylephrine (PE)- and KCl-precontracted endothelium intact (+E) aortic rings. In KCl-precontracted +E aortic rings, the melatonin-induced vasorelaxation was not inhibited by endothelium removal or by pretreatment with NOS inhibitors, L-$N^G$-nitor-arginine (L-NNA) and L-$N^G$-nitor-arginine methyl ester (L-NAME), guanylate cyclase (GC) inhibitors, methylene blue (MB) and 1H-[1,2,4] oxadiazolo-[4,3-a] quinoxalin-1-one (ODQ). In PE-precontracted +E aortic rings, the melatonin-induced vasorelaxation was inhibited by endothelium removal or by pretreatment with L-NNA, L-NAME, MB, ODQ and 2-nitro-4-carboxyphenyl-n,n-diphenylcarbamate (NCDC). Moreover, in without endothelium (-E) aortic rings and in the presence of L-NNA, L-NAME, MB and ODQ in +E aortic rings, the melatonin-induced residual relaxations and residual contractile responses to PE were not affected by NCDC, a PLC inhibitor. It is concluded that melatonin can evoke vasorelaxation due to inhibition of PLC pathway through the protein kinase G activation of endothelial NOS/cGMP signaling cascade.

Effects of FOENICULI FRUCTUS on the Regional Cerebral Blood Flow and Mean Arterial Blood Pressure in Rats (소회향이 흰쥐의 국소뇌혈류량 및 평균혈압에 미치는 영향)

  • Kim, Nam-Soon;Jeong, Hyun-Woo;Kang, Sung-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.3
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    • pp.652-657
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    • 2007
  • This experimental study was designed to investigate the effects of FOENICULI FRUCTUS freeze dry powder (FF) on the change of cerebral hemodynamics [regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP)] in normal and further to determine the mechanism of action of FF. The results in normal rats were as follows ; FF significantly increased rCBF in a dose-dependent, but decreased MABP, This results were suggested that FF significantly increased rCBF by dilating PAD. The FF-induced increase in rCBF was significantly inhibited by pretreatment with 1H[1,2,4]oxadizolo[4,3-a]quinoxalin-1-one (ODQ, 10 ${\mu}$g/kg, i.p.), an inhibitor of guanylate cyclase and indomethacin (IDN, 1 mg/kg, i.p.), an inhibitor of cyclooxygenase and propranolol (PPN, 3 mg/kg, i.p.), a blocker of adrenalic f receptor and Lu-Nitro-L-Arginine (L-NNA, 1 m9/kB, i.p.), an inhibitor of nitric oxide synthase. The FFE-induced decrease in MABP was significantly increased by pretreatment with L-NNA and was increased by pretreatment with PPN, Dut was inhibited by pretreatment with ODQ and IDN, This results were suggested that the mechanism of FF was mediated by nitric oxide synthase and adrenalic ${\beta}$ receptor.

Effects of Lumbar Stabilization Exercise using PNF Techniques on Thickness of Lumbar Deep Muscle and Functional Activity in Chronic Low Back Pain Patients (만성요통환자에서 PNF 기법을 이용한 요부안정화 운동이 요부 심부근 두께 및 기능적 활동에 미치는 효과)

  • Kim, Gi-Do;Lee, Yun-Jung;Choi, Wan-Suk;Lee, Dong-Woo;Jung, Dae-In;Kim, Kyung-Yoon
    • The Journal of the Korea Contents Association
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    • v.12 no.3
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    • pp.233-243
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    • 2012
  • The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.

Study on the Effect of Jakyakgamcho-tang (작약감초탕의 효능에 관한 연구)

  • Lee Yun Suk;Kim Hyung Chang;Whang Eui Hyun;Jo Sung Kyun;Lim In Gyu;Han Jong Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.493-498
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    • 2003
  • Paeoniae Radix, Glycyrrhizae Radix and Jakyakgamchotang have been used in Oriental Medicine for many centuries as a treatment for various disease. The purpose of the present study is to determine the effect of Paeoniae Radix, Glycyrrhizae Radix and Jakyakgamchotang on narepinephrine(NE) induced contraction of isolated rabbit femoral artery. Rabbits (2.0kg, female) were killed by CO₂ exposure and a segment (8-10mm) of the aortic ring from each rabbit was cut into equal segments and mounted 'in pairs' in a tissue bath. Contractile force was measured with force displacement transducers under 1.5g loading tension. The dose of NE which evoked 50% of maximal response (ED/sub 50/) was obtained from cumulative dose response curves for NE (10/sup -7/~10/sup -4/M). Contractions evoked by NE (ED/sub 50/) were inhibited significantly by Paeoniae Radix, Glycyrrhizae Radix and Jakyakgamcho-tang. The mean percent inhibition of NE induced contraction was 83.9% (p<0.01) after 150㎕/㎖ Paeoniae Radix, 101.1 %(p<0.01) after 150 ㎕/㎖, Glycyrrhizae Radix and 107.3%(p<0.01) after 150㎕/㎖ Jakyakgamcho-tang, Indomethacin slightly but significantly attenuated the inhibitory effects of Paeoniae Radix. Following treatment with indomethacin, the mean percent inhibition caused by 150㎕/㎖ Paeoniae Radix fell to 16.4% in femoral artery induced by NE contraction. Propranolol, ODQ, and L-NNA did not significantly alter the inhibitory effect of Paeoniae Radix. ODQ slightly but significantly attenuated the inhibitory effects of Glycyrrhizae Radix. Following treatment with ODQ, the mean percent inhibition caused by 150㎕/㎖ Glycyrrhizae Radix fell to 13.0% in femoral artery induced by NE contraction. Propranolol, indomethacin and L-NNA did not significantly alter the inhibitory effect of Glycyrrhizae Radix. L-NNA slightly but significantly attenuated the inhibitory effects of Jakyakgamchotang. Following treatment with L-NNA, the mean percent inhibition caused by 150㎕/㎖ Jakyakgamchotang fell to 13.8% in femoral artery induced by NE contraction. Propranolol, ODQ and indomethacin did not significantly alter the inhibitory effect of Jakyakgamcho-tang. These results indicate that Paeoniae Radix, Glycyrrhizae Radix and Jakyakgamcho-tang can relax NE induced contraction of the isolated rabbit femoral artery, and that this inhibition related to nitric oxide.

Effects of Samyoo-tang Extract on Pulmonary Artery and Cerebral Blood Flow in Rabbits and Rats (삼요탕이 폐혈관 및 뇌혈류량에 미치는 영향)

  • 이원중;고영철;박병민;신조영;이시형
    • The Journal of Korean Medicine
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    • v.23 no.3
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    • pp.63-73
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    • 2002
  • Objective : This study aimed to investigate the effects Samyoo-tang Extract (SE) on the vascular systems, including changes in blood pressure and regional cerebral blood flow (rCBF), of male Sprague-Dawley rats. Methods : The changes in rCBF were determined by Laser-Doppler flowmetry through the opened cranial method and norepinephrine (NE)-induced blood vessel contractions were determined by physiograph in the pulmonary artery of isolated rabbits. Results and Conclusion : 1. Contractions evoked by NE ($ED_{50}$) were inhibited significantly by SE in the pulmonary artery. 2. SE inhibited the relaxation of NE induced contractions pretreated with propranolol. 3. SE did not inhibit the relaxation of NE induced contractions pretreated with ODQ and L-NNA. 4. Blood pressure was not affected by SE in rats. 5. rCBF was increased by SE in a dose-dependent manner. 6. Pretreatment with propranolol was increased by SE in a dose-dependent manner in blond pressure. 7. Pretreatment with methylene blue, ODQ and L-NNA did not inhibit SE induced increased in rCBF. These results indicate that SE can relax NE-induced contraction of rabbit blood vessels and increased the changes of rCBF in rats, that relate to the sympathetic nerve system.

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