Development of the young spine questionnaire

Henrik Hein Lauridsen, Lise Hestbaek, Henrik Hein Lauridsen, Lise Hestbaek

Abstract

Background: Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood. Consequently, preventive efforts must be targeted the young population but research relating to spinal problems in this age group is scarce. Focus has primarily been on the working age population, and therefore specific questionnaires to measure spinal pain and its consequences, specifically aimed at children and adolescents are absent. The purpose of this study was to develop a questionnaire for schoolchildren filling this gap.

Methods: The Young Spine Questionnaire (YSQ) was developed in three phases--a conceptualisation, development and testing phase. The conceptualisation phase followed the Wilson and Cleary model and included questions regarding spinal prevalence estimates, pain frequency and intensity, activity restrictions, care seeking behaviour and influence of parental back trouble. Items from existing questionnaires and the "Revised Faces Pain Scale" (rFPS) were included during the development phase. The testing phase consisted of a mixed quantitative and qualitative iterative method carried out in two pilot tests using 4th grade children and focusing on assessment of spinal area location and item validity.

Results: The testing phase resulted in omission of the pain drawings and the questions and answer categories were simplified in several questions. Agreement between the questionnaire prevalence estimates and the interviews ranged between 83.7% (cervical pain today) and 97.9% (thoracic pain today). To improve the understanding of the spinal boundaries we added bony landmarks to the spinal drawings after pilot test I. This resulted in an improved sense of spinal boundary location in pilot test II. Correlations between the rFPS and the interview pain score ranged between 0.67 (cervical spine) and 0.79 (lumbar spine).

Conclusions: The Young Spine Questionnaire contains questions that assess spinal pain and its consequences. The items have been tested for content understanding and agreement between questionnaire scores and interview findings among target respondents. These preliminary results suggest that the YSQ is feasible, has content validity and is a well understood questionnaire to be used in studies of children aged 9 to 11 years.

Figures

Figure 1
Figure 1
The Wilson & Cleary conceptual model.Note: Adapted from Wilson et al. [21].
Figure 2
Figure 2
Conceptual model of the young spine questionnaire.Note: The crossed-lined boxes represent the content of YSQ and the stippled lines indicate where the content belongs in the Wilson & Cleary conceptual model. The item on care seeking behaviour has no link as it did not fit the model.
Figure 3
Figure 3
The testing and revision procedures of the young spine questionnaire.

References

    1. Grotle M, Brox JI, Vollestad NK. Functional Status and Disability Questionnaires: What Do They Assess?: A Systematic Review of Back-Specific Outcome Questionnaires. Spine. 2005;30(1):130–140.
    1. Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G. Outcome measures for low back pain research. A proposal for standardized use. Spine. 1998;23(18):2003–2013. doi: 10.1097/00007632-199809150-00018.
    1. Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP, Kerns RD, Stucki G, Allen RR, Bellamy N. et al.Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain. 2005;113(1–2):9–19.
    1. Duggleby T, Kumar S. Epidemiology of juvenile low back pain: a review. Disabil Rehabil. 1997;19(12):505–512. doi: 10.3109/09638289709166043.
    1. Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine (Phila Pa 1976) 2007;32(23):2630–2637. doi: 10.1097/BRS.0b013e318158d70b.
    1. Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29,424 individuals aged 12-41 years. Spine (Phila Pa 1976) 1998;23(2):228–234. doi: 10.1097/00007632-199801150-00015.
    1. Taimela S, Kujala UM, Salminen JJ, Viljanen T. The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland. Spine (Phila Pa 1976) 1997;22(10):1132–1136. doi: 10.1097/00007632-199705150-00013.
    1. Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA, Bohnen AM, van Suijlekom-Smit LW, Passchier J, van der Wouden JC. Pain in children and adolescents: a common experience. Pain. 2000;87(1):51–58. doi: 10.1016/S0304-3959(00)00269-4.
    1. Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine (Phila Pa 1976) 1996;21(20):2323–2328. doi: 10.1097/00007632-199610150-00004.
    1. Wedderkopp N, Leboeuf-Yde C, Andersen LB, Froberg K, Hansen HS. Back pain reporting pattern in a Danish population-based sample of children and adolescents. Spine. 2001;26(17):1879–1883. doi: 10.1097/00007632-200109010-00012.
    1. Balague F, Nordin M, Skovron ML, Dutoit G, Yee A, Waldburger M. Non-specific low-back pain among schoolchildren: a field survey with analysis of some associated factors. J Spinal Disord. 1994;7(5):374–379.
    1. Roth-Isigkeit A, Thyen U, Stoven H, Schwarzenberger J, Schmucker P. Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics. 2005;115(2):e152–e162. doi: 10.1542/peds.2004-0682.
    1. Brattberg G. The incidence of back pain and headache among Swedish school children. Qual Life Res. 1994;3(Suppl 1):S27–S31.
    1. Stull DE, Leidy NK, Parasuraman B, Chassany O. Optimal recall periods for patient-reported outcomes: challenges and potential solutions. Curr Med Res Opin. 2009;25(4):929–942. doi: 10.1185/03007990902774765.
    1. Carey TS, Garrett J, Jackman A, Sanders L, Kalsbeek W. Reporting of acute low back pain in a telephone interview. Identification of potential biases. Spine (Phila Pa 1976) 1995;20(7):787–790. doi: 10.1097/00007632-199504000-00009.
    1. Volinn E. The epidemiology of low back pain in the rest of the world. A review of surveys in low- and middle-income countries. Spine (Phila Pa 1976) 1997;22(15):1747–1754. doi: 10.1097/00007632-199708010-00013.
    1. Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C. The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine (Phila Pa 1976) 2006;31(4):468–472. doi: 10.1097/01.brs.0000199958.04073.d9.
    1. Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A, Fisker I, Laegaard E. Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J. 1999;8(6):444–450. doi: 10.1007/s005860050203.
    1. Siivola SM, Levoska S, Latvala K, Hoskio E, Vanharanta H, Keinanen-Kiukaanniemi S. Predictive factors for neck and shoulder pain: a longitudinal study in young adults. Spine (Phila Pa 1976) 2004;29(15):1662–1669. doi: 10.1097/01.BRS.0000133644.29390.43.
    1. UNFPA. State of World Population 2003: Overview of Adolescent Life. [ ], accessed 3. June 2012.
    1. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273(1):59–65. doi: 10.1001/jama.1995.03520250075037.
    1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233–237. doi: 10.1016/0003-6870(87)90010-X.
    1. Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001;93(2):173–183. doi: 10.1016/S0304-3959(01)00314-1.
    1. Kjaer P, Leboeuf-Yde C, Sorensen JS, Bendix T. An epidemiologic study of MRI and low back pain in 13-year-old children. Spine. 2005;30(7):798–806. doi: 10.1097/.
    1. Bo Andersen L, Wedderkopp N, Leboeuf-Yde C. Association between back pain and physical fitness in adolescents. Spine (Phila Pa 1976) 2006;31(15):1740–1744. doi: 10.1097/01.brs.0000224186.68017.e0.
    1. Tomlinson D, von Baeyer CL, Stinson JN, Sung L. A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics. 2010;126(5):e1168–e1198. doi: 10.1542/peds.2010-1609.
    1. Stinson JN, Kavanagh T, Yamada J, Gill N, Stevens B. Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain. 2006;125(1–2):143–157.
    1. Bieri D, Reeve RA, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain. 1990;41(2):139–150. doi: 10.1016/0304-3959(90)90018-9.
    1. von Baeyer CL. Children’s self-reports of pain intensity: scale selection, limitations and interpretation. Pain Res Manag. 2006;11(3):157–162.
    1. Murphy S, Buckle P, Stubbs D. A cross-sectional study of self-reported back and neck pain among English schoolchildren and associated physical and psychological risk factors. Appl Ergon. 2007;38(6):797–804. doi: 10.1016/j.apergo.2006.09.003.
    1. Whittfield J, Legg SJ, Hedderley DI. Schoolbag weight and musculoskeletal symptoms in New Zealand secondary schools. Appl Ergon. 2005;36(2):193–198. doi: 10.1016/j.apergo.2004.10.004.
    1. Salminen JJ. The adolescent back. A field survey of 370 Finnish schoolchildren. Acta Paediatr Scand Suppl. 1984;315:1–122.
    1. Patrick DL, Burke LB, Gwaltney CJ, Leidy NK, Martin ML, Molsen E, Ring L. Content validity–establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO Good Research Practices Task Force report: part 2–assessing respondent understanding. Value Health. 2011;14(8):978–988. doi: 10.1016/j.jval.2011.06.013.
    1. Guidelines about Notification etc. of a Biomedical Research Project to the Committee Systen on Biomedical Research Ethics, No 9154, 5 May 2011. [ ]
    1. Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J ClinNurs. 2005;14(7):798–804.
    1. The International Association for the Study of Pain (IASP) Faces Pain Scale – revised. [ ], accessed 16. July 2012.
    1. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186–3191. doi: 10.1097/00007632-200012150-00014.
    1. Briggs AM, Straker LM, Bear NL, Smith AJ. Neck/shoulder pain in adolescents is not related to the level or nature of self-reported physical activity or type of sedentary activity in an Australian pregnancy cohort. BMC Musculoskelet Disord. 2009;10:87. doi: 10.1186/1471-2474-10-87.
    1. Murphy S, Buckle P. Proceedings of the XVth Tiennial Congress of the International Ergonomics Association and the 7th Joint Conference of the Ergonomics Society of Korea/Japan Ergonomics Society: August 24-29 2003. Seoul, Korea; 2003. Back pain amongst schoolchildren and associated risk factors; pp. 16–20.
    1. Balague F, Dutoit G, Waldburger M. Low back pain in schoolchildren. An epidemiological study. Scand J Rehabil Med. 1988;20(4):175–179.
    1. Korovessis P, Koureas G, Papazisis Z. Correlation between backpack weight and way of carrying, sagittal and frontal spinal curvatures, athletic activity, and dorsal and low back pain in schoolchildren and adolescents. J Spinal Disord Tech. 2004;17(1):33–40. doi: 10.1097/00024720-200402000-00008.
    1. Troussier B, Marchou-Lopez S, Pironneau S, Alais E, Grison J, Prel G, Pequegnot C, Degaudemaris R, Phelip X. Back pain and spinal alignment abnormalities in schoolchildren. Rev Rhum Engl Ed. 1999;66(7–9):370–380.
    1. Balague F, Damidot P, Nordin M, Parnianpour M, Waldburger M. Cross-sectional study of the isokinetic muscle trunk strength among school children. Spine (Phila Pa 1976) 1993;18(9):1199–1205. doi: 10.1097/00007632-199307000-00013.
    1. von Baeyer CL, Spagrud LJ, McCormick JC, Choo E, Neville K, Connelly MA. Three new datasets supporting use of the Numerical Rating Scale (NRS-11) for children’s self-reports of pain intensity. Pain. 2009;143(3):223–227. doi: 10.1016/j.pain.2009.03.002.

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