Description of selected functional status instruments tested among workers
| Description | Validity | Reliability | Responsiveness to change | |
|---|---|---|---|---|
| VAS, visual analogue scale; SRM, standardised response mean; CTS, carpal tunnel syndrome; PT, physical therapist; N/A, not available. | ||||
| 1 | Neck Disability Index (NDI): 10 items Pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, recreation. Response: 1 (poorest) to 5 (best) [Vernon and Mior, 1991] | Peer review, patient feedback. Correlation of 0.6 between changes in scores pre- and post-treatment compared to VAS for activity levels. Correlation of 0.7 between NDI and McGill Pain Questionnaire. | Pearson correlation: 0.89 Cronbach alpha: 0.80 total index Cronbach alpha: each item above 0.76 | 33% change in pre- v post-treatment scores |
| 2 | Disability Rating Index (DRI): 12 items Dressing, outdoor walks, climbing stairs, sitting long time, standing over sink, carrying bag, making bed, running, light work, heavy work, lifting heavy objects, exercise/sports. Response: 10 cm VAS: without difficulty – not at all [Salén et al, 1994] | Construct validity: median scores very low (0.9% and 8.8%) in healthy groups, high (50–65%) among patients with arthritis. Pearson intraclass correlation to observers' assessment of performance=0.48. | Test-retest reliability 0.92 for 3 day interval 0.95 for 1 day interval Inter- 0.99 and intra-rater: 0.98 Cronbach alpha 0.84 | 16% change in median pre- v postoperative scores |
| 3 | Upper Extremity Function Scale: 8 items Sleeping, writing, opening jars, picking up small objects with fingers, driving car >30 min, opening door, carrying milk jug from refrigerator, washing dishes. Response: 1 (no problem) to 10 (major problem) [Pransky et al, 1997] | Able to discriminate between levels of severity (significant t test value) for working status, duration of symptoms, effect on job ability, Phalen's test. Correlation with average pain level r=0.67, fear of pain, r=0.44, pinch strength r=−0.40 | Cronbach alpha: 0.83 to 0.93 | Upper extremity cohort SRM range: −1.33 to −0.53 CTS cohort SRM range: −1.03 to 0.92 |
| 4 | Nordic Musculoskeletal Questionnaires: 27 items 3 questions: Have you had trouble (ache, pain, discomfort, numbness), Had trouble during last seven days; Been prevented from normal activities in 9 body areas (neck, shoulder, elbows, wrists/hands, upper back, lower back, hips/thighs/buttocks, knees, ankles/feet). Response: Yes/No, multiple choice [Kuorinka et al, 1987] | Tests with clinical history: non-identical answers varied between 0–20%. Comparison to PT assessment: percentage of disagreement varied between 0–13%. | Neck-shoulder questionnaire disagreeing responses varied from 0–30% Low back questionnaire disagreeing responses varied from 0–4% (1 item had 25% variance and reformulated in the final version) | N/A |
| 5 | Upper Extremity Questionnaire: 123 items Medical history, exercise, symptoms (burning, stiffness, pain, cramping, tightness, aching, soreness, tingling, numbness) in 3 body areas (neck/shoulder/upper arm, elbow/forearm, and wrist/hand/finger); frequency, severity, interference with work. Response: Yes/No, 10 cm VAS, multiple choice [Franzblau et al, 1997; Salerno et al, 2001] | N/A | Kappa: 0.56–1 medical history Symptom kappa values 0.39–0.86 neck/shoulder/upper arm 0.44–0.86 elbow/forearm 0.44–0.84 wrist/hand/fingers | N/A |
| 6 | Neck and Upper Limb Index (NULI): 20 items 7 physical activity items, 4 work-related, 6 psychosocial, 2 sleep related, 1 item related to negative effects of evaluation or treatment. Response: 7 pt scales [Stock et al, 2000] | Correlation to Sickness Impact Profile, question on overall functional status, PT perception of functional status, hand grip strength, shoulder abduction, scratch test. | Test-retest: ICC=0.88 Ontario cohort; ICC=0.83 Quebec cohort. Cronbach alpha: 0.90 Ontario Cronbach alpha: 0.93 Quebec | SRM: 1.48 Ontario cohort SRM: 1.63 Quebec cohort |