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Physical Functioning and Pain in Chronic Low Back Pain: a Systematic Review of Psychometric Properties of Various Outcomes Measures

      Objectives

      Existing evidence on the psychometric properties of physical functioning and pain outcomes measures used in the chronic low back pain (CLBP) trials are not been systematically reviewed. The objective of our study was to evaluate the methodological quality of studies that evaluated psychometric properties of functioning and pain outcome measures for CLBP using Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) check list.

      Methods

      We searched Pubmed and EMBASE databases from inception to June 2015 with specific key words. Longitudinal cohort and cross sectional studies which included at least one assessment of psychometric property of outcomes measure in CLBP patients were included. Studies published in English language and on humans were included. Studies published as reviews, editorials and case reports were excluded. Two reviewers independently performed study selection, data extraction and quality assessment procedures; disagreements between reviewers were resolved through discussion.

      Results

      A total of 32 studies met our inclusion criteria. In this systematic review only one third (34%) of instruments were tested for all psychometric properties and showed mixed methodological quality according to COSMIN check list. Among all instruments Quebec Back Pain Disability Scale had showed excellent reliability (Cronbach’s alpha coefficient 0.96) and test-retest reliability (ICC=0.92) for physical functioning assessment. Pain Catastrophising Scale had showed excellent reliability (α=0.92) and high degree test-retest reliability (ICC=0.842). More than half of the instruments showed excellent/good reliability and half showed fair validity. Responsiveness was assessed in only nine studies and had all showed fair quality.

      Conclusions

      Overall we found moderate methodological quality for most of the measures to advise tools use based on psychometric properties. Further research is needed to investigate the psychometric properties of all outcome measures used in CLBP research.