Evaluation of low back pain by patient questionnaires and therapist assessment.

Paper completed by D.J.B. and J.V.B. in partial fulfillment of the requirements for the Master of Science Degree, Physical Therapy, University of Southern California, Presented at the 63rd Annual Conference, American Physical Therapy Association. June, 1987. The purposes of this study were to determine reliability and validity of history and disability questionnaires completed by 165 low back pain patients; agreement between those questionnaires and a physical therapy assessment was determined. The short term repeatability of the patient-completed questionnaires was 89% and 87%, respectively, while agreement between the two therapists was 75%. Validity of the disability questionnaire was demonstrated. It was not related to epidemiological indicators and had significant agreement with only five out of nine related therapist history items. The patient history questionnaire had an overall agreement of 76% (range 67-93%) with five therapist history items. The pain rating scale was a less reliable index of disability than was the disability score. Physical findings were related to disability statements dealing with flexion and gait. These results suggest the disability questionnaire can be used on North American samples. While use of the three evaluation tools will give a more complete picture of the patient's status, modifications are suggested to increase their usefulness in assessment of patients with low back pain. Further testing is needed to show their utility in prediction of low back pain outcome. J Orthop Sports Phys Ther 1990;11(11):519-529.