Restricted accessResearch articleFirst published online 2019-7
Comparing functioning in spinal cord injury and in chronic spinal pain with two ICF-based instruments: WHODAS 2.0 and the WHO minimal generic data set covering functioning and health
To investigate whether the two briefest validated ICF-based (International Classification of Functioning, Disability and Health) tools can detect differences between different spinal conditions.
Design:
Cross-sectional study.
Setting:
University hospital rehabilitation clinic.
Subjects:
A total of 84 patients with spinal cord injury and 81 with chronic spinal pain.
Main measures:
Disability evaluated using self-reported and proxy 12-item WHODAS 2.0 ((World Health Organization Disability Assessment Schedule), and physician-rated WHO minimal generic data set covering functioning and health.
Findings:
The two measures used showed severe disability in both patient populations, those with spinal cord injury (mean age 47.5 years, SD 13.2) and those with chronic spinal pain (mean age 47.2 years, SD 9.5), WHODAS patient sum being 18.4 (SD 9.6) versus 22.0 (SD 9.0), P < 0.05, and the WHO generic data set 15.6 (SD 4.4) versus 14.2 (SD 3.7), P < 0.01, respectively. Correlations between patient and proxy ratings and between the two disability scales were mostly strong. Severe restrictions were found in the working ability of both the populations, in mobility of patients with spinal cord injury and in pain function of patients with chronic spinal pain. In this tertiary clinic patient population, patients with spinal pain perceived more problems in emotional and cognitive functions, and in participation than patients with spinal cord injury.
Conclusions:
Both scales were able to find differences between two patient populations with severe disability.
MagasiSRHeinemannAWWhiteneckGG.Participation following traumatic spinal cord injury: an evidence-based review for research. J Spinal Cord Med2008; 31(2): 145–156.
2.
AlexanderMSAndersonKBiering-SorensenFet al. Outcome measures in spinal cord injury: recent assessments and recommendations for future directions. Spinal Cord2009; 47(8): 582–591.
3.
BarclayLMcDonaldRLentinP.Social and community participation following spinal cord injury: a critical review. Int J Rehabil Res2015; 38(1): 1–19.
4.
WalshTLHanscomBLurieJDet al. Is a condition-specific instrument for patients with low back pain/leg symptoms really necessary? The responsiveness of the Oswestry Disability Index, MODEMS, and the SF-36. Spine2003; 28(6): 607–615.
5.
PatelMSNeweyMSellP.A comparison of patient-reported outcome measures after spinal surgery. Bone Joint J2015; 97-B(3): 366–371.
UedaHCutlerHSGuzmanJZet al. Current trends in the use of patient-reported outcome instruments in degenerative cervical spine surgery. Global Spine J2016; 6(3): 242–247.
8.
RamasamyAMartinMLBlumSIet al. Assessment of patient-reported outcome instruments to assess chronic low back pain. Pain Med2017; 18(6): 1098–1110.
9.
AlgattasHCohenJAgarwalNet al. Trends in the use of patient-reported outcome instruments in neurosurgical adult thoracolumbar deformity and degenerative disease literature. J Craniovertebr Junction Spine2017; 8(2): 103–107.
10.
BabingtonJREdwardsAWrightAKet al. Patient-reported outcome measures: utility for predicting spinal surgery in an integrated spine practice. PM R2018; 10(7): 724–729.
11.
DevivoMJ.Epidemiology of traumatic spinal cord injury: trends and future implications. Spinal Cord2012; 50(5): 365–372.
12.
KristmanVLHartvigsenJLeboeuf-YdeCet al. Does radiating spinal pain determine future work disability? A retrospective cohort study of 22,952 Danish twins. Spine2012; 37(11): 1003–1013.
13.
ManchikantiLSinghVFalcoFJet al. Epidemiology of low back pain in adults. Neuromodulation2014; 17(Suppl. 2): 3–10.
14.
SilvaAGQueirosASa-CoutoPet al. Self-reported disability: association with lower extremity performance and other determinants in older adults attending primary care. Phys Ther2015; 95(12): 1628–1637.
15.
MeyersARAndresenEMHagglundKJ.A model of outcomes research: spinal cord injury. Arch Phys Med Rehabil2000; 81(12Suppl. 2): S81–S90.
16.
CiezaAOberhauserCBickenbachJet al. Towards a minimal generic set of domains of functioning and health. BMC Public Health2014; 14: 218.
17.
De Pedro-CuestaJAlberquillaAVirues-OrtegaJet al. ICF disability measured by WHO-DAS II in three community diagnostic groups in Madrid, Spain. Gac Sanit2011; 25(Suppl. 2): 21–28.
18.
KuoCYLiouTHChangKHet al. Functioning and disability analysis of patients with traumatic brain injury and spinal cord injury by using the World Health Organization disability assessment schedule 2.0. Int J Environ Res Public Health2015; 12(4): 4116–4127.
19.
Tarvonen-SchroderSTenovuoOKaljonenAet al. Comparing disability between traumatic brain injury and spinal cord injury using the 12-item WHODAS 2.0 and the WHO minimal generic data set covering functioning and health. Clin Rehabil2018; 32(12): 1676–1683.
20.
Tarvonen-SchroderSKaljonenALaimiK.Disability in amyotrophic lateral sclerosis compared with traumatic brain injury using the World Health Organization disability assessment schedule 2.0 and the international classification of functioning minimal generic set. Int J Rehabil Res2018; 41(3): 224–229.
21.
GoldsteinLBSamsaGPMatcharDBet al. Charlson index comorbidity adjustment for ischemic stroke outcome studies. Stroke2004; 35(8): 1941–1945.
22.
KirshblumSWaringW3rd. Updates for the international standards for neurological classification of spinal cord injury. Phys Med Rehabil Clin N Am2014; 25(3): 505–517, vii.
23.
Evangelista Santos BarcelosACScardinoFBPatriotaGCet al. Paraparesis or incomplete paraplegia? How should we call it?Acta Neurochir2009; 151(4): 369–372.
24.
MooreJE.Chronic low back pain and psychosocial issues. Phys Med Rehabil Clin N Am2010; 21(4): 801–815.
25.
BletzerJGantzSVoigtTet al. Chronic low back pain and psychological comorbidity: a review. Schmerz2017; 31(2): 93–101.
26.
ShawWSHartvigsenJWoiszwilloMJet al. Psychological distress in acute low back pain: a review of measurement scales and levels of distress reported in the first 2 months after pain onset. Arch Phys Med Rehabil2016; 97(9): 1573–1587.
27.
PostMWvan LeeuwenCM.Psychosocial issues in spinal cord injury: a review. Spinal Cord2012; 50(5): 382–389.
28.
PostMWde WitteLPReichrathEet al. Development and validation of IMPACT-S, an ICF-based questionnaire to measure activities and participation. J Rehabil Med2008; 40(8): 620–627.
29.
NoonanVKKopecJANoreauLet al. Comparing the content of participation instruments using the international classification of functioning, disability and health. Health Qual Life Outcomes2009; 7: 93.
30.
NoonanVKKopecJANoreauLet al. A review of participation instruments based on the international classification of functioning, disability and health. Disabil Rehabil2009; 31(23): 1883–1901.
31.
SureATJMoonJZhouPet al. Patient reported satisfaction and its impact on outcomes in spinal surgery: a mini review. Ann Clin Lab Res2016; 4(3): 1–4.
32.
FedericiSBracalentiMMeloniFet al. World Health Organization disability assessment schedule 2.0: an international systematic review. Disabil Rehabil2017; 39(23): 2347–2380.
33.
NoonanVKKopecJANoreauLet al. Comparing the validity of five participation instruments in persons with spinal conditions. J Rehabil Med2010; 42(8): 724–734.
34.
NoonanVKKopecJANoreauLet al. Comparing the reliability of five participation instruments in persons with spinal conditions. J Rehabil Med2010; 42(8): 735–743.
35.
WolfACTateRLLanninNAet al. The World Health Organization Disability Assessment Scale, WHODAS II: reliability and validity in the measurement of activity and participation in a spinal cord injury population. J Rehabil Med2012; 44(9): 747–755.
36.
NoonanVKopecJNoreauLet al. Measuring participation among persons with spinal cord injury: comparison of three instruments. Topics Spinal Cord Inj Rehabil2010; 15(4): 49–62.
37.
FinePG.Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Med2011; 12(7): 996–1004.
38.
SilvaAGAlvarelhãoJQueirósAet al. Pain intensity is associated with self-reported disability for several domains of life in a sample of patients with musculoskeletal pain aged 50 or more. Disabil Health J2013; 6(4): 369–376.
39.
DuenasMOjedaBSalazarAet al. A review of chronic pain impact on patients, their social environment and the health care system. J Pain Res2016; 9: 457–467.
