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Croatian version of the neck disability index can distinguish between acute, chronic and no neck pain

Results of a validation study

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Summary

Objective

Longitudinal study to test the validity and reliability of the Croatian version of the neck disability index (NDI-CRO) for use in patients.

Methods

Three groups were given NDI-CRO on two occasions, 48 h apart: acute whiplash neck injury group (n = 30), hospital physiotherapists—professional chronic neck pain group (n = 56) and control group (n = 65). To test validity, correlation between NDI-CRO and the pain VAS and PHQ‑9 questionnaire for depression was analyzed. Reliability testing was done using the test-retest experiment and item-total score correlation.

Results

Test-retest showed excellent correlation in all groups: whiplash 0.86, control 0.95 and physiotherapist 0.89 (Spearman r). Item-total score in the 3 analyzed groups showed positive correlation in all 10 categories, varying from 0.43–0.85. The NDI-CRO score showed significant difference between groups (median whiplash 38%, physiotherapist 12% and control 6%, p < 0.05). Validity testing showed positive correlation between NDI and pain VAS (control r = 0.63, physiotherapist r = 0.68 and whiplash r = 0.83, p < 0.05) and PHQ‑9 (control r = 0.49, physiotherapist r = 0.71 and whiplash r = 0.69, p < 0.05). No correlation was found between NDI-CRO and age, gender or radiographic findings. In the whiplash injury group 75% of patients showed moderate to severe disability. The majority of physiotherapists showed mild to moderate disability due to neck pain while 40% showed no disability. In the control group two out of three people reported no disability.

Conclusion

The NDI-CRO is a valid index for measuring the degree of neck disability in people with acute and chronic neck pain and in control group. It is strongly correlated with pain VAS and PHQ‑9 index.

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References

  1. Connelly LB, Supangan R. The economic costs of road traffic crashes: Australia, states and territories. Accid Anal Prev. 2006;38(6):1087–93.

    Article  Google Scholar 

  2. Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, et al. Scientific monograph of the quebec task force on whiplash-associated disorders: redefining “whiplash” and its management. Spine. 1995;20(8 Suppl):1S–73S.

    CAS  PubMed  Google Scholar 

  3. Aljinovic J, Barisic I, Poljicanin A, Kuzmicic S, Vukojevic K, Gugic Bokun D, et al. Can measuring passive neck muscle stiffness in whiplash injury patients help detect false whiplash claims? Wien Klin Wochenschr. 2020;132(17–18):506–14.

    Article  CAS  Google Scholar 

  4. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409–15.

    CAS  PubMed  Google Scholar 

  5. Vernon H. The Neck Disability Index: state-of-the-art, 1991–2008. J Manipulative Physiol Ther. 2008;31(7):491–502.

    Article  Google Scholar 

  6. Jovicic MD, Konstantinovic LM, Grgurevic AD, Milovanovic ND, Trajkovic G, Jovicic VZ, et al. Validation of the neck disability index in Serbian patients with cervical Radiculopathy. J Manipulative Physiol Ther. 2018;41(6):496–502.

    Article  Google Scholar 

  7. Misterska E, Jankowski R, Glowacki M. Cross-cultural adaptation of the Neck Disability Index and Copenhagen Neck Functional Disability Scale for patients with neck pain due to degenerative and discopathic disorders. Psychometric properties of the Polish versions. BMC Musculoskelet Disord. 2011;12:84.

    Article  Google Scholar 

  8. Kaale BR, Krakenes J, Albrektsen G, Wester K. Whiplash-associated disorders impairment rating: neck disability index score according to severity of MRI findings of ligaments and membranes in the upper cervical spine. J Neurotrauma. 2005;22(4):466–75.

    Article  Google Scholar 

  9. Pereira MJ, Jull GA, Treleaven JM. Self-reported driving habits in subjects with persistent whiplash-associated disorder: relationship to sensorimotor and psychologic features. Arch Phys Med Rehabil. 2008;89(6):1097–102.

    Article  Google Scholar 

  10. Stewart M, Maher CG, Refshauge KM, Bogduk N, Nicholas M. Responsiveness of pain and disability measures for chronic whiplash. Spine. 2007;32(5):580–5.

    Article  Google Scholar 

  11. Vernon H, Guerriero R, Kavanaugh S, Soave D, Moreton J. Psychological factors in the use of the neck disability index in chronic whiplash patients. Spine. 2010;35(1):E16–E21.

    Article  Google Scholar 

  12. Howell ER. The association between neck pain, the Neck Disability Index and cervical ranges of motion: a narrative review. J Can Chiropr Assoc. 2011;55(3):211–21.

    PubMed  PubMed Central  Google Scholar 

  13. Sterling M. Clinical guidelines for best practice management of acute and chronic whiplash-associated disorders. 2008.

    Google Scholar 

  14. Nordin NA, Leonard JH, Thye NC. Work-related injuries among physiotherapists in public hospitals: a Southeast Asian picture. Clinics. 2011;66(3):373–8.

    PubMed  PubMed Central  Google Scholar 

  15. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8(2):94–104.

    Article  Google Scholar 

  16. Lim HHR, Tang ZY, Hashim M, Yang M, Koh EYL, Koh KH. Cross-cultural adaptation, reliability, validity, and responsiveness of the simplified-Chinese version of neck disability index. Spine. 2020;45(8):541–8.

    Article  Google Scholar 

  17. Nakamaru K, Vernon H, Aizawa J, Koyama T, Nitta O. Crosscultural adaptation, reliability, and validity of the Japanese version of the neck disability index. Spine. 2012;37(21):E1343–E7.

    Article  Google Scholar 

  18. Shashua A, Geva Y, Levran I. Translation, validation, and crosscultural adaptation of the Hebrew version of the neck disability index. Spine. 2016;41(12):1036–40.

    Article  Google Scholar 

  19. Trouli MN, Vernon HT, Kakavelakis KN, Antonopoulou MD, Paganas AN, Lionis CD. Translation of the Neck Disability Index and validation of the Greek version in a sample of neck pain patients. BMC Musculoskelet Disord. 2008;9:106.

    Article  Google Scholar 

  20. Uthaikhup S, Paungmali A, Pirunsan U. Validation of Thai versions of the neck disability index and neck pain and disability scale in patients with neck pain. Spine. 2011;36(21):E1415–E21.

    Article  Google Scholar 

  21. MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, McAlpine C, et al. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009;39(5):400–17.

    Article  Google Scholar 

  22. Hains F, Waalen J, Mior S. Psychometric properties of the neck disability index. J Manipulative Physiol Ther. 1998;21(2):75–80.

    CAS  PubMed  Google Scholar 

  23. Cramer H, Lauche R, Langhorst J, Dobos GJ, Michalsen A. Validation of the German version of the Neck Disability Index (NDI). BMC Musculoskelet Disord. 2014;15(2014). https://doi.org/10.1186/1471-2474-15-91

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hoving JL, O’Leary EF, Niere KR, Green S, Buchbinder R. Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders. Pain. 2003;102(3):273–81.

    Article  Google Scholar 

  25. Kose G, Hepguler S, Atamaz F, Oder G. A comparison of four disability scales for Turkish patients with neck pain. J Rehabil Med. 2007;39(5):358–62.

    Article  Google Scholar 

  26. Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, et al. Translation and validation study of the Iranian versions of the Neck Disability Index and the Neck Pain and Disability Scale. Spine. 2007;32(26):E825–E31.

    Article  Google Scholar 

  27. Walton DM, Macdermid JC, Giorgianni AA, Mascarenhas JC, West SC, Zammit CA. Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013;43(2):31–43.

    Article  Google Scholar 

  28. Carroll LJ, Holm LW, Hogg-Johnson S, Cote P, Cassidy JD, Haldeman S, et al. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4):S83–S92.

    Article  Google Scholar 

  29. Griffin A, Jagnoor J, Arora M, Cameron ID, Kifley A, Sterling M, et al. Evidence-based care in high- and low-risk groups following whiplash injury: a multi-centre inception cohort study. BMC Health Serv Res. 2019;19(1):806.

    Article  Google Scholar 

  30. Ritchie C, Hendrikz J, Jull G, Elliott J, Sterling M. External validation of a clinical prediction rule to predict full recovery and ongoing moderate/severe disability following acute whiplash injury. J Orthop Sports Phys Ther. 2015;45(4):242–50.

    Article  Google Scholar 

  31. Johnston V, Jimmieson NL, Jull G, Souvlis T. Contribution of individual, workplace, psychosocial and physiological factors to neck pain in female office workers. Eur J Pain. 2009;13(9):985–91.

    Article  Google Scholar 

  32. Kato S, Takeshita K, Matsudaira K, Tonosu J, Hara N, Chikuda H. Normative score and cut-off value of the Neck Disability Index. J Orthop Sci. 2012;17(6):687–93.

    Article  Google Scholar 

  33. Vernon H. The psychometric properties of the Neck Disability Index. Arch Phys Med Rehabil. 2008;89(7):1414–5. author reply 5–6.

    Article  Google Scholar 

  34. Malik AA, Robinson S, Khan WS, Dillon B, Lovell ME. Assessment of range of movement, pain and disability following a whiplash injury. Open Orthop J. 2017;11:541–5.

    Article  Google Scholar 

  35. Beltsios M, Savvidou O, Mitsiokapa EA, Mavrogenis AF, Kaspiris A, Efstathopoulos N, et al. Sagittal alignment of the cervical spine after neck injury. Eur J Orthop Surg Traumatol. 2013;23(Suppl 1):S47–S51.

    Article  Google Scholar 

  36. Helliwell PS, Evans PF, Wright V. The straight cervical spine: does it indicate muscle spasm? J Bone Joint Surg Br. 1994;76(1):103–6.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Institute of Physical Medicine and Rehabilitation with Rheumatology, University Hospital Split, Šoltanska 1, 21000, Split, Croatia

    Jure Aljinović, Blaž Barun, Ana Poljičanin, Ivanka Marinović, Tonko Vlak & Dinko Pivalica

  2. Department of Physical and rehabilitation medicine, University of Split, School of Medicine, Split, Croatia

    Tonko Vlak

  3. Department of Anatomy, Histology and Embryology and Neuroscience, University of Split, School of Medicine, Split, Croatia

    Benjamin Benzon

  4. Department of Health Studies, University of Split, Split, Croatia

    Jure Aljinović, Ana Poljičanin, Ivanka Marinović & Dinko Pivalica

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  1. Jure Aljinović
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Correspondence to Jure Aljinović.

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J. Aljinović, B. Barun, A. Poljičanin, I. Marinović, T. Vlak, D. Pivalica and B. Benzon declare that they have no competing interests.

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Aljinović, J., Barun, B., Poljičanin, A. et al. Croatian version of the neck disability index can distinguish between acute, chronic and no neck pain. Wien Klin Wochenschr 134, 162–168 (2022). https://doi.org/10.1007/s00508-021-01908-w

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