The online version of this article (doi:10.1186/s12891-017-1469-5) contains supplementary material, which is available to authorized users.
Despite the wide use of the neck disability index (NDI) for assessing disability in patients with neck pain, the NDI has not yet been translated and validated in Urdu. The first purpose of the present study was to translate and cross-culturally adapt the NDI into the Urdu language (NDI-U). The second purpose was to investigate the reliability, validity and responsiveness of the NDI-U in Urdu-speaking patients experiencing chronic mechanical neck pain (CMNP).
Translation and cross-cultural adaptation of the original version of the NDI were carried out using previously described procedures. Seventy-six patients with CMNP and thirty healthy participants were recruited for the study. NDI-U and visual analogue scales for pain intensity (VASpain) and disability (VASdisability) were administered to all the participants at baseline and to the patients 3 weeks after receiving physiotherapy intervention. The global rating of change scale (GROC) was also administered at this time. Test-retest reliability and internal consistency were carried out on forty-six randomly selected patients two days after they completed the NDI-U. The NDI-U was evaluated for factor analysis, content validity, construct validity (discriminative and convergent validity) and responsiveness.
An intra-class correlation coefficient (ICC2,1) revealed excellent test-retest reliability for all items (ICC2,1 = 0.86–0.98) and total scores (ICC2,1 = 0.99) of the NDI-U. The NDI-U was found internally consistent with a Cronbach’s alpha of 0.90 and a fair to good correlation between single items and the NDI-U total scores (r = 0.34 to 0.89). Factor analysis of the NDI-U produced two factors explaining 66.71% of the variance. Content validity was good, as no floor or ceiling effects were detected for the NDI-U total score. To determine discriminative validity, an independent t-test revealed a significant difference in the NDI-U total scores between the patients and healthy controls (P < 0.001). For convergent validity, Pearson’s correlation coefficient showed a strong correlation between NDI-U and VASdisability (r = 0.83, P < 0.001) and a moderate correlation between NDI-U and VASpain (r = 0.62, P < 0.001). To measure responsiveness, an independent t-test showed a significant difference in the NDI-U change scores between the stable and the improved groups (P < 0.001). Furthermore, moderate correlations were found between the NDI-U change scores and the GROC (r = 0.50, P < 0.001), VASdisability change scores (r = 0.58, P < 0.001) and VASpain change scores (r = 0.55, P < 0.001).
The results showed that the NDI-U is a reliable, valid and responsive questionnaire to measure disability in Urdu-speaking patients with CMNP.
Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, Hurwitz EL, Côté P, Nordin M, Peloso PM. Course and prognostic factors for neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. J Manipulative Physiol Ther. 2009;32(2):S87–96. CrossRefPubMed
Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA, American Society of Interventional Pain P. Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009;12(4):E35–70. PubMed
Pietrobon R, Coeytaux RR, Carey TS, Richardson WJ, DeVellis RF. Standard scales for measurement of functional outcome for cervical pain or dysfunction: a systematic review. Spine (Phila Pa 1976). 2002;27(5):515–22. CrossRef
van Randeraad-van der Zee CH, Beurskens AJ, Swinkels RA, Pool JJ, Batterham RW, Osborne RH, de Vet HC. The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping. Qual Life Res. 2016;25(5):1219–25. CrossRef
Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409–15. PubMed
Cook C, Richardson JK, Braga L, Menezes A, Soler X, Kume P, Zaninelli M, Socolows F, Pietrobon R. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the Neck Disability Index and Neck Pain and Disability Scale. Spine (Phila Pa 1976). 2006;31(14):1621–7. CrossRef
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(1):84. CrossRefPubMedPubMedCentral
Lee H, Nicholson LL, Adams RD, Maher CG, Halaki M, Bae SS. Development and psychometric testing of Korean language versions of 4 neck pain and disability questionnaires. Spine (Phila Pa 1976). 2006;31(16):1841–5. CrossRef
Aslan E, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagly N. The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2008;33(11):E362–5. CrossRef
Telci EA, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2009;34(16):1732–5. CrossRef
Mousavi SJ, Parnianpour M, Montazeri A, Mehdian H, Karimi A, Abedi M, Ashtiani AA, Mobini B, Hadian MR. Translation and validation study of the Iranian versions of the Neck Disability Index and the Neck Pain and Disability Scale. Spine (Phila Pa 1976). 2007;32(26):E825–31. CrossRef
Nieto R, Miro J, Huguet A. Disability in subacute whiplash patients: usefulness of the neck disability index. Spine (Phila Pa 1976). 2008;33(18):E630–5. CrossRef
Andrade Ortega JA, Delgado Martinez AD, Almecija Ruiz R. Validation of the Spanish version of the Neck Disability Index. Spine (Phila Pa 1976). 2010;35(4):E114–8. CrossRef
Salo P, Ylinen J, Kautiainen H, Arkela-Kautiainen M, Hakkinen A. Reliability and validity of the finnish version of the neck disability index and the modified neck pain and disability scale. Spine (Phila Pa 1976). 2010;35(5):552–6. CrossRef
Wu S, Ma C, Mai M, Li G. Translation and validation study of Chinese versions of the neck disability index and the neck pain and disability scale. Spine (Phila Pa 1976). 2010;35(16):1575–9. CrossRef
Monticone M, Ferrante S, Vernon H, Rocca B, Dal Farra F, Foti C. Development of the Italian Version of the Neck Disability Index: cross-cultural adaptation, factor analysis, reliability, validity, and sensitivity to change. Spine (Phila Pa 1976). 2012;37(17):E1038–44. CrossRef
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 (Phila Pa 1976). 2011;36(21):E1415–21. CrossRef
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186–91. CrossRef
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19(4):539–49. CrossRefPubMedPubMedCentral
Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271–3. PubMed
Hains F, Waalen J, Mior S. Psychometric properties of the neck disability index. J Manipulative Physiol Ther. 1998;21(2):75–80. PubMed
Pengel LH, Refshauge KM, Maher CG. Responsiveness of pain, disability, and physical impairment outcomes in patients with low back pain. Spine (Phila Pa 1976). 2004;29(8):879–83. CrossRef
Rebbeck TJ, Refshauge KM, Maher CG, Stewart M. Evaluation of the core outcome measure in whiplash. Spine (Phila Pa 1976). 2007;32(6):696–702. CrossRef
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737–45. CrossRefPubMed
Fleiss JL. The Design and Analysis of Clinical Experiments. New York: Wiley; 1999. CrossRef
Rosner B. Fundamentals of Biostatistics. 7th ed. Boston: Cengage Learning; 2010.
Norman GR, Streiner DL. Biostatistics: The Bare Essentials. Hamilton: B.D. Decker; 1994.
Sim J, Wright C. Research in health care: concepts, designs and methods. Cheltenham: Nelson Thornes; 2000.
Ntoumanis N. A step-by-step guide to SPSS for sport and exercise studies. London: Routledge London; 2001.
Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 2nd ed. New Jersey: Prentice Hall Health, Upper Saddle River; 2000.
Johansen JB, Andelic N, Bakke E, Holter EB, Mengshoel AM, Roe C. Measurement properties of the norwegian version of the neck disability index in chronic neck pain. Spine (Phila Pa 1976). 2013;38(10):851–6. CrossRef
Dawson J, Fitzpatrick R, Carr A. Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg (Br). 1996;78(4):593–600.
Odole AC, Adegoke BO, Akomas NC. Validity and test re-test reliability of the neck disability index in the Nigerian clinical setting. Afr J Med Med Sci. 2011;40(2):135–8. PubMed
Pickering PM, Osmotherly PG, Attia JR, McElduff P. An examination of outcome measures for pain and dysfunction in the cervical spine: a factor analysis. Spine (Phila Pa 1976). 2011;36(7):581–8. CrossRef
- Urdu version of the neck disability index: a reliability and validity study
Muhammad Nazim Farooq
Mohammad A. Mohseni-Bandpei
Syed Amir Gilani
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II