Questionnaires for the evaluation of the cervical and lumbar spine in Italian language: a systematic review of the structural and psychometric characteristics

Abstract

Introduction: There has been an increase in the use of questionnaires as tools for the subjective evaluation of patients with neuro-musculoskeletal problems. The aim of this study was to analyze the psychometric properties of the questionnaires published in Italian for the evaluation of cervical and lumbar spine pain and related dysfunction.

Evidence acquisition: Two blinded bibliographical searches were carried out on seven databases, regarding back, lumbar and/or cervical musculoskeletal problems. Both the structural characteristics and the psychometric aspects of each of the questionnaires were extracted from each of the selected articles. The structural characteristics were: full name, acronym, author and date of adaptation to the Italian language, what it measures, number of items, time to complete, the result scale, where the points are located and the cost. The psychometric aspects were: standard error of measurement (SEM), minimum detectable change (MDC), minimal clinically important difference (MCID), test-retest reliability, internal consistency, criterion validity, construct validity and sensitivity to changes.

Evidence synthesis: For the structural characteristics of the questionnaires identified for the valuation of the lumbar area, the number of items ranged between 10 and 24. Only two of the questionnaires presented specific categories, and the time to complete ranged between 5 and 7 minutes. The reliability of the questionnaires ranged between 0.869 and 0.961. None of the questionnaires calculated the inter-observer reliability. The internal consistency ranged between 0.82 and 0.90 for criterion validity. None of the questionnaires calculated sensitivity, SEM, MDC or MCID, with the exception of the Fear-Avoidance Beliefs Questionnaire, which showed a value of 12 on MDC. For the assessment of the cervical region, the number of items ranged from 6 to 20. Three of the questionnaires had sub-categories, and the time to complete them ranged between 2 and 5 minutes. The test-retest reliability ranged between 0.78 and 0.997. The internal consistency ranged between 0.842 and 0.942.

Conclusions: The Italian versions of the questionnaires present good basic structural and psychometric characteristics for the evaluation of patients with back, lumbar and/or cervical musculoskeletal disorders. The analysis of the structural and psychometric characteristics of these questionnaires is fundamental to identify the best tools to use in research and in clinical practice.