Development and psychometric properties of the Vertebral Compression Fracture Pain and Functional Disability Questionnaire

Object: Vertebral compression fractures (VCFs) result in severe and disabling pain, diminished quality of life, and substantial medical costs. There exists no standard instrument with which to measure pain and functional status before and after treatment of VCFs. Methods. A questionnaire was specifically developed to assess pain and disability in patients with VCFs before and after undergoing percutaneous polymethylmethacrylate-augmented vertebroplasty. The first section of the baseline questionnaire (before treatment) contains I I items that address the patient's previous and current levels of back pain and distress. The second section of the baseline questionnaire lists 24 activities of daily living (ADLs), each measured on a four-point scale ranging from "able to do without pain" to "cannot do because of pain." The follow-up questionnaire (after treatment) is similar in format. Among 72 vertebroplasty-treated patients, the internal consistency reliability of the 24 ADLs ranged from 0.87 to 0.98, with similar results observed before and after treatment. Correlations of 0.29 to 0.72 were observed among the 24 ADLs and the internal measures of pain and distress measured on both visual analog and adjectival scales. Similar correlations (range 0.35-0.63) were observed between the questionnaire and 10 dimensions of the Oswestry Disability Index's low-back pain questionnaire, an external instrument used to assess criterion-referenced validity. Evidence in support of the validity of the questionnaire was present before and after treatment. Conclusions. The Vertebral Compression Fracture Pain and Functional Disability Questionnaire appears to be a reliable and valid instrument for assessing back pain and functional ability in patients before and after treatment for VCFs.