Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study
Abstract Background Brief whole-spine patient-reported outcome measures (PROMs) provide regional solutions and future directions for quantifying functional status, evidence, and effective interventions. The whole-spine regional Spine Functional Index (SFI-25) is used internationally in clinical and...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07352-x |
| _version_ | 1797233877500035072 |
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| author | Charles Philip Gabel Antonio Cuesta-Vargas Almir Vieira Dibai-Filho Hamid Reza Mokhtarinia Markus Melloh Agnieszka Bejer |
| author_facet | Charles Philip Gabel Antonio Cuesta-Vargas Almir Vieira Dibai-Filho Hamid Reza Mokhtarinia Markus Melloh Agnieszka Bejer |
| author_sort | Charles Philip Gabel |
| collection | DOAJ |
| description | Abstract Background Brief whole-spine patient-reported outcome measures (PROMs) provide regional solutions and future directions for quantifying functional status, evidence, and effective interventions. The whole-spine regional Spine Functional Index (SFI-25) is used internationally in clinical and scientific contexts to assess general sub-acute/chronic spine populations. However, to improve structural validity and practicality a shortened version is recommended. This study developed a shortened-SFI from the determined optimal number of item questions that: correlated with criteria PROMs being highly with whole-spine, moderately with regional-spine, condition-specific and patient-specific, and moderately-low with general-health and pain; retained one-dimensional structural validity and high internal consistency; and improved practicality to reduce administrative burden. Methods A cross-sectional study (n = 505, age = 18-87 yrs., average = 40.3 ± 10.1 yrs) of sub-acute/chronic spine physiotherapy outpatients from an international sample of convenience. Three shortened versions of the original SFI-25 were developed using 1) qualitative ‘content-retention’ methodology, 2) quantitative ‘factorial’ methodology, and 3) quantitative ‘Rasch’ methodology, with a fourth ‘random’ version produced as a comparative control. The clinimetric properties were established for structural validity with exploratory (EFA) and confirmatory (CFA) factorial analysis, and Rasch analysis. Criterion validity used the: whole-spine SFI-25 and Functional Rating Index (FRI); regional-spine Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Roland Morris Questionnaire (RMQ), condition-specific Whiplash Disability Questionnaire (WDQ); and patient-specific functional scale (PSFS); and determined floor/ceiling effect. A post-hoc pooled international sub-acute/chronic spine sample (n = 1433, age = 18-91 yrs., average = 42.0 ± 15.7 yrs) clarified the findings and employed the general-health EuroQuol-Index (EQ-5D), and 11-point Pain Numerical Rating Scale (P-NRS) criteria. Results A 10-item SFI retained structural validity with optimal practicality requiring no computational aid. The SFI-10 concept-retention-version demonstrated preferred criterion validity with whole-spine criteria (SFI-25 = 0.967, FRI = 0.810) and exceeded cut-off minimums with regional-spine, condition-specific, and patient-specific measures. An unequivocal one-dimensional structure was determined. Internal consistency was satisfactory (α = 0.80) with no floor/ceiling effect. Post-hoc analysis of the international sample confirmed these findings. Conclusion The SFI-10 qualitative concept-retention version was preferred to quantitative factorial and Rasch versions, demonstrated structural and criterion validity, and preferred correlation with criteria measures. Further longitudinal research is required for reliability, error, and responsiveness, plus an examination of the practical characteristics of readability and administrative burden. |
| first_indexed | 2024-04-24T16:23:09Z |
| format | Article |
| id | doaj.art-2213e769445e49559871dea243642e5c |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-24T16:23:09Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-2213e769445e49559871dea243642e5c2024-03-31T11:06:10ZengBMCBMC Musculoskeletal Disorders1471-24742024-03-0125111210.1186/s12891-024-07352-xDeveloping a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional studyCharles Philip Gabel0Antonio Cuesta-Vargas1Almir Vieira Dibai-Filho2Hamid Reza Mokhtarinia3Markus Melloh4Agnieszka Bejer5Access PhysiotherapyDepartment of Psychiatry and Physiotherapy, Faculty of Medicine, Malaga UniversityFederal University of MaranhaoDepartment of Ergonomics, University of Social Welfare and Rehabilitation SciencesQueensland University of Technology, School of Public Health and Social WorkInstitute of Health Sciences, Medical College, Rzeszow UniversityAbstract Background Brief whole-spine patient-reported outcome measures (PROMs) provide regional solutions and future directions for quantifying functional status, evidence, and effective interventions. The whole-spine regional Spine Functional Index (SFI-25) is used internationally in clinical and scientific contexts to assess general sub-acute/chronic spine populations. However, to improve structural validity and practicality a shortened version is recommended. This study developed a shortened-SFI from the determined optimal number of item questions that: correlated with criteria PROMs being highly with whole-spine, moderately with regional-spine, condition-specific and patient-specific, and moderately-low with general-health and pain; retained one-dimensional structural validity and high internal consistency; and improved practicality to reduce administrative burden. Methods A cross-sectional study (n = 505, age = 18-87 yrs., average = 40.3 ± 10.1 yrs) of sub-acute/chronic spine physiotherapy outpatients from an international sample of convenience. Three shortened versions of the original SFI-25 were developed using 1) qualitative ‘content-retention’ methodology, 2) quantitative ‘factorial’ methodology, and 3) quantitative ‘Rasch’ methodology, with a fourth ‘random’ version produced as a comparative control. The clinimetric properties were established for structural validity with exploratory (EFA) and confirmatory (CFA) factorial analysis, and Rasch analysis. Criterion validity used the: whole-spine SFI-25 and Functional Rating Index (FRI); regional-spine Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Roland Morris Questionnaire (RMQ), condition-specific Whiplash Disability Questionnaire (WDQ); and patient-specific functional scale (PSFS); and determined floor/ceiling effect. A post-hoc pooled international sub-acute/chronic spine sample (n = 1433, age = 18-91 yrs., average = 42.0 ± 15.7 yrs) clarified the findings and employed the general-health EuroQuol-Index (EQ-5D), and 11-point Pain Numerical Rating Scale (P-NRS) criteria. Results A 10-item SFI retained structural validity with optimal practicality requiring no computational aid. The SFI-10 concept-retention-version demonstrated preferred criterion validity with whole-spine criteria (SFI-25 = 0.967, FRI = 0.810) and exceeded cut-off minimums with regional-spine, condition-specific, and patient-specific measures. An unequivocal one-dimensional structure was determined. Internal consistency was satisfactory (α = 0.80) with no floor/ceiling effect. Post-hoc analysis of the international sample confirmed these findings. Conclusion The SFI-10 qualitative concept-retention version was preferred to quantitative factorial and Rasch versions, demonstrated structural and criterion validity, and preferred correlation with criteria measures. Further longitudinal research is required for reliability, error, and responsiveness, plus an examination of the practical characteristics of readability and administrative burden.https://doi.org/10.1186/s12891-024-07352-xSpineMusculoskeletalAssessmentPatient-reported outcome measureFunctional limitationClinometric |
| spellingShingle | Charles Philip Gabel Antonio Cuesta-Vargas Almir Vieira Dibai-Filho Hamid Reza Mokhtarinia Markus Melloh Agnieszka Bejer Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study BMC Musculoskeletal Disorders Spine Musculoskeletal Assessment Patient-reported outcome measure Functional limitation Clinometric |
| title | Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study |
| title_full | Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study |
| title_fullStr | Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study |
| title_full_unstemmed | Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study |
| title_short | Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study |
| title_sort | developing a shortened spine functional index sfi 10 for patients with sub acute chronic spinal disorders a cross sectional study |
| topic | Spine Musculoskeletal Assessment Patient-reported outcome measure Functional limitation Clinometric |
| url | https://doi.org/10.1186/s12891-024-07352-x |
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