The validity and reliability of the functional rating index for evaluating low back pain in athletes. Chiropractic and exercise for seniors with low back pain or neck pain: the design of two randomized clinical trials
The purpose of the present study was to determine the reliability and validity of the Functional Rating Index ( FRI ) for athletes with low back pain ( LBP ) . In this cross-sectional and prospect i ve cohort study , the vali date d Persian FRI ( PFRI ) was tested in 100 athletes with LBP and 50 healthy athletes . From the athletes with LBP , data were recollected among 50 athletes with a 7-day interval to examine test-retest reliability . The content validity was excellent , and the athletes with LBP responded to all items with no floor or ceiling effects . The discriminative validity was supported by a statistically significant difference in PFRI total scores between the athletes with LBP and healthy athletes . The concurrent criterion validity was good ( rho = 0.72 ) . The construct , convergent validity was good ( r = 0.83 ) . The internal consistency reliability estimate was high ( Cronbach 's α = 0.90 ) . Factor analysis demonstrated a single-factor structure with an explained variance of 52.22 % . The test-retest reliability was excellent , indicated by an ICC(agreement ) of 0.97 , and the agreement observed in the Bl and and Altman plot demonstrated no systematic bias . It is concluded that the PFRI has excellent psychometric properties for assessing athletes with LBP Background Low back pain ( LBP ) and neck pain ( NP ) are common conditions in old age , leading to impaired functional ability and decreased independence . Manual and exercise therapies are common and effective therapies for the general LBP and NP population s. However , these treatments have not been adequately research ed in older LBP and NP sufferers . The primary aim of these studies is to assess the relative clinical effectiveness of 1 ) manual treatment plus home exercise , 2 ) supervised rehabilitative exercise plus home exercise , and 3 ) home exercise alone , in terms of patient-rated pain , for senior LBP and NP patients . Secondary aims are to compare the three treatment approaches in regards to patient-rated disability , general health status , satisfaction , improvement and medication use , as well as objective outcomes of spinal motion , trunk strength and endurance , and functional ability . Cost-effectiveness and cost-utility will also be assessed . Finally , using qualitative methods , older LBP and NP patient 's perceptions of treatment will be explored and described . Methods / Design This paper describes the design of two multi- methods clinical studies focusing on elderly patients with non-acute LBP and NP . Each study includes a r and omized clinical trial ( RCT ) , a cost-effectiveness study alongside the RCT , and a qualitative study . Four hundred and eighty participants ( 240 per study ) , ages 65 and older , will be recruited and r and omized to one of three , 12-week treatment programs .  Patient-rated outcome measures are collected via self-report question naires at baseline and at 4 , 12 , 26 , and 52 weeks post-r and omization . Objective outcomes are assessed by examiners masked to treatment assignment at baseline and 12 weeks . Health care cost data is collected through st and ardized clinician forms , monthly phone interviews , and self-report question naires throughout the study . Qualitative interviews using a semi-structured format are conducted at the end of the 12 week treatment period . Discussion To our knowledge , these are the first r and omized clinical trials to comprehensively address clinical effectiveness , cost-effectiveness , and patients ' perceptions of commonly used treatments for elderly LBP and NP sufferers . Trial Registration NCT00269321 and
Our findings show strong positive evidence for structural validity and internal consistency in patients with SP and LBP .
The current evidence shows that the FRI is comparable with both the Oswestry Disability Index and the Neck Disability Index in responsiveness .
To assess the measurement properties of the Functional Rating Index ( FRI ) and determine whether its measurement properties are comparable with other region-specific question naires .
In addition to low back pain ( LBP ) and neck pain ( NP ) , multiregion spinal pain ( SP ) is a common problem with a considerable prevalence in the general population .
The FRI was built to assess physical functioning in patients with SP .
However , a systematic review assessing evidence of its measurement properties in separated population s and a comparison with other question naires regarding each measurement property is lacking .