Back Pain Functional Scale
Original Editor - Sinead Greenan
Top Contributors - Sinead Greenan, Kim Jackson, 127.0.0.1, WikiSysop, Claire Knott, Lucinda hampton, Urvisha Lunagariya and Rishika BabburuIntroduction[edit | edit source]
Back pain is a vast topic to discuss as it shows its impacts on a patient's physical, emotional, and social quality of life [1]. Furthermore, treating back pain involves considering the biopsychosocial model into aspect [1]. Besides treating back pain, there is a need for using appropriate and suitable outcome measures in clinical practice. However, none of the single outcome measures can include and assess all perspectives of pain considering the patient's quality of life into aspects. In addition, there are different outcome measures used based on the needs of patients, their severity of symptoms, and their clinical presentations[2]. Therefore, it is necessary for Health Care Professionals to use valid and reliable outcome measures to evaluate and treat back pain effectively. Consecutively, an outcome measure that has psychometric properties in terms of good validity, reliability, sensitivity, and utility should be considered in clinical practices[2]. Hence, it is necessary to know the psychometric property of an outcome measure prior to its implication. Moreover, there are lists of outcome measures used to quantify back pain scores. These are the Numerical rating scale (NRS), Roland-Morris disability questionnaire (RMDQ), Back pain functional score, Oswestry disability index (ODI), Pain self-efficacy Questionnaire (PSEQ) and the patient-specific functional scale (PSFS) in order to assess and treat back pain efficiently.
However, it is not possible to use all these diagnostic tools to examine back pain functional scores. Besides, to assess the patient's quality of pain and physical function, the 'Back pain functional scale' is widely used in practice[3].
Back Pain Functional Scale[edit | edit source]
The Back Pain Functional Scale (BPFS) is a subjective scale used to measure the patient's physical function after low back pain. This scale was developed by Stratford et al. (2000). It is simple and easy to understand and administer by the patients. This scale is based upon the International Classification of Function (ICF) model proposed by the World Health Organisation. It is used to evaluate the patient's level of physical independence during the initial two weeks of low back pain. However, it is not used for backpain after two weeks. This scale consists of a total score of 60. Moreover, the patient's score can be measured from the responses obtained on the Likert scale (0 to 5), and accordingly, a total score is summed up out of 60. Furthermore, the maximum score obtained indicates the maximum physical abilities of the patients. In addition, this scale also has an 'Adjusted score' ranging from 0 (0%)-unable to perform any activity to 60 (100%)-no difficulty in any activity[4].
Method of Use[edit | edit source]
The BPFS consists of 12 items:
- Usual work, housework, or school activities
- Usual hobbies, recreational, or sporting activities
- Performance of heavy activities around your home
- Bending or stooping
- Putting on your shoes or socks
- Lifting a box of groceries from the floor
- Sleeping
- Standing for 1 hour
- Walking 1 mile
- Going up or down 2 flights of stairs (about 20 steps)
- Sitting for 1 hour
- Driving for 1 hour
| Responses | Points |
| Unable to perform activity | 0 |
| Extreme difficulty | 1 |
| Quite a bit of difficulty | 2 |
| Moderate difficulty | 3 |
| A little bit of difficulty | 4 |
| No difficulty | 5 |
Total Score = Sum of points from all 12 measures
Adjusted Total Score = Total Score / 60
Interpretation:
- Minimum Score: 0
- Maximum Score: 60
- Maximum Adjusted Score: 1 (100%)
- The higher the score the greater the patient's functional ability
| Total Score (Adjusted) | Interpretation |
| 0 (0%) | unable to perform any activity |
| 60 (100%) | no difficulty in any activity |
Psychometric properties of Back Pain Functional Scale (BPFS)[edit | edit source]
According to Stratford et al. (2000), this scale has a minimal detectable change of 22.2% with a standard error of measure of 6.5% at a 95% confidence interval. In addition, this scale has excellent test-retest reliability with an intra-class correlation coefficient of 0.88 at a confidence interval of 77%. Thus, this representation indicates that this scale can be used in the clinical setting to measure the functional outcome of patients after low back pain[4].
However, there are other functional scales used to measure physical function in patients with low back pain besides back pain functional scale. These are 'Roland-Morris disability scale', 'Oswestry disability scale', and 'Short form 36 surveys'. Therefore, it is necessary to consider the relative efficacy and effectiveness of 'Back Pain Functional Scale' as compared to other scales.
Evidence[edit | edit source]
There is one study aim to evaluate the correlation of back pain functional scale with other functional scales. This study has examined correlation of 'Back pain functional scale with 'Roland and Morris', 'Oswestry disability scale', and 'Short form 36 surveys'.
Study Design: Correlational quantitative study
Participants: 120 low back patients
Recruitment: Patients were recruited from in-patient and out-patient physiotherapy rehabilitation center
Study setting: This study was performed in Turkey
Methods: In this study, questionnaire from each outcome measure was used and correlational analysis was performed using Spearman and Pearson statistics in order to compare the scores obtained from different outcome measures.
Results: The results of this study indicate that the ' Back pain functional scale' has a good correlation with other outcomes measures used in clinical setting for assessing low back pain
Conclusion: 'Back pain functional scale' can be used in the clinics for evaluating, examining, and assessing low back pain. In addition, this outcome measure is simple and easy to demonstrate and implement[3]
The strength of this aforementioned study is that this article has considered the specific outcome measures ('Back pain functional scale', 'Roland-Morris scale, 'Oswestry disability scale', and 'Short form 36 surveys') used to assess physical function and found its correlation to get clear glimpses for evidence-based practice in clinical settings. However, this study has not considered the relative sensitivity of the 'Back pain functional scale' over time and thus, it is difficult to predict the persistent effects of this scale over a long period of time.
Advantages and Disadvantages of Back Pain Functional scale[edit | edit source]
Advantages:
Easy to demonstrate and administer
Good psychometric properties
Used for assessing physical functions during stages weeks of back pain
The patient can easily understand and use this scale
Disadvantages:
Cannot be used in patients having back pain after two weeks
Recommendations:[edit | edit source]
Further research is required to know the sensitivity of this scale over time. In addition, the aforementioned study was performed considering only 120 back pain patients[3]. However, there are approximately one-quarter of patients affected by back pain annually[2], Thus, the results obtained from this study cannot be generalizable to overall population. Hence, further research on larger population is required to prove the generalisability of the results obtained from this study[3].
Links[edit | edit source]
Back Pain Functional Scale (PDF)
References[edit | edit source]
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- ↑ 1.0 1.1 Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, Baciarello M, Manferdini ME, Fanelli G. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research. 2016:5
- ↑ 2.0 2.1 2.2 Maughan EF, Lewis JS. Outcome measures in chronic low back pain. European Spine Journal. 2010 Sep 1:19(9): 1484-94.
- ↑ 3.0 3.1 3.2 3.3 Koc M, Bayar B, Bayar K. A comparison of Back pain functional scale with Roland Morris disbility questionnaire, Oswestry disability index, and short form 36-health survey. Spine. 2018 Jun 15:43(12):877-82
- ↑ 4.0 4.1 Stratford, P. W. and Binkley, J. M. "A comparison study of the back pain functional scale and Roland Morris Questionnaire. North American Orthopaedic Rehabilitation Research Network." J Rheumatol 2000 27(8): 1928-1936.
