Original article The ability to change of three questionnaires for neck pain Samantha Wlodyka-Demaille a , Serge Poiraudeau a, *, Jean-François Catanzariti b , François Rannou a , Jacques Fermanian c , Michel Revel a a Department of Physical and Rehabilitation Medicine, Service de Rééducation et de Réadaptation de l’Appareil locomoteur et des Pathologies du Rachis, Hôpital Cochin AP-HP, Université René Descartes, 27, rue du Fbg Saint-Jacques, 75014 Paris cedex 14, France b Outpatient Clinic in Physical and Rehabilitation Medicine, 74, rue Jeanne d’Arc, 59000 Lille, France c Department of Biostatistics, Hôpital Necker AP-HP, Université René Descartes, 149-161, rue de Sèvres, 75015 Paris, France Received 11 February 2003; accepted 24 April 2003 Available online 29 October 2003 Abstract Objective. – To assess the sensitivity to change of three algofunctional scales for neck pain. Methods. – Observational, prospective study. Patients with neck disorders were included. Pain and patients’perceived handicap assessed on visual analogue scales (VAS Pain,VAS Handicap), and functional disability measures (Neck Disability Index, Neck Pain and Disability Scale, Northwick Park Neck Pain Questionnaire) were recorded twice, at baseline and at an 11-month follow-up assessment. Sensitivity to change was assessed using the effect size (ES) and the standardised response mean (SRM), and the non-parametric Spearman’s rank correlation coefficient (r) was used to assess the correlation between quantitative variable changes and patients’ overall opinion. Analysis of variance (ANOVA) followed by a Tukey-test was performed to determine if the scales distinguished improved, stable, and deteriorated patients. Results. – Seventy-one patients (43 women, mean age 49 years) were included and evaluated twice at an interval of 11 ± 2 months. The three scales showed good sensitivity to change. The ANOVA showed a group effect, and individual changes in the scales scores were statistically different in two-by-two comparisons (improved, stable or deteriorated patients). Changes in NPDS scores had the highest correlation with patient’s overall assessment (r = 0.592). Conclusion. – The three scales can detect changes in patients with neck disorders. Changes in NPDS score had the best correlation with patients’ overall opinion concerning their neck disorder and this questionnaire should be given preference in clinical trials. © 2003 Elsevier SAS. All rights reserved. Keywords: Sensitivity to change; Disability; Pain; Neck 1. Introduction Cervical spine disorders are an extremely common com- plaint. The point prevalence is nearly 50% in the USA [1–3], and up to 41% of the working population reported neck pain during the last 6 months [1,3]. In 30% of cases, neck pain lasts more than 6 months [4–6]. It is costly in terms of treatment and lost work time. Total costs for posttraumatic neck disorders are estimated to be $3.75 billion per year in the USA [2,4]. Neck pain is usually defined as pain in the neck, the shoulders and the arms [2,4,7,8]. Symptoms arising in the neck are often poorly localised, and there may be difficulty in making a precise anatomical diagnosis, particularly as the clinical signs of neck disorders are neither sensitive nor specific [1]. Treatments for neck pain are varied and often unspecific. The results and perception of the benefits of these treatments are varied, and some of them need more accurate evaluations [3,6]. The collar is used for acute neck pain, but it encourages persisting neck stiffness [2]; manual therapies, mobilisation or manipulative techniques performed by physiotherapists have good results in chronic pain [1]; traction, TENS and ultrasound are active but less popular [1,2,4,9]; educating patients to correct postural abnormalities could be useful [5,10]. Drugs are regularly associated with physical treat- ment, and surgery is the last resort, except for radicular or spinal cord compression. To evaluate neck disorders and * Corresponding author. E-mail address: serge.poiraudeau@cch.ap-hop-paris.fr (S. Poiraudeau). Joint Bone Spine 71 (2004) 317–326 www.elsevier.com/locate/bonsoi © 2003 Elsevier SAS. All rights reserved. doi:10.1016/j.jbspin.2003.04.004