Spine Outcome Measurements: Quebec Back Pain Disability Scale

The Quebec Back Pain Disability Scale (QBPDS) is a self-administered questionnaire used to measure the level of disability in patients with back pain. It is typically used to assess the impact of back pain on a patient's ability to perform daily activities and to monitor changes in disability over time.

The QBPDS consists of 20 items that assess the following domains: pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, and traveling. The patient rates the level of difficulty experienced in each domain on a six-point scale ranging from "no difficulty" to "impossible". The scores for each item are summed to provide a total score ranging from 0 (no disability) to 100 (maximum disability).

The QBPDS can be used with patients who are experiencing back pain of any duration, including chronic back pain. It is appropriate for use in both clinical and research settings. 

Some potential applications of the QBPDS include:

• Monitoring changes in disability over time in response to treatment
• Comparing the level of disability between different patient populations
• Assessing the impact of back pain on a patient's ability to perform specific activities of daily living
• Identifying areas of functional impairment that may be amenable to targeted interventions

The total score on the Quebec Back Pain Disability Scale (QBPDS) ranges from 0 (no disability) to 100 (maximum disability). Higher scores indicate greater levels of disability.

Interpreting the results of the QBPDS involves comparing the patient's score to established norms or to the patient's own baseline score, if available. The QBPDS has been validated in several studies, which have reported mean scores ranging from 18 to 50 in patients with back pain. It is important to note that the interpretation of the QBPDS scores should be done in conjunction with a thorough clinical evaluation and other relevant assessments. The QBPDS is a tool that provides additional information about the patient's functional status, but it should not be used in isolation to make clinical decisions.

In general, a decrease in QBPDS score over time or after treatment indicates an improvement in the patient's functional status and a reduction in disability related to back pain. A stable or increasing score may suggest that the patient's back pain is not improving or may be worsening.

References:

1. Kopec JA, Esdaile JM, Abrahamowicz M, et al. The Quebec Back Pain Disability Scale. Measurement properties. Spine (Phila Pa 1976). 1995;20(3):341-352. doi:10.1097/00007632-199502000-00020
2. Brisson NM, Wilson-MacDonald J, Tosteson AN, et al. Prospective longitudinal assessment of outcomes for lumbar disc herniation: a preliminary report. J Orthop Sci. 2003;8(4):396-401. doi:10.1007/s00776-003-0704-4
3. Hancock MJ, Maher CG, Latimer J, McLachlan AJ, Cooper CW, Day RO. Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial. Lancet. 2007;370(9599):1638-1643. doi:10.1016/S0140-6736(07)61686-9
4. Stratford PW, Binkley JM, Riddle DL, Guyatt GH. Sensitivity to change of the Roland-Morris Back Pain Questionnaire: part 1. Phys Ther. 1998;78(11):1186-1196. doi:10.1093/ptj/78.11.1186
5. Spitzer WO, Leblanc FE, Dupuis M. Scientific approach to the assessment and management of activity-related spinal disorders. A monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Spine (Phila Pa 1976). 1987;12(7 Suppl):S1-S59. doi:10.1097/00007632-198708001-00001