Development and Validation of the Youth Back Activity Questionnaire: A Measure of Function for Adolescents with Low Back Pain

Mitchell Selhorst; Christina Metzger; William Rice; Brittany Ibinson; Christine Mansfield

doi:10.1097/BRS.0000000000005169

Development and Validation of the Youth Back Activity Questionnaire: A Measure of Function for Adolescents with Low Back Pain

Spine (Phila Pa 1976). 2024 Oct 1. doi: 10.1097/BRS.0000000000005169. Online ahead of print.

Authors

Mitchell Selhorst¹, Christina Metzger, William Rice, Brittany Ibinson, Christine Mansfield

Affiliation

¹ Sports and Orthopedic Physical Therapy, Nationwide Children's Hospital, Columbus, Ohio, United States.

PMID: 39351861
DOI: 10.1097/BRS.0000000000005169

Abstract

Design: Psychometric study.

Objective: To develop a reliable and valid patient-reported outcome measure to assess functional ability in adolescents with low back pain (LBP) using the Rasch model.

Summary of background data: LBP is quite common in adolescence. Currently, no method adequately measures the functional ability of adolescents with LBP. Widely used outcome measures for LBP are problematic in adolescents, with significant ceiling/floor effects.

Methods: Two hundred adolescents (15.4 ± 1.9 years; 56% female) with LBP. This study was comprised of two parts: Part 1: Development of the Youth Back Activity Questionnaire (YouthBAQ) (n = 75), and Part 2: Psychometric evaluation of the newly designed YouthBAQ using the Rasch Model (n = 125). Participants also completed the Oswestry Disability Index (ODI) and Micheli Functional Scale (MFS), Data Analysis: Reliability and construct validity of the YouthBAQ were assessed using Rasch analyses. Correlations with the ODI and MFS were used to determine the convergent validity of the YouthBAQ.

Results: Part 1: Based on the results of the Rasch analysis, 31 items were reduced to 14. Part 2. The 14-item YouthBAQ demonstrated good reliability and construct validity, with good item fit (>0.7 and <1.3), acceptable item hierarchy and spacing, response category functioning, unidimensionality (ratio >3:1), local independence (<0.30). The MFS demonstrated unacceptable reliability (person reliability = 0.62) and was not compared against the YouthBAQ. The ODI demonstrated acceptable reliability (person reliability =0.70), but poor construct validity among adolescents with LBP. The YouthBAQ demonstrated a moderate correlation with the ODI (r = 0.4).

Conclusion: The YouthBAQ is a quick and easily understood measure of function with good validity and reliability in adolescents with LBP. The YouthBAQ is a more appropriate measure of functional ability than the ODI or MFS in this population.