COSMIN database

Content and psychometric evaluations of questionnaires for assessing physical function in people with neck disorders: a systematic review of the literature

Wiitavaara, B. and Heiden, M.
PURPOSE: The purpose was to investigate how physical function is assessed in people with musculoskeletal disorders (MSD) in the neck. Specifically, we aimed to determine: (1) Which questionnaires are used to assess physical function in people with MSD in the neck? (2) What do those questionnaires measure? (3) What are the measurement properties of the questionnaires?

MATERIALS AND METHODS: A systematic review was performed to identify questionnaires and psychometric evaluations. The content of the questionnaires was categorized according to the International Classification of Function, Disability and Health, and the psychometric properties were quality-rated using the COnsensus-based Standards for the selection of health Measurement INstruments checklist.

RESULTS: Ten questionnaires and 32 articles evaluating measurement properties were analyzed. Most questionnaires covered only the components body functions and activity and participation, more often activity participation than body function. Internal consistency was adequate in most questionnaires, whereas responsiveness was generally low. Neck Disability Index was most evaluated, but the evaluations of all questionnaires tended to cover most properties in the checklist.

CONCLUSIONS: The questionnaires differed substantially in items and extent to which their psychometric properties had been evaluated. Focus of measurement was on activities in daily life rather than physical function as such. Implications for Rehabilitation To provide early diagnostics and effective treatment for patients with neck disorders, valid and reliable instruments that measure relevant aspects of the disorders are needed. This paper presents an overview of content and quality of questionnaires used to assess physical function in neck disorders, which may facilitate informed decisions about which measurement instruments to use when evaluating the course of neck disorders. Most of the questionnaires need more testing to judge the quality, however the NDI was the most frequently tested questionnaire. The COnsensus-based Standards for the selection of health Measurement INstruments checklist is a useful tool in relation to psychometric testing of questionnaires, but clear definitions of interpretation of the quality criteria in each study would enhance comparability of results.
Disabil Rehabil
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
Role functioning
Social functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
CNFDS - Copenhagen Neck Functional Disability Scale
CSOQ - Cervical Spine Outcome Questionnaire
NBQ - Neck Bournemouth Questionnaire
NDI - Neck Disability Index    
NFSQ - Neck Functional Status Questionnaire
NOOS - Neck OutcOme Score
NPDS - Neck Pain and Disability Scale   
NPFLS - Neck Pain and Functional Limitation Scale
NPQ - Northwick Park Neck Pain Questionnaire [alias: Northwick Questionnaire]
ProfitMap‑Neck - Profile fitness mapping neck pain