Subject: Cervical Spine Related Studies

Title: Validity and Internal Consistency of a Whiplash-Specific Disability Measure

Reference: Melanie Pinfold,BPhysio; Ken R. Niere,BappSc; Elizabeth F. O'Leary,,BPhysio; Jan Lucas Hoving, PhD; Sally Green, PhD; Rachelle Buchbinder,MBBS....Spine 2004; 29(3): pp.263-268

Study Design: Cross-sectional study of patients withwhiplash-associated disorders investigating the internal consistency, factor structure, response rates, and presence of floor and ceiling effects of the Whiplash Disability Questionnaire (WDQ).

Objectives: The aim of this study was to confirm the appropriateness of the proposed WDQ. items.

Summary of Background Data: Whiplash injuries are a common cause of pain and disability after motor vehicle accidents. Neck disability questionnaires are often used in whiplash studies to assess neck pain but lack content validity for patients with whiplash-associated disorders. The newly developed WDQ measures functional limitations associated with whiplash injury and was designed
after interviews with 83 patients with whiplash in a previous study.

Methods: Researchers sought expert opinion on items of the WDQ, and items were then tested on a clinical whiplash population. Data were inspected to determine floor and ceiling effects, response rates, factor structure, and intemal consistency. Packages of questionnaires were distributed to 55 clinicians, whose patients with whiplash completed and returned 101 questionnaires to researchers.

Results: No substaliltial floor or ceiling effects were identified on inspection of data. The overall floor effect was 12%, and the overall ceiling effect was 4%. Principal component analysis ldentified one broad factor that accounted for 65% of the variance in responses. Internal consistency was high; Cronbach's alpha = 0.96.

Conclusion: Results of the study supported the retention of the 13 proposed items in a whiplash specific disability questionnaire. Dependent on the results of further psychometric testing, the WDQ is likely to be an appropriate outcome measure for patients with whiplash.

Key Indexing Terms: Whiplash, Disability, Functional Limitation, Questionnaire