Responsiveness of the PROMIS-29 Scales in Individuals With Chronic Low Back Pain.

STUDY DESIGN: Prospective cohort study. OBJECTIVE: To evaluate responsiveness and estimate the minimal clinically important differences (MCIDs) for the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) scales in individuals with chronic low back pain. SUMMARY OF BACKGROUND DATA: The PROMIS-29 questionnaire assesses seven health-related quality-of-life domains. However, research to evaluate the responsiveness and MCIDs of the PROMS-29 scores in individuals with low back pain is limited. METHODS: The study was conducted in physical therapy clinics in Thailand, using validated Thai versions of the study measures. One hundred and eighty-three individuals with chronic low back pain completed the PROMIS-29 at baseline and at 4-weeks follow-up. Perceived change in each domain assessed by the PROMIS-29 scales was assessed at 4 weeks using a 7-point measure of Global Perceived Effect (GPE). Responsiveness of the PROMIS-29 scale scores was evaluated by examining the effect sizes, the standardized response means (SRMs) for change over time, and examining these as a function of the GPE ratings. MCIDs for the scales were estimated by computing a half a standard deviation (SD) and standard error of measurement statistic for each scale. RESULTS: The mean change scores, effect sizes, and SRMs increased as a function of the GPE ratings. Significant differences in change scores between those who reported that they were very much improved and those who did not improve were found for the PROMIS-29 Pain Intensity, Physical Function, and Anxiety scales. The correlations between changes scores and GPE ratings were mostly weak in magnitude. The MCID estimates computed as 0.50 of a SD unit and as a standard error of measurement showed similar values. CONCLUSION: The PROMIS-29 scale scores assessing pain intensity, physical function, and anxiety evidenced the most responsivity in the study sample. The results, when considered in light of the findings from other investigators, support 5.0 points as a reasonable MCID for most of the PROMIS-29 scales. Further studies are needed to determine the generalizability of the findings.Level of Evidence: 2.

Pain and muscle activity of neck, shoulder, upper back, and forearm during touch screen tablet use by children.

BACKGROUND: Children regularly use tablets in a variety of postures. Previous studies have shown that prolonged use of such an IT device increases the risk of musculoskeletal pain. OBJECTIVE: To investigate pain and muscle activity during tablet use by children in three different workstation positions-on the table with a case set, on a table, and on the lap. METHODS: Twenty five healthy and right-handed participants aged 10-12 years were recruited and assigned to play computer games for 15 minutes in each workstation. Pain(VAS) was measured at the neck, shoulder, upper back, and forearm regions immediately after tablet use. Electromyography (EMG) was measured at the cervical erector spinae (CES), upper trapezius (UT), middle trapezius (MT), and wrist extensors (WE) muscles during the final two minutes. RESULTS: Results showed that using a tablet on the table with a case set caused the least pain in the neck region (p < 0.05), compared with the use on the table and on the lap(which had pain scales of 0.37±0.86, 1.74±1.77, 1.72±1.90, respectively; mean±SD). EMG of cervical erector spinae during tablet use on the table with a case set was significantly lower (p < 0.05) than those on the table and on the lap (muscle activity of 22.38±9.54,35.37±16.82, 35.29±13.30 respectively). CONCLUSIONS: Tablet use on the table with a case set demonstrated a significantly lower severity of pain at the neck region than tablet use on the table and on the lap. To prevent musculoskeletal disorders, tablet use on the table with a case set is recommended as the optimal workstation for children.