Article

OBJECTIVE: To determine and compare the sensitivity to change of the
condition-specific cervical Northern American Spine Society (NASS) and the
generic Short Form 36 (SF-36). Design: Prospective cohort study. SUBJECTS: One
hundred and seventy five patients after whiplash injury. Interventions: Four-week
inpatient interdisciplinary pain management programme. MAIN MEASURES :
Responsiveness of the NASS and the SF-36 was quantified by effect size and
standardized response mean and compared within the same construct by the modified
Jacknife test. Ability to detect improvement was compared using sensitivities
determined from receiver operating characteristics curves. RESULTS: In pain, the
NASS was comparable responsive to the SF-36 at the one-month follow-up (n = 175):
effect sizes: 0.62 (NASS) versus 0.61 (SF-36), P = 0.914. The NASS was less
responsive than the SF-36 in function: 0.23 versus 0.63, P < 0.001 and in
pain+function: 0.35 versus 0.58 (P = 0.001). These relationships remained
consistent using standardized response means, at the six-month follow-up (n =
103), and in the comparison of the sensitivities. Sensitivities at one month,
pain: 70% (NASS) versus 62% (SF-36), P = 0.234; function: 65% versus 80%, P =
0.002; pain+function: 68% versus 78%, P = 0.035. The six-month data were similar.
CONCLUSIONS: The generic SF-36 was more responsive in function and equally
responsive in pain when compared to the condition-specific NASS. The SF-36 can be
recommended as a responsive instrument for measurement of pain and function in
chronic whiplash syndrome.

Langue : ANGLAIS