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PubMed2001

[Severely disabled employees and their experiences with corporate policies concerning job retention. Selected results of an empirical study].

While the public has been paying attention to the topics illness and disability with respect to public health, long-term care insurance and public old age insurance systems for years, the risk of becoming disabled at work has been considered less. Research in this area has for a long time been focused on questions regarding first-time entry and return to work of disabled persons into the regular labour market. Also, much policy research has tended to deny an active role of the enterprise as an independent player and creator of policy in the management of disability. Hence only little documentation of employers' programmes and strategies as well as analysis concerning the question of job retention is available. In order to cover the research deficit a study with regard to employment careers of severely disabled was conducted in Rhineland-Palatinate from 1997 to 1999. The study pursues two different paths: On the one hand living and working conditions of this group are analysed, on the other the study's purpose is to give an overview of employers' disability management practices from the severely disabled employees' point of view. This article deals with the results of the policies within the enterprise study. It concerns the analysis of the following issues: Does disability have a negative impact on the employees' careers? Which measures are preferred by the persons interviewed and why? The final question, whether the need for supporting measures ascertained may be satisfied by the existing instruments available under the German Severely Disabled Persons Act must be answered with a clear "No"! Employers and disabled employees need alternative measures of support.

Adolescent↗

PubMed2002

Concepts of disablement in documents guiding physical therapy practice.

PURPOSE: To describe disability concepts used within documents guiding physical therapist practice. METHODS: Content analysis was performed on the Guide to Physical Therapist Practice, second edition; A Normative Model of Physical Therapist Professional Education, version 2000; APTA House of Delegates Standards, Policies, Positions and Guidelines; APTA Board of Directors Policies, Positions and Guidelines; The Model Practice Act for Physical Therapy and The Illinois Physical Therapy Act. Using a word sense framework, text-in-context lists were compiled, from which contextual themes and counts for all occurrences of disability terms were developed. RESULTS: Across documents, contextual themes with number of occurrences were: disability as role performance limitations within specific contexts: 819; disability resulting from health status: 39, disability law: 29; and rights of individuals with disabilities: 25. CONCLUSIONS: Documents guiding physical therapist practice commonly conceptualize disability as individual limitations within specific contexts and infrequently conceptualize disability as a societal phenomenon affecting persons across most settings and circumstances. It is believed that a concept of disability that is more inclusive of broad, as well as specific, contexts of disability may lead to improved physical therapy management for individuals with a wide range of performance capacities.

Concept Formation↗

PubMed1999

The prevalence of disability from chronic conditions due to injury among adults ages 18-69 years: United States, 1994.

PURPOSE: To describe the causes and determine the prevalence of disability from chronic conditions due to injury among US civilian non-institutionalized persons aged 18-69 years. METHODS: Data from the National Health Interview Survey Disability (NHIS-D) Supplement Phase I, United States 1994 were analysed and six disability categories were examined: activities of daily living (ADL), instrumental activities of daily living (IADL), functional activities (FA), sight, hearing, and communication. RESULTS: In 1994, 5.6 million persons aged 18-69 years reported a disability because of a chronic condition that was caused by injury. The prevalence of ADL disability due to chronic conditions caused by injury was 370 per 100000 population; IADL disability was 1256; FA disability was 2512; sight was 231; hearing was 339; and communication was 91 per 100000 population. Fifty per cent of ADL, IADL, and FA disabilities were attributed to motor vehicle crashes and falls, as were 31% of sight, 19% of hearing, and 23% of communication disabilities. CONCLUSIONS: Though these estimates may be conservative, this study indicates that injury is a major cause of disability in addition to a leading cause of death in the US.

Adolescent↗

PubMed2000

Socio-demographic differences in the onset and progression of disability in early old age: a longitudinal study.

OBJECTIVES: to analyse socio-demographic differences in the onset and progression of disability. DESIGN: analysis of a cohort of people aged 55-69 in 1988-9 and in 1994. SUBJECTS: a representative sample of 3543 adults. METHODS: we measured severity of disability at baseline and follow-up. We analysed variations in incidence and progression of disability by using logistic regression. RESULTS: Baseline severity of disability was similar for men and women but varied by age group, social class, educational qualifications and housing tenure. At follow-up, 36% had worse disability, 12% better and 53% the same as at baseline. Increased severity of disability and new incidence of disability were associated with lower socioeconomic status, baseline self-rated health status, age and gender. High initial levels of disability were associated with improvement at follow-up. CONCLUSION: disability can be dynamic, although deterioration is more usual than improvement. The reasons for the associations found between disability and socio-economic status are unclear.

Aged↗

PubMed2003

Prognostic effect of prior disability episodes among nondisabled community-living older persons.

The objective of this prospective cohort study, conducted in 1998-2002 in New Haven, Connecticut, was to determine the prognostic effect of prior episodes of disability. The analytical sample included 580 community-living persons aged 71 years or older who were nondisabled during an 18-month face-to-face assessment (i.e., zero-time). During monthly telephone interviews, participants were assessed for disability in activities of daily living. The primary explanatory variable was a history of disability in the year prior to zero-time as determined from the monthly interviews. The primary outcome was time to onset of disability over a 3-year period subsequent to zero-time. In Cox proportional hazards analyses that adjusted for several potential confounders, a prior history of disability was found to be significantly associated with development of any disability (i.e., > or = 1 month) and persistent disability (i.e., > or = 2 months); hazard ratios were 2.0 (95% confidence interval: 1.4, 2.7) and 2.0 (95% confidence interval: 1.3, 2.9), respectively. These strong associations were maintained after participants who had a prior history of chronic disability were excluded. Results demonstrate the long-term, deleterious effect of short-term disability among community-living older persons. More frequent assessments of functional status may be warranted in epidemiologic studies and clinical trials when disability is a primary focus.

Activities of Daily Living↗

PubMed1999

Coimpairments: strength and balance as predictors of severe walking disability.

BACKGROUND: Little information is available on the joint effects of multiple impairments (coimpairments) on the risk of disability. Our aim was to study the joint effects of strength and balance impairments on severe walking disability. METHODS: The data are from the baseline of the Women's Health and Aging Study (WHAS), a study of moderately to severely disabled women. A total of 1,002 women aged 65 and older participated in the tests, which took place in their homes. Severe walking disability was defined as self-reported inability to walk one-quarter mile and customary walking speed in a 4-meter test of < or =0.4 m/s. Balance was measured as an ability to hold progressively more difficult stands (feet side-by-side, semitandem and tandem stands). Maximal knee extension strength was measured using a hand-held dynamometer. RESULTS: There were 129 women who were severely walking disabled but able to walk at least minimally. In logistic regression analysis, balance and knee extension strength were independent predictors of severe walking disability. To study the combined effects, nine groups were formed on the basis of strength tertiles by balance categories in the entire population. In the best balance category, the crude prevalences of severe walking disability were 1.2%, 4.9%, and 14.3% in the highest to lowest strength tertiles. In the middle balance category, the rates were 2.9%, 10.0%, and 45.4.1%, and in the poorest balance category 4.9%, 22.1%, and 42.6%, correspondingly. The age, body weight, and height-adjusted odds ratios (OR) showed that the risk of severe walking disability in the subgroup with best balance and strength was less than 5% of the risk in the subgroup with poorest balance and strength (OR .034, 95% confidence interval [CI] .007-.166). Correspondingly, in the subgroups with poorest strength and best balance (OR .097, 95% CI .025-.38) or poorest balance and best strength (OR .102, 95% CI .012-.866) the risk was about 10%. The age-specific estimates of prevalence of severe walking disability in women were: 2.0% for ages 65-74 years, 3.4% for ages 75-84 years, and 9.1% for ages 85 years and older. CONCLUSIONS: The burden of coimpairments seems to be greater than the sum of single impairments involved. An effective way to reduce severe disabilities could be prevention of coimpairments.

Age Factors↗

PubMed2004

Activities of daily living function and disability in older adults in a randomized trial of the health enhancement program.

BACKGROUND: Disability in basic activities of daily living (ADLs) implies a loss of independence and increases the risk for hospitalization, nursing home admission, and death. Little is known about ways by which ADL disability can be prevented or reversed. The authors evaluated the efficacy of the Health Enhancement Program in preventing and reducing ADL disability in community-dwelling older adults. METHODS: The authors analyzed data from a 12-month, randomized, single-blinded, controlled trial of a disability prevention, chronic disease self-management program involving 201 adults aged 70 years and older that was conducted from February 1995 to June 1996 at a senior center in western Washington state. Activities of daily living disability incidence, improvement, and worsening were assessed using intention-to-treat methods. RESULTS: The cumulative incidence of ADL disability among those who were not ADL disabled at baseline (n = 56 in the intervention group, n = 57 in the control group) was modestly lower in the intervention group than in the control group at 12 months (14.3% vs 21.3%, p = .466). Cumulative improvement in ADL function among those who reported any ADL disability at baseline (n = 41 in the intervention group, n = 43 in the control group) was greater in the intervention group at 12 months (80.5% vs 46.5%, p = .026). The likelihood for ADL improvement was greater in the intervention group compared with controls at 12 months (adjusted hazard ratio, 1.84; 95% confidence interval, 1.05 to 3.22; p = .020). Cumulative worsening of ADL function was slightly lower in the intervention group at 12 months (18.6% vs 26.5%, p = .237). Intervention participants tended to be at lower risk for ADL worsening (adjusted hazard ratio, 0.71; 95% confidence interval, 0.38 to 1.30; p = .266) compared with control participants. CONCLUSION: The Health Enhancement Program intervention led to improved ADL functioning in those who were disabled initially and thereby offers a promising strategy for limiting or reversing functional decline in disabled elderly persons.

Activities of Daily Living↗

PubMed2004

A longitudinal study of parkinsonism and disability in a community population of older people.

BACKGROUND: Parkinsonian signs in patients without Parkinson's disease are often undetected but occur frequently in older people, and are often considered benign. We measured the association between parkinsonism and subsequent disability. METHODS: We conducted a prospective, longitudinal, community-based population study in East Boston, Massachusetts, using a stratified random sample of 455 community residents, aged 65 years and older. Four categories of parkinsonian signs were measured at baseline: bradykinesia, gait disturbance, rigidity, and tremor. Parkinsonism was defined as the presence of two or more categories of parkinsonian signs, and cases of Parkinson's disease were excluded from analyses. Disability was assessed annually over a mean of 4.7 years using the Katz, Rosow-Breslau, and Nagi disability measures. RESULTS: Parkinsonism at baseline strongly predicted subsequent disability as assessed with the three disability measures (on the Katz measure, beta = -1.30, p < .001). On average, a person with parkinsonism had a disability level at follow-up equal to that of a comparable person approximately 16.7 years for men and 8 years for women. The rate of developing disability for persons with parkinsonism increased each year; on the Katz measure, participants with parkinsonism declined on average 16.4% faster than those without. Gait impairment and bradykinesia strongly predicted subsequent disability; tremor and rigidity did not. The effect of parkinsonism was attenuated but still persistent in persons with coexistent moderate-to-severe cognitive impairment or stroke. CONCLUSIONS: Parkinsonism strongly predicts progressive disability in the older community population and has a marked aging effect on disability level.

Aged↗

PubMed2002

Impact of differential item functioning on age and gender differences in functional disability.

OBJECTIVES: Estimates of group differences in functional disability may be biased if items exhibit differential item functioning (DIF). For a given item, DIF exists if persons in different groups do not have the same probability of responding, given their level of disability. This study examines the extent to which DIF affects estimates of age and gender group differences in disability severity among adults with some functional disability. METHODS: Data came from the 1994/1995 National Health Interview Survey Disability Supplement. Analyses focused on 5,750 adult respondents who received help or supervision with at least one of 11 activities of daily living/instrumental activities of daily living tasks. We estimated gender and age group (18-39, 40-69, and 70+) differences in disability, using multiple-indicator/multiple-cause models, which treat functional disability as a latent trait. RESULTS: Nine items manifested significant DIF by age or gender; DIF was especially large for "shopping" and "money management." Without adjusting for DIF, middle-aged persons were less disabled than elderly men, and women were less disabled than men among nonelderly persons. After adjusting for DIF, middle-aged persons did not differ from elderly persons, and gender differences within age groups were not significant. DISCUSSION: Comparisons of disability across sociodemographic groups need to take DIF into account. Future research should examine the causes of DIF and develop alternative question wordings that reduce DIF effects.

Activities of Daily Living↗

PubMed2004

Working status among Dutch patients with rheumatoid arthritis: work disability and working conditions.

OBJECTIVES: To assess work disability and variables associated with work disability among Dutch patients with rheumatoid arthritis (RA). METHODS: A questionnaire on working status was filled out by 296 patients of working age. Employment and work disability rates adjusted for age and sex from the Dutch population were determined using indirect standardization. Cox proportional hazard analysis was used to assess baseline predictors of work disability in a subgroup of patients (n = 195). RESULTS: After a mean disease duration of 4.3 yr, patients had a 0.78 (95% CI 0.67-0.88) chance of being employed and a 2.14 (95% CI 1.75-2.54) risk of being work disabled when compared with the Dutch population. Functional disability and job type at the start of the disease were predictors of future work disability. In total, 48 (37%) currently employed patients had changed their working conditions, of which reduced working hours (46%), reduced pacing of work (42%) and help from colleagues (49%) were the most important alterations. Of the 60 work disabled patients without a paid job, only 11 patients (18%) would be willing to work again. CONCLUSION: This study shows that the adjusted employment rates were lower and that work disability rates were higher in patients with RA when compared with the general Dutch population. In addition, a substantial number of employed patients had to change their working conditions due to RA. Only a minority of work disabled RA patients was willing to return to the paid labour force.

Arthritis, Rheumatoid↗

PubMed1981

Objective obstacles in hiring disabled persons -- the employers' point of view.

In the comprehensive rehabilitation process, one of the most accepted criteria for success or failure is the suitable placement of the client in the open employment market. The present study examined employer's attitudes toward hiring disabled persons. The sample consisted of 233 employers in the public and private sectors of the Israeli economy, and the method entailed interviewing each employer about his attitudes toward the risks of employing disabled persons, his actual hiring practices, and his expected response to financial aid for surmounting technical obstacles (architectural barriers and inappropriate work methods and tools). Interpretation of the results indicated that employers' reluctance to hire disabled employees was often explained by the existence of technical obstacles. However, when the possibility of financial aid for eliminating these obstacles was proposed, the employers responded with reservation. Although Israeli has mandated legislation requiring the employment of disabled war veterans, not all employers were aware of this, and almost half of those who were did not employ disabled persons. Evidently, legislation does not suffice in order to ensure actual hiring of disabled persons. In order to increase compliance with the law, and to encourage hiring of disabled persons who are not war veterans, it was suggested that more information be provided to the employers on the possibilities of employing disabled persons, with emphasis placed on the positive aspects of the disabled worker's true potential. Additional methods that should be applied to encourage employment include appropriate vocational training of disabled persons themselves and demonstration before the employers of the practical conditions under which successful employment is possible.

Architectural Accessibility↗

PubMed1997

Instrument for locating students with suspected learning disabilities: a quantitative approach.

The instrument to locate students with learning disabilities was developed to create equality and uniformity, so that such difficulties could be spotted independently of socialization factors, teachers and parents to whom the student had been exposed. The instrument was developed on the basis of research that defines the reading rate of students with reading disabilities in words per minute, the minimum number of errors for locating writing disabilities, and the number of answers and lines a student uses to reconstruct the content of a passage adapted to his or her age level. The research carried out in order to construct the instrument is the first to attempt to quantify disability, and on this basis to construct an instrument to locate students with disabilities in reading, writing and visual recall. The procedure can be carried out for a whole class in a single lesson period. One indirect conclusion from the research is that disability indicators remain with the learning disabled regardless of time since diagnosis or remedial help. Other implications related to combining the quantity component in diagnoses of degrees of difference in the disability identified, and in extra examination time for the learning disabled. The instrument should solve the problem of locating students with difficulty reading, writing or in visual recall, due to disability. Students thus identified will be directed to individual diagnosis to find out whether their difficulties are primary or secondary (e.g. a new immigrant who still has trouble with Hebrew). A personal corrective programme can then be constructed.

Achievement↗

PubMed1997

Disablement outcomes in geriatric rehabilitation.

Until recently, knowledge in the field of geriatric rehabilitation has been based largely on empirical findings. There is a need for greater conceptual clarity about major disablement outcomes to provide a foundation for future theoretical research. Disablement terms promulgated by the World Health Organization's (WHO) International Classification of Impairments Disabilities and Handicaps (ICIDH) are reviewed and compared with those of an alternative model proposed by Saad Nagi in 1965. Distinctions are drawn between the disablement concepts each system includes to refer to (1) inherent attributes of patients and (2) the interaction of the patient with the social and physical environment. The importance of a disablement model reflecting this distinction between inherent and relational concepts is emphasized. Areas for fertile research opportunities in which the disablement concepts could be used are discussed. It is suggested that improved understanding of disablement outcomes could be most readily achieved by application of an epidemiologic model separating the factors affecting outcomes into three sets of variables: the host factors representing intra-individual attributes; the agent factors, which are the external event or events causing the disability; and the environmental factors, which relate to the physical or social surroundings in which the disability occurs. In future research efforts, a more theoretical approach to studying disablement outcomes is advocated as a basis for improvements in geriatric rehabilitation.

Aged↗

PubMed2005

Regional variation and other correlates of Department of Veterans Affairs Disability Awards for patients with posttraumatic stress disorder.

BACKGROUND: Minnesota, Minneapolis, Minnesota. Posttraumatic stress disorder (PTSD) is a chronic disabling condition affecting more than 600,000 United States veterans and is the most common psychiatric condition for which veterans seek Veterans Affairs disability benefits. Receipt of such benefits enhances veterans' access to Veteran Affairs health care and reduces their chance of poverty. OBJECTIVES: We sought to determine whether previously identified regional variations in PTSD disability awards are explained by appropriate subject characteristics (eg, differences in PTSD symptomatology or dysfunction) and to estimate the impact of veterans' PTSD symptom severity or level of dysfunction on their odds of obtaining PTSD disability benefits. RESEARCH DESIGN: We used a mailed survey linked to administrative data. SUBJECTS: Subjects included 4918 representative, eligible men and women who filed PTSD disability claims between 1994 and 1998. RESULTS: A total of 3337 veterans returned useable surveys (68%). Before adjustment, PTSD disability claims approval rates ranged from 43% to 75% across regions. After adjustment, rates ranged from 33% to 72% (P <0.0001). Severer PTSD symptoms were associated with greater odds of having PTSD disability benefits (P <0.0001). Unexpectedly, poorer functional status was associated with lower odds of having benefits (P <0.0001). On average, clinical differences between veterans who did and did not have PTSD disability benefits were small but suggested slightly greater dysfunction among those without benefits. CONCLUSIONS: An almost twofold regional difference in claims approval rates was not explained by veterans' PTSD symptom severity, level of dysfunction, or other subject-level characteristics. Veterans who did not obtain PTSD disability benefits were at least as disabled as those who did receive benefits.

Adult↗

PubMed1993

The development of guideline factors for the evaluation of disability in neck and back injuries. Division of Industrial Accidents, State of California.

This is the second article documenting the development of guideline factors for the evaluation of spine injuries by a committee supported by the Division of Industrial Accidents (DIA) in the State of California. The committee was asked to develop guidelines that incorporated cervical and thoracic spine injuries into the original guidelines developed for lumbar spine injuries (Clark et al, Spine 1988; 13:332). Multiple Independent Medical Examiners (IMEs) were requested to rate disability on 42 case reports submitted to the DIA. A tremendous variation existed in the disability rating recommended by physicians given the same set of facts. One hundred eighty-five IMEs then were asked to evaluate a series of potential factors influencing disability. Each factor was listed according to its perceived importance in determining disability. These factors then were subjected to an intensive search of the medical and scientific literature to determine their validity. A final list of 28 factors for the cervical and thoracic spine were developed and combined with the previously published factors for the lumbar spine. This led to the development of 37 factors or guidelines for the evaluation of spine disability. Testing of this schedule was performed by reviewing 159 submitted disability consultation reports. This review showed that there were no factors in the reports that were not included in the schedule. An average of 3.1 subjective factors and 2.3 objective factors were noted in the reports, with a very poor relationship between the number of factors and the level of disability given by the assessing physician. It is thought that the incorporation of the proposed guideline factors into the current disability rating system would allow for a more reproducible evaluation of disability and allow Workers' Compensation judges and administrators to make disability decisions based on documentable and reliable facts.

Back Pain↗

PubMed1996

Effect of an early intervention program on the relationship between subjective pain and disability measures in nurses with low back injury.

STUDY DESIGN: The effect of a workplace-based early intervention program on perceptions of pain and disability in nurses with low back injury was studied using a preintervention versus postintervention design with concurrent control group. OBJECTIVES: To examine the relationship and changes over time between pain and disability measures in two groups of back-injured nurses--those who received the early intervention program (study) and those who were not offered the program (control). SUMMARY OF BACKGROUND DATA: The relationship between back pain and disability is not straightforward. The effects of an intervention program on changes in perceptions of pain and disability over time have not been widely reported. METHODS: The Oswestry Low Back Disability Questionnaire and a visual analog pain scale were administered to 46 study nurses and 137 control nurses at time of injury and at 6 months after injury. Correlation and regression analyses were used to explore the relationships between the two measures. Changes over time were compared with analyses of variance. RESULTS: Pain and disability were positively correlated in both groups at time of injury and at follow-up evaluation. Mean scores for pain and disability were lower at follow-up evaluation than at initial injury in both groups; study nurses had significantly (P < 0.01) lower scores at 6 months than nurses in the control group. Disability at time of injury predicted disability at 6 months only for nurses in the control group. CONCLUSIONS: This workplace-based early intervention program decreased levels of pain and disability in back-injured nurses and altered the relationship between these two variables over a 6-month time interval.

Demography↗

PubMed1998

The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults.

STUDY DESIGN: Population-based, cross-sectional mailed survey. OBJECTIVE: To determine the lifetime, period, and point prevalence of neck pain and its related disability among Saskatchewan adults and investigate the presence and strength of nonresponse bias. SUMMARY OF BACKGROUND DATA: In Europe, the lifetime and point prevalence of neck pain is almost as high as the prevalence of low back pain. Similarly, chronic neck pain is highly prevalent and a common source of disability in the working-age population. However, no studies specifically have documented the prevalence of neck pain and its related disability in North America. METHODS: The Saskatchewan Health and Back Pain Survey was mailed to 2184 randomly selected Saskatchewan adults aged 20-69 years. Fifty-five percent of the study population participated. The presence of nonresponse bias was investigated through logistic regression and wave analysis. The Chronic Pain Questionnaire was used to classify the severity of chronic neck pain. RESULTS: The age-standardized lifetime prevalence of neck pain is 66.7% (95% confidence interval, 63.8-69.5), and the point prevalence is 22.2% (95% confidence interval, 19.7-24.7). The age-standardized 6-month prevalence of low-intensity and low-disability neck pain is 39.7% (95% confidence interval, 36.7-42.7), whereas it is 10.1% (95% confidence interval, 8.2-11.9) for high-intensity and low-disability neck pain and 4.6% (95% confidence interval, 3.3-5.8) for significantly disabling neck pain. The prevalence of low-intensity and low-disability neck pain decreases with age. More women experience high-disability neck pain than men. Wave analysis suggests that the point prevalence and 6-month prevalence of high-intensity and low-disability neck pain are overestimated in this survey. CONCLUSION: This cross-sectional study shows that neck pain is highly prevalent in Saskatchewan and that it significantly disables 4.6% (95% confidence interval, 3.3-5.8) of the adult population.

Adult↗

PubMed1999

Development of the Neck Pain and Disability Scale. Item analysis, face, and criterion-related validity.

STUDY DESIGN: The development and testing of a new comprehensive measure of neck pain and disability, the Neck Pain and Disability Scale. OBJECTIVES: To provide an initial evaluation of the Neck Pain and Disability Scale's reliability and validity. SUMMARY OF BACKGROUND DATA: Although several measures exist for generalized pain and disability, none is specific for neck pain. More specific measurements should improve assessment of treatments and clinical research aimed at cervical pain syndromes. METHODS: The Neck Pain and Disability Scale was designed using the Million Visual Analogue Scale as a template and consists of 20 items that assess neck pain. In this study, 100 patients with neck pain, 52 patients with lower back and leg pain, and 27 pain-free volunteers were rated by the Neck Pain and Disability Scale. In addition, a subset of the 47 patients with neck pain were rated by several other established psychometric instruments. RESULTS: An item analysis showed a high degree of internal consistency among the 20 items on the Neck Pain and Disability Scale (r = 0.93), and face validity was established by comparing patients who had neck pain as well as lower back and leg pain with a pain-free group. The Neck Pain and Disability Scale scores correlated with the Oswestry Disability Questionnaire, the Pain Disability Index, and psychological measures of depression and neuroticism. CONCLUSIONS: The results suggest a highly reliable instrument for evaluating neck pain with at least four underlying dimensions. Further work to address the predictive validity of this new tool are under way.

Adult↗