Brigham Spinal Stenosis Questionnaire


Name

Brigham Spinal Stenosis Questionnaire.

Synonyms

Swiss Spinal Stenosis Scoring, Swiss Spinal Stenosis Score, Swiss Spinal Stenosis Measure, Zurich Claudication Questionnaire.

Source Article

Stucki G, Daltroy L, Liang MH, et al. Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine 1996; 21: 796–803.

Definition

The Brigham Spinal Stenosis Questionnaire is a disease-specific self-report outcome instrument commonly used in trials to measure treatment outcomes in patients with lumbar spinal stenosis (LSS). The Brigham Spinal Stenosis Questionnaire quantifies severity of symptoms, physical function characteristics, and patient's satisfaction after treatment. It was designed to complement existing generic measures of lumbar spine disability and health status in the evaluation of patients with LSS. This tool is diversely referred to as the ‘Swiss Spinal Stenosis Questionnaire’, the ‘Zurich Claudication Questionnaire’ and the ‘Brigham Spinal Stenosis Questionnaire’, which all of them are exactly the same.

Structure / Content

The scale relates to symptoms over the past month. There are 12 questions for all patients, and a further 6 questions to measure treatment outcome (for those who have had treatment).

    The BrighamSpinal Stenosis Questionnaire consists of three subscales:

        1. Symptom severity scale  (questions I-VII) [further subdivided into pain domain (questions I-IV) and a neuroischemic domain (questions V-VII)]: Possible range of the score is 1 to 5.

        2. Physical function scale (questions VIII-XII): Possible range of scores is 1 to 4.

        3. Patient's satisfaction with treatment scale (questions XIII-XVIII): the range of the scale is 1 to 4.



In the past month, how would you describe:
 
  1. The pain you have had on the average, including pain in your back and buttocks, as well as pain that goes down the legs?
  1. None
  2. Mild
  3. Moderate
  4. Severe
  5. Very Severe

  1. How often have you had back, buttock, or leg pain?
  1. Less than once a week
  2. At least once a week
  3. Every day, for at least a few minutes
  4. Every day for most of the day
  5. Every minute of the day
  1. The pain in your back or buttocks?
  1. None
  2. Mild
  3. Moderate
  4. Severe
  5. Very Severe

  1. The pain in your legs or feet?
  1. None
  2. Mild
  3. Moderate
  4. Severe
  5. Very Severe

  1. Numbness or tingling in your legs or feet?
  1. None
  2. Mild
  3. Moderate
  4. Severe
  5. Very Severe

  1. Weakness in your legs or feet?
  1. None
  2. Mild
  3. Moderate
  4. Severe
  5. Very Severe

  1. Problems with your balance?
    1. No, I’ve had no problems with balance
    3. Yes, sometimes I feel my balance is off, or that I am not surefooted
    5. Yes, often I feel my balance is off, or that I am not surefooted

In the past month, on a typical day:
 
  1. How far have you been able to walk?
  1. More than 2 miles
  2. More than 2 blocks, but less than 2 miles
  3. More than 50 feet, but less than 2 miles
  4. Less than 50 feet

  1. Have you taken walks outdoors or around the shops for  pleasure?
  1. Yes, comfortably
  2. Yes, but sometimes with pain
  3. Yes, but always with pain
  4. No

  1. Have you been shopping for groceries or other items?
  1. Yes, comfortably
  2. Yes, but sometimes with pain
  3. Yes, but always with pain
  4. No

  1. Have you walked around the different rooms in your house or apartment?
  1. Yes, comfortably
  2. Yes, but sometimes with pain
  3. Yes, but always with pain
  4. No

  1. Have you walked from your bedroom to the bathroom?
  1. Yes, comfortably
  2. Yes, but sometimes with pain
  3. Yes, but always with pain
  4. No

If you have had treatment for your back or legs recently, how satisfied are you with:
 
  1. The overall result of your back operation?
  1. Very satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied

  1. Relief of pain after your operation?
  1. Very satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied

  1. The ability to walk after your operation?
  1. Very satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied

  1. Your ability to do housework, yardwork, or job after your operation?
  1. Very Satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied

  1. Your strength in your thighs, legs, and feet?
  1. Very satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied
 
  1. Your balance, or steadiness, on your feet?
  1. Very satisfied
  2. Somewhat satisfied
  3. Somewhat dissatisfied
  4. Very dissatisfied


Scoring Method / Interpretation

The result is expressed as a percentage of the maximum possible score. The score increases with worsening disability. 

Validity / Reliability / Predictive Ability

Validity of the instrument was studied well.  Also, psychometric properties of the questionnaire was evaluated using the Rasch model by Comer et al. (Comer, 2011)

Cost

Free.

Scientific Spine's Comment

The Brigham Spinal Stenosis Questionnaire was designed specifically for use in the evaluation of physical function in patients with lumbar spinal stenosis. Subscales of questionnaire may be used separately. For example, the 5-item Physical Function Scale is used primarily to evaluate walking capacity. These 5 items assess distance walked and activities of daily living involving walking. The Physical Function Scale has been used to assess walking as an outcome for surgical and nonsurgical treatment in patients with LSS. North American Spine Society (NASS) recommended this scale as the "gold standard" to quantify outcome in patients with spinal stenosis.




References

Stucki G, Daltroy L, Liang MH, et al. Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine 1996; 21: 796–803.

Pratt RK, Fairbank JC, Virr A. The reliability of the Shuttle Walking Test, the Swiss Spinal Stenosis Questionnaire, the Oxford Spinal Stenosis Score, and the Oswestry Disability Index in the assessment of patients with lumbar spinal stenosis. Spine 2002;27(1):84-91.

Comer CM, Conaghan PG, Tennant A. Internal construct validity of the Swiss Spine Stenosis Questionnaire: Rasch analysis of a disease-specific outcome measure for lumbar spinal stenosis. Spine (Phila Pa 1976). 2011 Feb 1. [Epub ahead of print]

Conway J, Tomkins CC, Haig AJ. Walking assessment in people with lumbar spinal stenosis: capacity, performance, and self-report measures.  Spine J. 2010 Dec 7. [Epub ahead of print]

Tomkins-Lane CC, Battié MC. Validity and reproducibility of self-report measures of walking capacity in lumbar spinal stenosis. Spine (Phila Pa 1976). 2010 Nov 1;35(23):2097-102.

Tomkins CC, Battié MC, Hu R Construct validity of the physical function scale of the Swiss Spinal Stenosis Questionnaire for the measurement of walking capacity. Spine (Phila Pa 1976). 2007 Aug 1;32(17):1896-901.









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