1. Content validity and reproducibility of a low back pain questionnaire in Zimbabwean adolescents: results from a pilot study
Tafadzwa Nicole Chikasha
Supervisor :Matthew Chiwaridzo
Department of Rehabilitation
University of Zimbabwe

2. Introduction
What is
Low Back Pain??
12th rib
Inferior gluteal fold

3. No specific cause!!! Types of Low back pain Causes e.g. Non specific
Inflammatory process
Cancer
Infection
Osteoporosis
Non specific
No specific cause!!!

4. Recurrent Non Specific Low back pain
No specific cause
Pain that comes and goes
At least 2 episodes per year
Region between 12th rib & inferior gluteal fold

5. Characteristics of Recurrent NSLBP
Pain of High intensity
Episodes usually lasts a week
Tendency to manifest as chronic NSLBP in adulthood

6. Prevalence of Recurrent NSLBP
Lifetime prevalence 28-74%
7-10% (disabled)
Zimbabwe 29%

7. Risk factors Age Tight muscles (Hamstrings & Quads) Body mass index
Psychosocial factors

8. Risk factors cont.. Weight of the satchel Sports e.g. basketball
Sitting for long hours

9. Consequences of NSLBP

10. Consequences of NSLBP Health Psychosocial Economic Education
Quality of life
Health
Psychosocial
Economic
Education

11. Increased analgesic use Disability (7-10%)
Health consquences
Increased analgesic use
Disability (7-10%)
Poor health treatment outcomes
Economic consequences
Increased medical costs

12. Frustrated caregivers
Psychosocial consequences
Loss of self esteem
Depression
Frustrated caregivers

13. Education Consequences
School absenteeism
Poor school grades

14. What was the Problem???
In Zimbabwe there was no study ever conducted on validating a survey questionnaire designed for the investigation of recurrent non-specific low back pain among the young population

15. Objective
To determine the content validity and test-retest reliability of a low back pain survey questionnaire used to screen for recurrent non- specific low back pain in high school adolescents in Harare, Zimbabwe.

16. Why is this essential to us??
Validated and reliable questionnaire
Early identification
Primary & Secondary preventative strategies
Early treatment
Improved rehabilitation outcomes
Better prognosis & outlook
Decreased economic and social burden

17. Methodology Reliability Content validity 3 schools randomly selected
A panel of four experts to evaluate relevance of each item on the questionnaire
Item Content Validity Index’s & Scale Content Validity Index
Reliability
3 schools randomly selected
150 students
(11-19)years
Test -retest design used
(1 week interval)
Percentage agreement &kappa statistic
Statistica version 13 (data analysis)

18. Results Reliability Content Validity Final sample =125 adolescents.
Mean age (SD=1.9).
Content Validity
(26/30) had (I-CVIs) of 1.00 except
Items on smoking status, recurrence and duration had I-CVI’s of 0.75.
The overall (S-CVI/Ave) was 0.97.
Reliability
High levels of reproducibility were for items that evaluated perceived characteristics , consequences of low back pain, demographic characteristics and also for factors associated with low back pain (kappa coefficient= ).
Low level of reproducibility was found for items on functional limitations (kappa coefficient= ).

19. Discussion
The questionnaire offered excellent content valid for 26 of the items although further elaboration on questions on smoking status, recurrence and duration is necessary.
The questionnaire used provided reproducible information except for few items on functional limitations as consistent with other studies

20. Conclusion
Questionnaire offered excellent content validity and highly reproducible information
Revision on smoking status, recurrence and duration

21. Recommendations
Low back pain Questionnaire
Used in conjunction with a function limitations questionnaire
Used in clinical and non clinical settings e.g. schools

22. “LOOKING FORWARD TO THE FUTURE” (Future research)
Focus should be on recurrent cases of NSLBP to identify
Coping strategies employed to deal with the condition
Efficacy of primary and secondary prevention strategies (short term & long term effectiveness)

23. References
1. Chiwaridzo M, Naidoo N. Prevalence and Associated Characteristics of Recurrent Non-specific Low Back Pain in Zimbabwean Adolescents: A cross-sectional study. BMC Musculoskeletal Disorders. 2014; 15(381): 1-10. 
2. Chiwah RV, Chiwaridzo M, Dambi JM, Matare T. Recurrent Non-Specific Low Back Pain in Adolescents: A Cross-sectional Survey on Prevalence, Nature of Recurrent episodes and the Role of Physical Activity and Psychological factors. Annals of Paediatric Rheumatology ; 4(4): doi: /apr

24. Acknowledgements
I also want to express my profound appreciation to the following
Mr Chiwaridzo my supervisor
The parents and school children who participated in filling out the questionnaire
Mrs. F Kaseke, Mr. J Dambi, Mr. T Mudawarima, Miss C Tadyanemhandu for participating in this study as the content validity experts.
The Ministry of Primary and Secondary Education and the Provincial Education Officer
The Headmasters of the schools and teachers

25. Thank you for listening !!!

26. Any Questions ???