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When quality of life questionnaires are used as measures of treatment outcomes, it is essential to know how well these can respond to clinical changes. The objective of this study is to examine the responsiveness of the Brazilian-Portuguese version of the Oswestry Disability Index (ODI-Brazil) in subjects with chronic low back pain submitted to a physical therapy program. Thirty subjects with chronic low back pain completed the ODI-Brazil questionnaire, along with an 11-point pain visual analogue scale (Pain VAS), and the Brazilian-Portuguese version of Roland-Morris disability questionnaire before and after the program. All patients also completed a global perception of change Likert scale in condition after the program. This scale was collapsed to produce a dichotomous variable outcome: improved and non-improved. Responsiveness was determined using effect size statistics and receiver operating characteristic curve (ROC curve), with best cut-point analysis. The best change score cut-off was identified when equally balanced sensitivity and specificity was found, as an expression of the minimum clinically important difference (MCID). After treatment, 19 patients considered themselves improved. Both the effect size (0.37) and the area under the ROC curve (0.73) for ODI-Brazil score in relation to global outcome after program indicated that the ODI-Brazil showed responsiveness. The ROC curve for ODI-Brazil was distributed at the upper corners of the diagonal line, indicating that the questionnaire presents discriminative ability. The best cut-off point for ODI-Brazil was approximately 4.45 points (63.2% sensitivity, 81.8% specificity). The Brazilian-Portuguese version of ODI has comparable responsiveness to other commonly used functional status measures and is appropriate for use in chronic low back pain patients receiving conservative care.

Study Design: Translation, cross-cultural adaptation and psychometric testing of self-report outcome measurements., Objectives: The aims of this study were to adapt the Functional Rating Index (FRI) to Brazilian-Portuguese and to test the psychometric properties of this new questionnaire and the Brazilian-Roland Morris Disability Questionnaire (RMDQ)., Summary of Background Data: Self-report measures are commonly used in clinical practice and in research studies. Most existing questionnaires were developed in English and there is only 1 Brazilian-Portuguese cross-cultural adaptation of a spine outcome measure., Methods: The FRI was translated and adapted into Brazilian-Portuguese according to the Guidelines for the process of cross-cultural adaptation of self report measures. The Brazilian-Portuguese FRI and RMDQ were tested for internal consistency, reliability, ceiling and floor effects, construct validity, and responsiveness in 140 low back pain (LBP) patients., Results: A very high level of internal consistency (Cronbach's alpha = 0.92) and reliability [ICC = 0.95 (95% confidence interval, 0.93-0.97)] was shown for both instruments. The FRI and RMDQ were highly correlated (r = 0.80), while both the FRI and RMDQ were moderately correlated with pain at baseline (r = 0.67 and 0.55, respectively). No ceiling or floor effects were detected; however, the responsiveness of both questionnaires was quite small (RMDQ ES = 0.10 [84% confidence interval, 0.04-0.16] and FRI ES = 0.18 [84% confidence interval, 0.11-0.24])., Conclusion: The results of this study indicate that the Brazilian-Portuguese versions of the FRI and RMDQ are reliable and valid instruments for the measurement of disability in Brazilian-Portuguese-speaking patients with LBP presenting for physiotherapy treatment. Both instruments are suitable for use in clinical practice and research studies.

Objective: Evidence-based practice requires access to systematic reviews and randomized controlled trials; however, most literature databases index primarily English-language journals. We sought to determine the extent and quality of Portuguese- and Spanish-language reports of randomized trials relevant to physiotherapy by searching the LILACS database (Literatura Latino Americana e do Caribe em Ciências da Saúde). A secondary aim was to compare the sensitivity of three strategies for searching for Portuguese- and Spanish-language randomized trials in physiotherapy., Study Design and Setting: The LILACS database was searched for randomized trials using three search strategies., Results: Three search strategies returned 5,262 records, of which only 47 were randomized trials. Most trials reported treatments for pain or cardiopulmonary disease, and most were of moderate to high quality. The sensitivity of the three search strategies varied from 2% to 53%., Conclusion: A small number of moderate- to high-quality randomized trials in physiotherapy are published in Spanish and Portuguese languages, but they are difficult to find.