DOI: 10.6084/m9.figshare.23531005
title: Questionnaires that assess disability in children and adolescents with low back pain adhere to the concepts of the International classification of functioning, disability and health (ICF), but lack validity for this population: a systematic review

description: We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs. We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM. We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity. Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs. This review adds evidence to the area of musculoskeletal disorders in children and adolescents, which is still underexplored.Valid adult Patient-Reported Outcome Measures (PROMs) have been used to assess disability in children and adolescents with low back pain. However, it is recommended to use PROMs that are tested and valid for evaluation of the population of interest.The activities domain was the International Classification of Functioning, Disability and Health domain that presented the highest number of linked concepts, whereas concepts from personal factors were absent.The modified Hannover Functional Ability Questionnaire and the Micheli Functional Scale could potentially be used to assess disability in children and adolescents with low back pain, but high-quality studies are needed for the measurement properties, in particular content validity and responsiveness. This review adds evidence to the area of musculoskeletal disorders in children and adolescents, which is still underexplored. Valid adult Patient-Reported Outcome Measures (PROMs) have been used to assess disability in children and adolescents with low back pain. However, it is recommended to use PROMs that are tested and valid for evaluation of the population of interest. The activities domain was the International Classification of Functioning, Disability and Health domain that presented the highest number of linked concepts, whereas concepts from personal factors were absent. The modified Hannover Functional Ability Questionnaire and the Micheli Functional Scale could potentially be used to assess disability in children and adolescents with low back pain, but high-quality studies are needed for the measurement properties, in particular content validity and responsiveness.