The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) ^[1] is a screening tool which assesses the risk that a worker will develop long term disability or fail to return to work following a musculoskeletal injury. It consists of 21 questions which address psycho-social factors, including beliefs and expectations that may influence recovery and return to work ('yellow flags').

Ideally, this questionnaire should be completed between four and 12 weeks following a musculoskeletal injury. The screening tool enables a practitioner to identify possible risks factors and apply appropriate interventions (for instance, use of activity programs based on cognitive behavioural strategies, addressing fear-avoidance or 'catastrophising') to reduce the risk of long term disability in injured workers. Evidence indicates that these factors can be changed if they are addressed early in the recovery process.

Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPQ)

 
References
^[1] Linton SJ, Boersma K. Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro Musculoskeletal Pain Questionnaire. Clin J Pain. 2003 Mar-Apr;19(2):80-6.

The Kessler Psychological Distress Scale (K10) ^[1] is a simple measure of psychological distress. The K10 scale involves 10 questions about emotional states each with a five-level response scale. The measure can be used as a brief screen to identify levels of distress. The tool can be given to patients to complete, or alternatively the questions can be read to the patient by the practitioner.

In the context of injury management, the measure can be provided to the patient where recovery is not proceeding as anticipated (for instance, between weeks four and six), and may highlight the need for more regular review, or referral to a specialist health provider such as a psychologist.

The Kessler Psychological Distress Scale (K10)

 
References
^[1] Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003 Feb;60(2):184-9.

The Visual Analogue Scale (VAS) ^[1] is a subjective measure of pain. It consists of a 10 cm line with two end-points representing 'no pain' and 'worst pain imaginable'. Patients are asked to rate their pain by placing a mark on the line corresponding to their current level of pain. The distance along the line from the 'no pain' marker is then measured with a ruler giving a pain score out of 10.

Visual Analogue Scale

 
References
^[1] Huskisson EC. Measurement of pain. Lancet. 1974 Nov 9;2(7889):1127-31.

Neck disorders are a significant source of pain and activity limitation in workers and those involved in motor vehicle collisions. The Neck Disability Index (NDI) ^[1] is designed to measure neck-specific disability. The questionnaire has 10 items concerning pain and activities of daily living including personal care, lifting, reading, headaches, concentration, work status, driving, sleeping and recreation. The measure is designed to be given to the patient to complete, and can provide useful information for management and prognosis of those with neck pain.

Neck Disability Index

 
References
^[1] Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991 Sep;14(7):409-15.

The Distress and Risk Assessment Method (DRAM) ^[1] is a simple and straightforward psychological assessment method for pain problems. The DRAM is designed as no more than a first-stage screening procedure, whether as a confirmation of clinical impression, or to alert the clinician that a more comprehensive psychological or psychophysiological assessment is indicated.

Distress and Risk Assessment Method (DRAM)

 
References
^[1] Main CJ, Wood PL, Hollis S, Spanswick CC, Waddell G. The Distress and Risk Assessment Method. A simple patient classification to identify distress and evaluate the risk of poor outcome. Spine. 1992 Jan;17(1):42-52.

Lovibond’s Depression Anxiety Stress Scale (DASS) ^[1] is a 42-item self report instrument designed to measure the three related negative emotional states of depression, anxiety and tension/stress. The DASS was constructed not merely as another set of scales to measure conventionally defined emotional states, but to further the process of defining, understanding and measuring the ubiquitous and clinically significant emotional states usually described as depression, anxiety and stress. The DASS should thus meet the requirements of both researchers and scientist-professional clinicians.

Scoring instructions
Each of the three DASS scales contains 14 items, divided into subscales of 2-5 items with similar content. Subjects are asked to use 4-point severity/frequency scales to rate the extent to which they have experienced each state over the past week. Scores for Depression, Anxiety and Stress are calculated by summing the scores for the relevant items.

Interpretation of scores
The DASS may be administered and scored by non-psychologists, but decisions based on particular score profiles should be made only by experienced clinicians who have carried out an appropriate clinical examination. A set of cut-off scores for defining mild/moderate/severe/extremely severe scores for each DASS scale has been developed. To avoid misinterpretation and reification of these (arbitrary) labels, they are only provided in the DASS manual which can be ordered from: http://www.psy.unsw.edu.au/research/resources/depressiontools.html.
 
References
^[1] Crawford JR, Henry JD. The Depression Anxiety Stress Scales (DASS): normative data and latent structure in a large non-clinical sample. Br J Clin Psychol. 2003 Jun;42(Pt 2):111-31.

The Oswestry Disability Index (aka: Oswestry Low Back Pain Disability Questionnaire) is an extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the 'gold standard' of low back functional outcome tools ^[1].

Oswestry Low Back Disability Questionnaire

References
^[1] Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine. 2000 Nov 15;25(22):2940-52; discussion 52.

The Roland-Morris Questionnaire (RMQ) ^[1] is a self-administered disability measure in which greater levels of disability are reflected by higher numbers on a 24-point scale. The RMQ has been shown to yield reliable measurements, which are valid for inferring the level of disability, and to be sensitive to change over time for groups of patients with low back pain.

Roland Morris Low Back Pain and Disability Questionnaire (RMQ)

References
^[1] Stratford PW, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Defining the minimum level of detectable change for the Roland-Morris questionnaire. Phys Ther. 1996 Apr;76(4):359-65; discussion 66-8.

The Quebec Back Pain Disability Scale ^[1] is a 20-item self-administered instrument designed to assess the level of functional disability in individuals with back pain. The scale is a reliable and valid measure and can be used for monitoring the progress of individual patients participating in treatment or rehabilitation programs.

The Quebec Back Pain Disability Scale

References
^[1] Kopec JA, Esdaile JM, Abrahamowicz M, Abenhaim L, Wood-Dauphinee S, Lamping DL, et al. The Quebec Back Pain Disability Scale. Measurement properties. Spine. 1995 Feb 1;20(3):341-52.

The Shoulder Pain and Disability Index (SPADI) ^[1] is a self-administered questionnaire that consists of two dimensions, one for pain and the other for functional activities. The pain dimension consists of five questions regarding the severity of an individual's pain. Functional activities are assessed with eight questions designed to measure the degree of difficulty an individual has with various activities of daily living that require upper-extremity use. The SPADI takes 5 to 10 minutes for a patient to complete and is the only reliable and valid region-specific measure for the shoulder.

Shoulder Pain and Disability Index (SPADI)

References
^[1] Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991 Dec;4(4):143-9.

The Lower Extremity Functional Scale (LEFS) ^[1] is a questionnaire containing 20 questions about a person's ability to perform everyday tasks. The LEFS can be used by clinicians as a measure of patients' initial function, ongoing progress and outcome, as well as to set functional goals.

The LEFS can be used to evaluate the functional impairment of a patient with a disorder of one or both lower extremities. It can be used to monitor the patient over time and to evaluate the effectiveness of an intervention.

Lower Extremity Functional Scale (LEFS)

References
^[1] Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther. 1999 Apr;79(4):371-83.

The Knee Injury and Osteoarthritis Outcome Score (KOOS) ^[1] is a questionnaire designed to assess short and long-term patient-relevant outcomes following knee injury. The KOOS is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport and recreation function, and knee-related quality of life. The KOOS meets basic criteria of outcome measures and can be used to evaluate the course of knee injury and treatment outcome. KOOS is patient-administered, the format is user friendly, and takes about 10 minutes to fill out.

Knee Injury and Osteoarthritis Outcome Score (KOOS)

References
^[1] Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96.

The Patient-Specific Functional Scale ^[1] is designed to measure disability in people with an orthopaedic condition.

Patient-Specific Functional Scale

References
Stratford P, Gill C, Westaway M, Binkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiotherapy Canada 1995;47:258-63.

The Upper Extremity Functional Index (UEFI) ^[1] is a self-administered questionnaire which measures disability in people with upper extremity orthopaedic conditions. The questionnaire lists 20 activities and the patient gives a score to each based on the difficulty they have completing that activity.

Upper Extremity Functional Index (UEFI)

References
Stratford P, Binkley J, Stratford D. Development and initial validation of the upper extremity functional index. Physiotherapy Canada 2001;53(4):259-67.