A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure

Abstract Background To assess the 10-item Spine Functional Index (SFI-10) clinimetric properties in a general musculoskeletal disorder (MSD) spine population. Ascertain the psychometric characteristics’ consistency with the developmental study findings for structural and criterion validity, internal...

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Main Authors: Hamid Reza Mokhtarinia, Antonio Cuesta-Vargas, Almir Vieira Dibai-Filho, Markus Melloh, Agnieszka Bejer
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08604-0
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author Hamid Reza Mokhtarinia
Antonio Cuesta-Vargas
Almir Vieira Dibai-Filho
Markus Melloh
Agnieszka Bejer
author_facet Hamid Reza Mokhtarinia
Antonio Cuesta-Vargas
Almir Vieira Dibai-Filho
Markus Melloh
Agnieszka Bejer
author_sort Hamid Reza Mokhtarinia
collection DOAJ
description Abstract Background To assess the 10-item Spine Functional Index (SFI-10) clinimetric properties in a general musculoskeletal disorder (MSD) spine population. Ascertain the psychometric characteristics’ consistency with the developmental study findings for structural and criterion validity, internal consistency, and floor/ceiling effect; establish the longitudinal characteristics for test–retest reliability, responsiveness, construct validity, and error scores; and clarify practical characteristics of readability, missing responses, and time/errors for completion/scoring related to administrative burden. Methods A longitudinal study of deidentified spine MSD patients (n = 1317, 53.4% female, age = 18-91yrs, av = 49.5 ± 16.4yrs; neck = 36.5%, mid-back = 8.4%, low back = 56.0%, multi-site = 0.3%) who completed the SFI-10, the Patient Specific Functional Scale (PSFS), and Numerical Rating Scales for Global-function (G-NRS) and Pain (P-NRS). Structural validity used factor analysis, exploratory (EFA) and confirmatory (CFA), plus Rasch analysis. Criterion validity used Spearman's correlation coefficient (r) between the SFI-10 and criteria (PSFS, G-NRS and P-PRS) scores, and construct validity (n = 91, known-groups independent t-test). Internal consistency used Cronbach's alpha (α) and floor/ceiling effects were determined. Subgroups determined reliability (n = 104, intraclass correlation coefficient, ICC2.1); error (n = 171) through the standard error of measurement (SEM) and minimum detectable change (MDC90). Responsiveness (n = 171) was calculated using effect-size (ES), standard response mean (SRM), and area under the curve (AUC); and interpretability through the minimal clinically important difference (MCID). Practicality (n = 16) clarified missing responses, readability, and time/errors for completion/scoring. Results The SFI-10’s structural validity was unequivocally one-dimensional from EFA and verified by CFA with acceptable fit-indices (chi-square/df = 2.88, CFI = 0.981, TLI = 0.975, RMSEA = 0.061), and supported by Rasch analysis (PSR = 0.79, Infit = 0.678–1.216, Outfit = 0.604–1.279, Item-difficulties = -1,215–2.488). Criterion validity varied from high (G-NRS, r = 0.60) and moderate (PSFS, r = 0.43) to low-inverse (P-NRS, r = -0.24). Internal consistency was strong (α = 0.84) and no floor/ceiling effects were present. Reliability was excellent (ICC2.1 = 0.97), responsiveness substantial (ES = 1.54; SRM = 1.64; AUC = 0.89), and measurement error robust (SEM = 3.84; MDC90 = 8.98%, MDIC = 10.4%), with construct validity confirmed (p < 0.001). Practicality showed no missing responses, completion/scoring errors < 1%, excellent readability (Grade = 5.1, Ease = 74.1%), short completion (39.2 ± 10.3 s) and scoring times (8.5 ± 1.8 s). Conclusions The SFI-10 demonstrates sound measurement properties in a general physiotherapy outpatient MSD spine population for both psychometric and practical characteristics. Further investigation in culturally diverse settings that include both inpatients and community settings with whole-spine and regional-spine criteria is required.
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spelling doaj-art-b9b1977dc20e47cbb2204db3ee9bf3162025-08-20T02:27:50ZengBMCBMC Musculoskeletal Disorders1471-24742025-04-0126111510.1186/s12891-025-08604-0A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measureHamid Reza Mokhtarinia0Antonio Cuesta-Vargas1Almir Vieira Dibai-Filho2Markus Melloh3Agnieszka Bejer4Department of Ergonomics, University of Social Welfare and Rehabilitation SciencesDepartment of Physiotherapy, Faculty of Health Science at the University of Malaga, IBIMAPostgraduate Program in Physical Education, Federal University of MaranhaoSchool of Health Sciences, Zurich University of Applied SciencesFaculty of Health Sciences and Psychology, Collegium Medicum, University of RzeszówAbstract Background To assess the 10-item Spine Functional Index (SFI-10) clinimetric properties in a general musculoskeletal disorder (MSD) spine population. Ascertain the psychometric characteristics’ consistency with the developmental study findings for structural and criterion validity, internal consistency, and floor/ceiling effect; establish the longitudinal characteristics for test–retest reliability, responsiveness, construct validity, and error scores; and clarify practical characteristics of readability, missing responses, and time/errors for completion/scoring related to administrative burden. Methods A longitudinal study of deidentified spine MSD patients (n = 1317, 53.4% female, age = 18-91yrs, av = 49.5 ± 16.4yrs; neck = 36.5%, mid-back = 8.4%, low back = 56.0%, multi-site = 0.3%) who completed the SFI-10, the Patient Specific Functional Scale (PSFS), and Numerical Rating Scales for Global-function (G-NRS) and Pain (P-NRS). Structural validity used factor analysis, exploratory (EFA) and confirmatory (CFA), plus Rasch analysis. Criterion validity used Spearman's correlation coefficient (r) between the SFI-10 and criteria (PSFS, G-NRS and P-PRS) scores, and construct validity (n = 91, known-groups independent t-test). Internal consistency used Cronbach's alpha (α) and floor/ceiling effects were determined. Subgroups determined reliability (n = 104, intraclass correlation coefficient, ICC2.1); error (n = 171) through the standard error of measurement (SEM) and minimum detectable change (MDC90). Responsiveness (n = 171) was calculated using effect-size (ES), standard response mean (SRM), and area under the curve (AUC); and interpretability through the minimal clinically important difference (MCID). Practicality (n = 16) clarified missing responses, readability, and time/errors for completion/scoring. Results The SFI-10’s structural validity was unequivocally one-dimensional from EFA and verified by CFA with acceptable fit-indices (chi-square/df = 2.88, CFI = 0.981, TLI = 0.975, RMSEA = 0.061), and supported by Rasch analysis (PSR = 0.79, Infit = 0.678–1.216, Outfit = 0.604–1.279, Item-difficulties = -1,215–2.488). Criterion validity varied from high (G-NRS, r = 0.60) and moderate (PSFS, r = 0.43) to low-inverse (P-NRS, r = -0.24). Internal consistency was strong (α = 0.84) and no floor/ceiling effects were present. Reliability was excellent (ICC2.1 = 0.97), responsiveness substantial (ES = 1.54; SRM = 1.64; AUC = 0.89), and measurement error robust (SEM = 3.84; MDC90 = 8.98%, MDIC = 10.4%), with construct validity confirmed (p < 0.001). Practicality showed no missing responses, completion/scoring errors < 1%, excellent readability (Grade = 5.1, Ease = 74.1%), short completion (39.2 ± 10.3 s) and scoring times (8.5 ± 1.8 s). Conclusions The SFI-10 demonstrates sound measurement properties in a general physiotherapy outpatient MSD spine population for both psychometric and practical characteristics. Further investigation in culturally diverse settings that include both inpatients and community settings with whole-spine and regional-spine criteria is required.https://doi.org/10.1186/s12891-025-08604-0SpineMusculoskeletalQuestionnairesPsychometricsPracticalitySFI- 10
spellingShingle Hamid Reza Mokhtarinia
Antonio Cuesta-Vargas
Almir Vieira Dibai-Filho
Markus Melloh
Agnieszka Bejer
A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure
BMC Musculoskeletal Disorders
Spine
Musculoskeletal
Questionnaires
Psychometrics
Practicality
SFI- 10
title A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure
title_full A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure
title_fullStr A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure
title_full_unstemmed A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure
title_short A shortened 10-item Spine Functional Index: clinimetric properties indicate a reliable, responsive and practical measure
title_sort shortened 10 item spine functional index clinimetric properties indicate a reliable responsive and practical measure
topic Spine
Musculoskeletal
Questionnaires
Psychometrics
Practicality
SFI- 10
url https://doi.org/10.1186/s12891-025-08604-0
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