Last Revised 3/20/18

Authors: Kate Jordan, Brandi Preston, Aqela Rahman

Rehabilitation Measures Database: Measure Summary

TITLE OF ASSESSMENT Bad Sobernheim Stress Questionnaire - Deformity

YEAR PUBLISHED 2005 (Germany)

LAST UPDATED Unknown

ACRONYM BSSQ-Deformity

AREA OF ASSESSMENT ● Quality of Life

● Life Participation
● Stress & Coping

PURPOSE To measure the effect of spine deformity on mood, acceptance, and

interactions with environment, and as a result, the effect of experienced
stress.

LINK TO INSTRUMENT Unavailable

INSTRUMENT IN PDF Unavailable

FORMAT

ASSESSMENT TYPE Patient Reported Outcomes Measure

KEY DESCRIPTION ● 8 questions answered by patient

● Each question is marked on a four-point scale and scored 0-3
● 0–8 = strong stress, 9–16 = moderate stress, 17–24 = little
stress (minimum score = 0, maximum score = 24)
● Created in Germany; no English adaptation or validation

TIME TO ADMINISTER 2 minutes

NUMBER OF ITEMS 8 questions

EQUIPMENT REQUIRED Questionnaire form, writing utensil

REQUIRED TRAINING Unknown

 Last Revised 3/20/18
Authors: Kate Jordan, Brandi Preston, Aqela Rahman

AGE RANGE Child: 6 – 12 Years

Adolescent: 13 – 17 Years
Adult: 18 – 64 Years

INSTRUMENT Kate Jordan, OTS, UIC

REVIEWER(S) Brandi Preston, OTS, UIC
Aqela Rahman, OTS, UIC

BODY PART Not applicable

ICF DOMAIN Participation

DOMAIN Emotion

COST Unknown

ACTUAL COST Unknown

COST DESCRIPTION N/A

ADMINISTRATION MODE Unknown

CONSIDERATIONS ● Quick and easy to administer

● Patient self report

PROFESSIONAL None
ASSOCIATION
RECOMMENDATIONS

BIBLIOGRAPHY Kotwicki, T., Kinel, E., Stryla, W., & Szulc, A. (2007). Estimation of the
stress related to conservative scoliosis therapy: an analysis based on
BSSQ questionnaires. Scoliosis Journal, 2(1).
https://doi.org/10.1186/1748-7161-2-1

Misterska, E., Głowacki, M., & Harasymczuk, J. (2009). Polish

adaptation of Bad Sobernheim Stress Questionnaire-Brace and Bad
 Last Revised 3/20/18
Authors: Kate Jordan, Brandi Preston, Aqela Rahman

Sobernheim Stress Questionnaire-Deformity. European Spine Journal,

18(12), 1911. https://doi.org/10.1007/s00586-009-1126-2

Xu, X., Wang, F., Yang, M., Huang, Q., Chang, Y., Wei, X., … Li, M.
(2015). Chinese Adaptation of the Bad Sobernheim Stress
Questionnaire for Patients With Adolescent Idiopathic Scoliosis Under
Brace Treatment. Medicine, 94(31).
https://doi.org/10.1097/MD.0000000000001236

POPULATIONS Musculoskeletal Conditions

POPULATION # 1

POPULATION REFERENCE Adolescent Idiopathic Scoliosis (AIS)

STANDARD ERROR OF Adolescent Idiopathic Scoliosis: (Xu et al., 2015; n = 86; mean age =
MEASUREMENTS (SEM) 13.5 (1.5) years; wearing a brace >12 h/d for 3 months; mean Cobb
angle = 30.5 degrees; Chinese sample)
● SEM for entire group (n = 86): 1.007 (calculated from RMD
Statistics Calculator)

MINIMAL DETECTABLE Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

CHANGE (MDC) ● MDC for entire group (n = 86): 2.79 (calculated from RMD
Statistics Calculator)

MINIMALLY CLINICALLY Not reported in the literature.

IMPORTANT DIFFERENCE
(MCID)

CUT-OFF SCORES Not reported in the literature.

NORMATIVE DATA Not reported in the literature.

TEST-RETEST RELIABILITY Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

● Excellent test-retest reliability: (ICC = 0.85)
Adolescent Idiopathic Scoliosis: (Misterska et al., 2009; n = 35;
 Last Revised 3/20/18
Authors: Kate Jordan, Brandi Preston, Aqela Rahman

median age = 14.8 (1.5) years; wearing a brace 14.9 h/d for 16.1 mos;
median Cobb angle = 27.8 degrees; Polish sample)
● Excellent test-retest reliability: (ICC = 0.88)

INTERRATER/ Not reported in the literature.

INTRARATER RELIABILITY

INTERNAL CONSISTENCY Adolescent Idiopathic Scoliosis: (Xu et al., 2015)

● Excellent: Cronbach's alpha 0.85
Adolescent Idiopathic Scoliosis: (Misterska et al., 2009)
● Excellent: Cronbach’s alpha 0.87

*Scores higher than .9 may indicate redundancy in the scale questions.

CRITERION VALIDITY Not reported in the literature.

(PREDICTIVE/
CONCURRENT)
 Last Revised 3/20/18
Authors: Kate Jordan, Brandi Preston, Aqela Rahman

CONSTRUCT VALIDITY Convergent validity:

(CONVERGENT/ Adolescent Idiopathic Scoliosis: (Xu et al., 2015)
DISCRIMINANT) ● Adequate convergent validity of the BSSQ-Deformity with SRS-
22 (r = 0.48)
● Excellent convergent validity of the BSSQ-Deformity with
BSSQ-Brace (r = 0.79)
● Poor convergent validity of the BSSQ-Deformity with Pain (r =
0.29)
● Adequate convergent validity of the BSSQ-Deformity with
Mental Health (r = 0.32)
● Adequate convergent validity of the BSSQ - Deformity with Self
Image (r = 0.37)
● Adequate convergent validity of the BSSQ - Deformity with
Function Activity Level (r = 0.33)
● Adequate convergent validity of the BSSQ - Deformity with
Treatment Satisfaction (r = 0.34)

Adolescent Idiopathic Scoliosis: (Misterska et al, 2009)

● Poor convergent validity of the BSSQ-Deformity with Cobb
angle (r = -.096)
● Poor convergent validity of the BSSQ-Deformity with angle of
trunk rotation (r = -.063)
● Poor convergent validity of the BSSQ-Deformity with distance
from CSVL (r = -.331)
● Poor convergent validity of the BSSQ-Deformity with no. of
hours a day of brace wearing (r = .028)
● Poor convergent validity of the BSSQ-Deformity with duration of
brace wearing in months (r = .200)

Adolescent Idiopathic Scoliosis: (Kotwicki et al., 2007; n=111; mean

age = 14.2 (2.2) years; mean Cobb angle = 42.8 (17) degrees; mean
Bunnell angle = 11.4 (4.5) degrees; Polish sample)
● Adequate convergent validity of the BSSQ-Deformity with Cobb
angle (r = -0.34)
● Adequate convergent validity of the BSSQ-Deformity with
Bunnell primary curve rotation (r = -0.34)
● Adequate convergent validity of the BSSQ-Deformity with
Bunnell sum of rotation (r = -0.33)

Discriminant validity:
Adolescent Idiopathic Scoliosis (Xu et al., 2015)
● Excellent discriminant validity for Item 1 (r = 0.62)
● Excellent discriminant validity for Item 2 (r = 0.66)
● Adequate discriminant validity for Item 3 (r =0.59)
● Poor discriminant validity for Item 4 (r = 0.21)
● Excellent discriminant validity for Item 5 (r =0.66)
● Adequate discriminant validity for Item 6 (r =0.37)
● Adequate discriminant validity for Item 7 (r =0.50)
● Excellent discriminant validity for Item 8 (r =0.63)

BSSQ - Z skewness Corrected Item- Standard for

Deformity total Clinical Use
Correlation
 Last Revised 3/20/18
Authors: Kate Jordan, Brandi Preston, Aqela Rahman

Item 1 -0.26 0.62 excellent

Item 2 0.03 0.66 excellent

Item 3 -0.22 0.59 adequate

Item 4 -0.34 0.21 poor

Item 5 -0.24 0.66 excellent

Item 6 0.40 0.37 adequate

Item 7 0.18 0.50 adequate

Item 8 0.01 0.63 excellent

 Last Revised 3/20/18
Authors: Kate Jordan, Brandi Preston, Aqela Rahman

CONTENT VALIDITY Not reported in the literature.

FACE VALIDITY Not reported in the literature.

FLOOR/CEILING EFFECTS Adolescent Idiopathic Scoliosis: (Misterska et al., 2009)

● Adequate ceiling effect of 17.1% found for the first
administration of the BSSQ-Deformity
● Adequate ceiling effect of 11.4% found for the second
administration of the BSSQ-Deformity

RESPONSIVENESS Not reported in the literature.