Copenhagen Neck Functional Disability Scale (CNFDS)
- Fysiobasen
- 26. nov.
- 3 min lesing
The Copenhagen Neck Functional Disability Scale (CNFDS) is a self-administered questionnaire developed to measure functional limitations in patients with neck pain. The scale was created by Jordan et al. in 1998 and is partly based on the Neck Disability Index (NDI) and the Low Back Pain Rating Scale¹.
Target Group
CNFDS was designed to improve the generalizability of the Neck Disability Index in European populations⁷. It is used for patients with:
Chronic neck pain
Cervical disc herniation
Mechanical neck pain
Patients undergoing physiotherapy³
The test has been validated for patients aged 20 to 75 years⁷.
Method
The scale consists of 15 questions, with three possible answers:
“Yes,” “Sometimes,” or “No.”
Scoring is structured as follows:
Items 1–5: “Yes” = good function
Items 6–15: “No” = good function
Point allocation:
0 points = good function
1 point = moderate function
2 points = poor function
Total score:
0 = no neck disability
30 = maximum functional disability³
Scores can be compared as raw scores or expressed as percentage change from baseline³.
Validity and Reliability
Reliability
Test–retest reliability:
Same day: Pearson r = 0.99
Two days later: Pearson r = 0.98
Internal consistency: Cronbach’s α = 0.90, indicating excellent reliability³,⁷.
Validity
Construct validity: Measures functional limitations due to neck pain³.
Comparison with patient self-rating: Spearman r = 0.89 (high)³.
Comparison with physician rating: Spearman r = 0.56 (moderate)³,⁷.
Correlation with VAS pain scores:
CNFDS and current pain: r = 0.45
CNFDS and worst pain: r = 0.37
CNFDS and average pain: r = 0.19⁸.
Responsiveness
Responsiveness to the NDI, Northwick Park Pain Questionnaire, and Neck Pain and Disability Scale is nearly identical (SRM = 0.89, p < 0.01)⁴.
Correlation with pain scores over time:
6 weeks: r = 0.49, p < 0.0001
4 months: r = 0.48, p < 0.0001
12 months: r = 0.54, p < 0.0001³,⁷,⁹.
Other Factors
No floor or ceiling effects observed⁶,⁵.
No gender or age differences in scoring³.
No established minimal clinically important difference (MCID) reported⁷.
Conclusion
The CNFDS is a reliable and validated tool for assessing functional disability in patients with neck pain. It is simple to administer, takes about 10 minutes, and can be delivered via paper, mail, or telephone. The questionnaire demonstrates high test–retest reliability and strong agreement with patients’ self-perceived disability.
Kilder:
FEJER, R., JORDAN, A. & HARTVIGSEN, J. 2005. Categorising the severity of neck pain: establishment of cut-points for use in clinical and epidemiological research. Pain, 119, 176-82.
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JORDAN, A., MANNICHE, C., MOSDAL, C. & HINDSBERGER, C. 1998. The Copenhagen Neck Functional Disability Scale: a study of reliability and validity. J Manipulative Physiol Ther, 21, 520-7.
KOSE, G., HEPGULER, S., ATAMAZ, F. & ODER, G. 2007. A comparison of four disability scales for Turkish patients with neck pain. J Rehabil Med, 39, 358-62.
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MISTERSKA, E., JANKOWSKI, R. & GLOWACKI, M. 2011. Cross-cultural adaptation of the Neck Disability Index and Copenhagen Neck Functional Disability Scale for patients with neck pain due to degenerative and discopathic disorders. Psychometric properties of the Polish versions. BMC Musculoskelet Disord, 12, 84. .
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FERREIRA, M. L., BORGES, B. M., REZENDE, I. L., CARVALHO, L. P., SOARES, L. P., DABES, R. A., CARVALHO, G., DRUMMOND, A. S., MACHADO, G. C. & FERREIRA, P. H. 2010. Are neck pain scales and questionnaires compatible with the international classification of functioning, disability and health? A systematic review. Disabil Rehabil, 32, 1539-46.
