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Rehab Measures: Back Pain Functional Scale

Link to instrument

Back Pain Functional Scale 

Title of Assessment

Back Pain Functional Scale 



Instrument Reviewer(s)

Initially reviewed by Jill Smiley, MPH and the Rehabilitation Measurse Team in August 2013.

Summary Date



To evaluate functional ability in people with back pain.


The BPFS is a self-report measure that evaluates a patient's functional status related to back pain.  Items were pulled from already existing instruments, such as SIP, OLBPD, QBPD, Dallas pain questionnaire(DPQ), RMQ, MOS-36,and PSFS, and interviews with physical therapists. (Longo et al, 2010)

The BPFS consists of 12 items:

  1. Usual work, housework, or school activities
  2. Usual hobbies, recreational, or sporting activities
  3. Performance of heavy activities around your home
  4. Bending or stooping
  5. Putting on your shoes or socks (or stockings or pantyhose)
  6. Lifting a box of groceries from the floor
  7. Sleeping
  8. Standing for 1 hour
  9. Walking 1 mile
  10. Going up or down 2 flights of stairs (about 20 steps)
  11. Sitting for 1 hour
  12. Driving for 1 hour

Unable to perform activity
Extreme difficulty
Quite a bit of difficulty
Moderate difficulty
A little bit of difficulty
No difficulty

Total Score = Sum of points from all 12 measures

Adjusted Total Score = Total Score / 60


  • Minimum Score:  0
  • Maximum Score: 60
  • Maximum Adjusted Score: 1 (100%)
  • The higher the score the greater the patient's functional ability

Total Score (Adjusted)
0 (0%)
unable to perform any activity
60 (100%)
no difficulty in any activity


Area of Assessment

Functional Mobility; Pain 

Body Part


ICF Domain




Assessment Type

Patient Reported Outcomes 

Length of Test


Time to Administer

Number of Items


Equipment Required


Training Required


Type of training required




Actual Cost


Age Range


Administration Mode




Populations Tested

People with back pain

Standard Error of Measurement (SEM)

Back Pain:
(Stratford et al, 2000; n = 77 patients with low back pain who were referred by physicians to 10 outpatient physical therapy clinics located in Canada and the United States; sex = 47 females and 30 males; median age = 44 years; mean duration of symptoms associated with the current episode of back pain was 4.5 weeks, Back Pain)
  • SEM = 6.5% (95% CI: 5.2, 8.8)

Minimal Detectable Change (MDC)

Back Pain:
(Stratford and Binkley, 2000; n = 153 patients with low back pain attending physical therapy; 11 Canadian clinics and 8 American clinics participated in the study, Back Pain)
  • MDC = 22.2%

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability

Back Pain:
(Stratford et al, 2000, Back Pain)
  • Excellent test-retest reliability (ICC = 0.88 (95% CI: 0.77, 0.94))
(Stratford and Binkley, 2000, Back Pain)
  • Excellent test-retest reliability (ICC = 0.82)

Interrater/Intrarater Reliability

Not Established

Internal Consistency

Back Pain:
(Stratford et al, 2000, Back Pain)
  • Excellent internal consistency (ICC = 0.93 (95% CI: 0.90 - 0.96))
(Stratford and Binkley, 2000, Back Pain)
  • Excellent internal consistency (ICC = 0.93)

Criterion Validity (Predictive/Concurrent)

Not Established

Construct Validity (Convergent/Discriminant)

Not Established

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Back Pain:
(Stratford and Binkley, 2000, Back Pain)
  • There was a ceiling effect for three patients' scores


Not Established

Professional Association Recommendations


Do you see an error or have a suggestion for this instrument summary? Please e-mail us!


Longo, U. G., Loppini, M., et al. (2010). "Rating scales for low back pain." British medical bulletin 94(1): 81-144.

Stratford, P. W. and Binkley, J. M. (2000). "A comparison study of the back pain functional scale and Roland Morris Questionnaire. North American Orthopaedic Rehabilitation Research Network." J Rheumatol 27(8): 1928-1936. Find it on PubMed

Stratford, P. W., Binkley, J. M., et al. (2000). "Development and initial validation of the back pain functional scale." Spine 25(16): 2095-2102.

Year published


Instrument in PDF Format

Approval Status Approved 
Created at 8/9/2013 12:51 PM  by Jason Raad 
Last modified at 12/11/2013 12:46 PM  by Jason Raad