Neurogenic Bowel Dysfunction Score (NBD)

Download Clinical Summary PDF

Tool Description:

The NBD is a self-report questionnaire designed to help healthcare professionals evaluate the effectiveness of their patient's current bowel management routine by assessing the impact it has on the patient's quality of life.
Questions ask about background parameters (n=8), faecal incontinence (n=10), constipation (n=10), obstructed defecation (n=8), and impact on quality of life (QOL).


Available for free here:

ICF Domain:

Body Functions; Subcategory: Digestive, Metabolic, and Endocrine

Number of Items:

10 items

Brief Instructions for Administration and Scoring:

Total score: out of 47 (each item has a weighted response base)

  • Severity of bowel dysfunction:
    • Score 0-6: Very minor
    • Score 7-9: Minor
    • Score 10-13: Moderate
    • Score 14+: Severe


MCID: not established for SCI
SEM: not established for SCI

  • Bowel subjects: 15.18 (SD ± 5.77)
  • Control subjects: 4.68 (SD ± 2.98)



Measurement Property Summary:

# of studies reporting psychometric properties: 3


  • Test-retest reliability of the NBD is High for each question (r=1.00)
  • Internal consistency of the NBD is High (α = 0.547)
  • The consistency of frequency distribution of the NBD is High (r=1.00)

[Erdem et al. 2017]


  • There is High Spearman’s rank-order correlation for construct validity (rs = 0.943), the total NBD score & SF-36 vitality subscale (r = -0.626), the total NBD score & SF-36 social role functioning subscale (r = -0.741), the total NBD score & SF-36 emotional role functioning subscale (r = -0.604), and the change in total NBD score and change in Global Rating of Change scale at end of 2 months (r = 0.821)
  • There is Low Correlation between total NBD score & SF-36 bodily pain subscale (r = -0.382), the total NBD score & SF-36 mental health subscale (r = -0.687)
  • There is Moderate Correlation between total NBD score & SF-36 general health subscale (r = -0.560)

[Kelly et al. 2017, Erdem et al. 2017]


Not established in SCI.

Floor/ceiling effect:

Not established in SCI.


Dr. Bill Miller, Marzena Zhou, Risa Fox

Date Last Updated:

August 3, 2020

Download the measure

Download Worksheet:





Equipment Needed

Krogh K1, Christensen P, Sabroe S, Laurberg S. Neurogenic bowel dysfunction score. Spinal Cord. 2006;44(10):625-31.

Erdem D, Hava D, Keskinoğlu P, Bircan Ç, Peker Ö, Krogh K, Gülbahar S. Reliability, validity and sensitivity to change of neurogenic bowel dysfunction score in patients with spinal cord injury. Spinal Cord. 2017;55(12):1084-1087.

Kelly MS, Thibadeau J, Struwe S, Ramen L, Ouyang L, Routh J. Evaluation of spina bifida transitional care practices in the United States. J Pediatr Rehabil Med. 2017;10(3-4):275-281.