• 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).

ICF Domain

Body Functions ▶ Digestive, Metabolic, and Endocrine.

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.

Equipment

None.

Number of Items

10 items.

Languages

English, Spanish, and Dutch.

Training

None.

Availability

Can be found here.

# of studies reporting psychometric properties: 3

Interpretability

MCID: not established in SCI.
SEM: not established in SCI.
MDC: Bowel subjects: 15.18 (SD ± 5.77), and Control subjects: 4.68 (SD ± 2.98).

(Kelly et al. 2017)

Reliability

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

(Erdem et al. 2017)

Validity

  • 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)

Responsiveness

No values were reported for the responsiveness of the NBD for the SCI population.

Floor/ceiling effect

No values were reported for the presence of floor/ceiling effects in the NBD for the SCI population.

Reviewers

Dr. Bill Miller, Marzena Zhou, Risa Fox.

Date Last Updated

3 August 2020.

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.
https://www.nature.com/articles/sc201782

Erdem D, Gülbahar S, Keskinoglu P. Response to “The neurogenic bowel dysfunction score in patients with spinal cord injury: methodological issues in reliability and validity”. Spinal Cord. 2018; 56:297-298.
https://pubmed.ncbi.nlm.nih.gov/29348689/

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.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896760/

Krogh K, Christensen P, Sabroe S, Laurberg S. Neurogenic bowel dysfunction score. Spinal Cord. 2006;  44, 625–631.
https://pubmed.ncbi.nlm.nih.gov/16344850/

Sabour S. The neurogenic bowel dysfunction score in patients with spinal cord injury: methodological issues in reliability and validity. Spinal Cord. 2018; 56:295–296
https://pubmed.ncbi.nlm.nih.gov/29348690/