Oswestry Disability Index

Original Editor - Rachael Lowe

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Objective[edit | edit source]

Patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in those rehabilitating from low back pain.

Oswestry Low Back Pain Disability Questionnaire

Intended Population[edit | edit source]

Acute or chronic low back pain.  Most effective for persistent severe disability while the Roland-Morris is better for mild to moderate disability[1]

Method of Use[edit | edit source]

Questionnaire examines percthe eived level of disability in 10 everyday activities of daily living.

  1. Pain intensity
  2. Personal care
  3. Lifting
  4. Walking
  5. Sitting
  6. Standing
  7. Sleeping
  8. Sex (if applicable)
  9. Social
  10. Travel

Each item consist of 6 statements which are scored from 0 to 5. With 0 indicating the least disability and 5 the greatest.

From Paper Based to Electronic Patient Record Systems[edit | edit source]

Conventionally ODI is applied as paper based forms. By development of internet technologies, online calculator tools for ODI become popular. Electronic patient record (EPR) systems are specialised databases for management on patient's health records. By the integration of EPR and outcome measure databases distance patient assessment can be possible. 

In 2007 Irmak and Ergun has developed experimental tool for integration of EPR and online assessment system for ODI and rolland Morris Questionnaire by using different programming languages and databases; PHP-Mysql, C# Javascript, and MS Access. Currently this system is available for online calculation and assessment for non registered users. For scientists a distance patient assessment interface is also available.

The ODI was originally developed in English but has now been translated into over 40 languages.

Evidence[edit | edit source]

Research has concluded that the ODI is a valid, reliable and responsive clinical tool when used to determine the level of function (disability) associated with low back pain.[2]

Reliability[edit | edit source]

The ODI addresses a broader concept of disability than that directly related to pain intensity[3]. Test-retest reliability has been shown to be high, a study by Fairbank et al[4] recorded values ranging from = 0.83 to 0.99 that can vary over a given period of time.

Validity[edit | edit source]

In a study 1997 by Fisher K, Johnston M it was concluded that the measure had good face validity, where patients found it relevant with none of them refusing to complete it. However, they found there were moderately clear relationships between reported ability on walking and sitting and the actual measured performance on these activities, although lifting was not as well validated[5].

In a more recent study by Vianin in 2008 the ODI construct validity was tested and it found that compared to other outcome measures that measure disability due to low back pain, the ODI was found to be consistent with them. This shows that the ODI is a valid measure of disability due to low back pain[2].

Responsiveness[edit | edit source]

In a study by Walsh et al did not find that there was a significant benefit of using condition-specific outcome measures. However, they did report that the ODI has been found to have a greater responsiveness when comparing the measurement of function over pain.[6]

Miscellaneous[edit | edit source]

Bolton JE, Fish RG (1997) Responsiveness of the Revised Oswestry Disability Questionnaire Eur J Chiropractic 45, 1, 9-14

Hudson-Cook N, Tomes-Nicholson K, Breen AA (1989) Revised Oswestry disability questionnaire In Roland MO, Jenner JR, eds (1989) Back pain: new approaches to rehabilitation and education New York NY Manchester University Press 187ñ204.

McDowell I, Newell C (1996) Measuring Health ñ a guide to rating scales and questionnaires Oxford University Press ISBN 0-19-510371-8.

Deyo RA, Andersson G, Bombardier C (1994) Outcomes measures for studying patients with low back pain Spine 19, 185, 2032S-2036S.

Beattie P, Maher C (1997) The role of functional status questionnaires for low back pain Australian Journal of Physiotherapy 43, 1, 29-38.

LeClaure R, Bher F et al (1997) A cross sectional study comparing the Oswestry and Roland Morris functional disability scales in two populations of patients with low back pain at different levels of severity Spine 22, 1, 68-71

Davidson M & Keating J (2001) A comparison of five low back disability questionnaires: reliability and↵responsiveness. Physical Therapy 2002;82:8-24.[7]

Resources[edit | edit source]

More information on the use of the Oswestry Disability Index.

Baker D, Pynsent PB, Fairbank JCT (1989) The Oswestry disability index revisited: its reliability, repeatability, and validity, and a comparison with St Thomas Disability Index. In Roland MO, Jenner JR eds (1989) Back Pain: new approaches to rehabilitation and education. New York, NY. Manchester University Press 174-186

Fairbank J, Couper J, Davies J, O'Brian J. The Oswestry low backpain questionnaire, Physiotherapy 1980;66:271-3. (Version 1.0)[4]

Fairbank J, Pynsent P. The Oswestry disablility index. Spine 2000;25:2490-53. (Version 2.0)[8]

Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25:3115-3124 (Version 2.1)[9]

References[edit | edit source]

  1. ↑ Davies, Claire C.1; Nitz, Arthur J. Psychometric properties of the Roland-Morris Disability Questionnaire compared to the Oswestry Disability Index: a systematic review. Physical Therapy Reviews, Volume 14, Number 6, December 2009 , pp. 399-408(10)
  2. ↑ 2.0 2.1 Vianin M. Psychometric properties and clinical usefulness of the Oswestry Disability Index. Journal of chiropractic medicine. 2008 Dec 1;7(4):161-3.
  3. ↑ Gronblad M, Hupli M et al (1989) Intercorrelation and test-retest reliability of the pain disability index and the Oswestry disability questionnaire and their correlation with pain intensity in low back pain patients The Clinical Journal of Pain 9, 189-195.
  4. ↑ 4.0 4.1 Fairbank J, Davies J, Couper J, OBrien J (1980) The Oswestry low back pain disability questionnaire Physiotherapy 66, 8, 271-273
  5. ↑ Fisher, K. and Johnston, M., 1997. Validation of the Oswestry low back pain disability questionnaire, its sensitivity as a measure of change following treatment and its relationship with other aspects of the chronic pain experience. Physiotherapy theory and practice, 13(1), pp.67-80.
  6. ↑ Walsh TL, Hanscom B, Lurie JD, Weinstein JN. Is a condition-specific instrument for patients with low back pain/leg symptoms really necessary?: the responsiveness of the Oswestry Disability Index, MODEMS, and the SF-36. Spine. 2003 Mar 15;28(6):607-15.
  7. ↑ Davidson M & Keating J (2001) A comparison of five low back disability questionnaires: reliability and responsiveness. Physical Therapy 2002;82:8-24.
  8. ↑ Fairbank J, Pynsent P. The Oswestry disablility index. Spine 2000;25:2490-53.
  9. ↑ Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25:3115-3124


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