Oswestry Disability Index
Original Editor - Rachael Lowe
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.
Method of Use
Questionnaire examines perceived level of disability in 10 everyday activities of daily living.
The 6 statements are scored from 0 to 5 with the first statement scoring 0 through to the last at 5, e.g.,
Section 1 - Pain intensity
• I have no pain at the moment. Score = 0
• The pain is very mild at the moment. Score = 1
• The pain is moderate at the moment. Score = 2
• The pain is fairly severe at the moment. Score = 3
• The pain is very severe at the moment. Score = 4
• The pain is the worst imaginable at the moment. Score = 5
If more than one box is marked in each section, take the highest score.
The ODI score (index) is calculated as:
If all 10 sections are completed the score is calculated as follows:
if 16 (total scored) out of 50 (total possible score) x 100 = 32%
If one section is missed (or not applicable) the score is calculated:
If 16 (total scored) / 45 (total possible score) x 100 = 35.5%
Rounding the percentage to a whole number for convenience is suggested.
Interpretation of Scores
|0% to 20%: minimal disability:||The patient can cope with most living activities. Usually no treatment is indicated apart from advice on lifting sitting and exercise.|
|21%-40%: moderate disability:|| The patient experiences more pain and difficulty with sitting, lifting and|
standing. Travel and social life are more difficult and they may be
disabled from work. Personal care, sexual activity and sleeping are not
grossly affected and the patient can usually be managed by
|41%-60%: severe disability|| Pain remains the main problem in this group but activities of daily|
living are affected. These patients require a detailed investigation.
|61%-80%: crippled:|| Back pain impinges on all aspects of the patient's life. Positive|
intervention is required.
|81%-100%:||These patients are either bed-bound or exaggerating their symptoms.|
From Paper Based to Electronic Patient Record Systems
Conventionaly ODI is applied as paper based forms. By development of internet tecnologies, online calculator tools for ODI become popular. Electronic patient record (EPR) systems are specialised databases for manegement on patient's healt records. By the integration of EPR and outcome measure databeses distance patient assesment can be possible.
(See Resoruces Section for link to Online ODI Website)
The ODI addresses a broader concept of disability than that directly related to pain intensity.
Fisher K, Johnston M (1997) Validation of the ODQ, 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, 67-80
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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)
Fairbank J, Pynsent P. The Oswestry disablility index. Spine 2000;25:2490-53. (Version 2.0)
Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25:3115-3124 (Version 2.1)
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- 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)
- 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.
- Fairbank J, Davies J, Couper J, OBrien J (1980) The Oswestry low back pain disability questionnaire Physiotherapy 66, 8, 271-273
- Fairbank J, Pynsent P. The Oswestry disablility index. Spine 2000;25:2490-53.
- Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25:3115-3124
- Davidson M & Keating J (2001) A comparison of five low back disability questionnaires: reliability and responsiveness. Physical Therapy 2002;82:8-24.