Oswestry Disability Index

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Oswestry Disability Index
Purposeused to qualify low back pain

The Oswestry Disability Index (ODI) is an index derived from the Oswestry Low Back Pain Questionnaire used by clinicians and researchers to quantify disability for low back pain and quality of life.

This validated questionnaire was first published by Jeremy Fairbank et al. in Physiotherapy in 1980.[1] The current version was published in the journal Spine in 2000.[2][3] Four versions of the ODI are available in English and nine in other languages. Some published versions contain misprints, and many omit the scoring system.[4] It is unclear, however, if these adapted versions of the ODI are as credible as the original ODI developed for English-speaking nations.[5]

The self-completed questionnaire contains ten topics concerning intensity of pain, lifting, ability to care for oneself, ability to walk, ability to sit, sexual function, ability to stand, social life, sleep quality, and ability to travel.[2] Each topic category is followed by 6 statements describing different potential scenarios in the patient's life relating to the topic. The patient then checks the statement which most closely resembles their situation. Each question is scored on a scale of 0–5 with the first statement being zero and indicating the least amount of disability and the last statement is scored 5 indicating most severe disability.[2] The scores for all questions answered are summed, then multiplied by two to obtain the index (range 0 to 100). Zero is equated with no disability and 100 is the maximum disability possible.[2]

Scoring

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  • 0% –20%: Minimal disability
  • 21%–40%: Moderate Disability
  • 41%–60%: Severe Disability
  • 61%–80%: Crippling back pain
  • 81%–100%: These patients are either bed-bound or have an exaggeration of their symptoms.[2]

Recommendations for the minimal clinically important difference (MCID)

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Copay calculated the minimal clinically important difference (MCID) to be 12.8[6]. Davidson recommends an MCID of 10.5 or 15[7].

Fritz calculated a value for the MCID of 6.[8]

Vianin's literature review finds the range of MCIDs proposed is 4 to 10.5.[9]

References

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  1. ^ Fairbank JC, Couper J, Davies JB. The Oswestry Low Back Pain Questionnaire. Physiotherapy 1980; 66: 271-273.
  2. ^ a b c d e Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine 2000 Nov 15;25(22):2940-52
  3. ^ National Council for Osteopathic Research http://www.ncor.org.uk/wp-content/uploads/2012/12/Oswestry-Disability-questionnairev2.pdf Archived 2022-10-06 at the Wayback Machine
  4. ^ Fairbank, J. C.; Pynsent, P. B. (2000-11-15). "The Oswestry Disability Index". Spine. 25 (22): 2940–2952, discussion 2952. doi:10.1097/00007632-200011150-00017. ISSN 0362-2436. PMID 11074683.
  5. ^ Sheahan, Peter J.; Nelson-Wong, Erika J.; Fischer, Steven L. (2015). "A review of culturally adapted versions of the Oswestry Disability Index: the adaptation process, construct validity, test-retest reliability and internal consistency". Disability and Rehabilitation. 37 (25): 2367–2374. doi:10.3109/09638288.2015.1019647. ISSN 1464-5165. PMID 25738913.
  6. ^ Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY (2008). "Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales". Spine J. 8 (6): 968–74. doi:10.1016/j.spinee.2007.11.006. PMID 18201937.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ^ Davidson M, Keating JL (2002). "A comparison of five low back disability questionnaires: reliability and responsiveness". Phys Ther. 82 (1): 8–24. doi:10.1093/ptj/82.1.8. PMID 11784274.
  8. ^ Fritz, J. M.; Irrgang, J. J. (2001). "A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale" (PDF). Physical Therapy. 81 (2): 776–788. doi:10.1093/ptj/81.2.776. ISSN 0031-9023. PMID 11175676. Retrieved 2025-08-19.
  9. ^ Vianin M (2008). "Psychometric properties and clinical usefulness of the Oswestry Disability Index". J Chiropr Med. 7 (4): 161–3. doi:10.1016/j.jcm.2008.07.001. PMC 2697602. PMID 19646379.
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