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 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:

For example:

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
conservative means.
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[edit | edit source]

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. 

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

(See Resoruces Section for link to Online ODI Website)

Online Oswestry Disability Index Calculators in Multilanguages (English, Turkish, Greece, Tai, Japan..)

Facebook Group for Online Oswestry Disability Index

Evidence[edit | edit source]

Reliability[edit | edit source]

The ODI addresses a broader concept of disability than that directly related to pain intensity[2].

Validity[edit | edit source]

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

Responsiveness[edit | edit source]

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

Miscellaneous[edit | edit source]

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

Resources[edit | edit source]

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

More information on the use of the Oswestry Disability Index.

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

Fairbank J, Pynsent P. The Oswestry disablility index. Spine 2000;25:2490-53. (Version 2.0)[4]

Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25:3115-3124 (Version 2.1)[5]

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References[6][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. 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.
  3. Fairbank J, Davies J, Couper J, OBrien J (1980) The Oswestry low back pain disability questionnaire Physiotherapy 66, 8, 271-273
  4. Fairbank J, Pynsent P. The Oswestry disablility index. Spine 2000;25:2490-53.
  5. Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine 2000;25:3115-3124
  6. Davidson M & Keating J (2001) A comparison of five low back disability questionnaires: reliability and responsiveness. Physical Therapy 2002;82:8-24.