Outpatient Therapy
Lindsey Carpenter SPT
Title:
Oswestry Disability Index
Link to the test: http://www.aadep.org/documents/filelibrary/presentations/pmd_evaluationmartin_and_pilley_aafp/Appendix_D__The_Oswestry_Disability_E42C3CC567278.pdf
Purpose:
The purpose of the Oswestry Disability Index is to capture information on patient perceived low back pain performing functional activities.
Acronym:
ODI
Description:
The Oswestry Disability Index is a survey that includes 10 components in which the patient must identify perceived pain performing the various activities. For each section, the answer the patient chooses correlates to a point value. The highest score is 50, which would mean the patient is 100% disabled.
ICF Domain:
Not available in the literature.
Time to administer:
The time to administer this test will depend on the amount of time that it takes the patient to read and answer the questions. However, this tool should take no longer than 10 minutes to complete.
Equipment Required:
Pens/Pencils and paper
Training Required: None
Actual Cost: Free
Populations Tested:
The target population for this outcome measurement tool is acute, subacute, and chronic back pain patients; various conservative, surgical, and behavioral intervention groups.1
Standard Error of Measurement:
Not available in the literature.
Minimal Detectable Change:
A study performed on Italian subjects with subacute or chronic low back pain to assess differences in the ODI and Roland Morris Disability Questionnaire resulted in a minimal detectable change of 13.67.2 Davidson and Keating also performed a comparison of several low back pain questionnaires and concluded that the minimal detective change is 10.5 with a 90% confidence interval.3
Sensitivity:
The literature review did not reveal sensitivity of the standard ODI. However, the sensitivity of the Italian adapted ODI was 76% with a cutoff point of 9.5.2
Specificity:
The literature review did not reveal sensitivity of the standard ODI. However, the specificity of the Italian adapted ODI was 63% with a cutoff point of 9.5.2
Effect Size:
The total effect size for chronic and subacute low back pain patients is .53.2 Firsh et al gave an effect size of .65.1
Minimally Clinically Important Difference:
A 10 point difference should be noted in order to be a clinically important difference.4
Cut-Off Scores:
The cutoff scores for the Oswestry Disability Index are described by Fairbank and Pynsent as follows5:
ODI Scoring:
0% to 20% (minimal disability): Patients can cope with most activities of daily living. No treatment may be indicated except for suggestions on lifting, posture, physical fitness and diet. Patients with sedentary occupations (ex. secretaries) may experience more problems than others.
21%-40% (moderate disability): Patients may experience more pain and problems with sitting, lifting and standing. Travel and social life are more difficult. Patients may be off work. Personal care, sleeping and sexual activity may not be grossly affected. Conservative treatment may be sufficient.
41%-60% (severe disability): Pain is a primary problem for these patients, but they may also be experiencing significant problems in travel, personal care, social life, sexual activity and sleep. A detailed evaluation is appropriate.
61%-80% (crippled): Back pain has an impact on all aspects of daily living and work. Active treatment is required.
81%-100%: These patients may be bed bound or exaggerating their symptoms. Careful evaluation is recommended.
Normative Data:
Not available in the literature
Test-Retest Reliability:
In an original study, low back pain patients were tested twice at a 24 hour interval and yielded r=.99.5 If the test interval is extended to 4 days, the correlation of scores decreased to r=.99.5
Interrater/Intrarater Reliability:
Not available in the literature.
Construct Validity:
Not available in the literature.
Content Validity:
Not available in the literature.
Face Validity:
Not available in the literature.
Floor/Ceiling Effects:
Not available in the literature.
References
1.Firsh E, Brooks D, Stafford P, Mayo N. Physical Rehabilitation Outcome Measures. Second ed. Hamilton, ON:BC Decker Inc;2002:186-187.
2.Monticone M, Baiardi P, Vanti C, et al. Responsiveness of the oswestry disability index and the roland morris disability questionnaire in italian subjects with sub-acute and chronic low back pain. Eur Spine J. 2012;21(1):122-129.
3. Davidson M, Keating JL. A comparison of five low back disability questionnaires: Reliability and responsiveness. Phys Ther. 2002;82(1):8-24.
4. Ostelo RWJG, de Vet HCW. Clinically important outcomes in low back pain. Best Practice & Research Clinical Rheumatology. 2005;19(4):593-607.
5. Fairbank JC, Pynsent PB, The Oswestry Disability Index. Spine 2000; 25(22):2940-2952.
Home Care Setting
Joseph Ventress SPT
Title:
Patient Specific Functional Scale
(RMDQ)
Link to the test:
http://www.tac.vic.gov.au/media/upload/patient-specific.pdf
Purpose:
Patient Specific Functional Scale is a modifiable tool used to assess functional ability to complete specific activities. The test has the patient rate an activity on an 11 point scale.
• 0= unable to perform
• 10= able to perform and prior level.
In order to tailor the test to changing and maintaining positions, activities should be selected that require these abilities. Example: roll in bed, stand at sink, etc. The patient must also relate the limitation to a cause. Example: I have trouble standing at the sink because my back gets fatigued.
Acronym:
PSFS
Description:
Used to assess functional ability to complete specific activities
ICF Domain:
Activity: Participation
Time to administer:
Less than 4 minutes
Equipment Required:
None
Training Required:
None
Actual Cost:
Free
Populations Tested:
Compression fracture secondary to osteoporosis
Standard Error of Measurement:
Not available in the literature.
Minimal Detectable Change:
For limitations caused by low back pain
MDC = 1.4 points
(Maughan and Lewis, 2010)
Sensitivity:
Not available in the literature.
Specificity:
Not available in the literature.
Effect Size:
Not available in the literature.
Minimally Clinically Important Difference:
For limitations caused by low back pain
MDC = 1.4 points
(Maughan and Lewis, 2010)
Cut-Off Scores:
Used to assess functional ability to complete specific activities
Normative Data:
Not available in the literature.
Test-Retest Reliability:
Lower Back Pain: (Maughan and Lewis, 2010)
· Excellent interrater reliability (ICC = 0.92)
Interrater/Intrarater Reliability:
Not available in the literature.
Construct Validity:
A comparison of correlation coefficients determined good convergent validity of the Patient Specific Functional Scale (PSFS) with Global Rating of Change Scale (GRC), better than with the generic 36-item Short Form Health Survey (36-SF), possibly because both PSFS and GRC ask patients to self-identify areas of disability while a more generic measure would include items not relevant to the patient (Chatman et al, 1997).
Content Validity:
Not available in the literature.
Face Validity:
Not available in the literature.
Floor/Ceiling Effects:
Not available in the literature.
References
1. Chatman, A. B., Hyams, S. P., et al. (1997). "The Patient-Specific Functional Scale: measurement properties in patients with knee dysfunction." Physical Therapy 77(8): 820-829.
2. Hammer, A., Nilsagard, Y., et al. (2005). "Evaluation of therapeutic riding (Sweden)/hippotherapy (United States). A single-subject experimental design study replicated in eleven patients with multiple sclerosis." Physiother Theory Pract 21(1): 51-77.
3. Maughan, E. F. and Lewis, J. S. (2010). "Outcome measures in chronic low back pain." European Spine Journal 19(9): 1484-1494.
4. Resnik, L. and Borgia, M. (2011). "Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error." Physical Therapy 91(4): 555-565.
5. Stratford, P. (1995). "Assessing disability and change on individual patients: a report of a patient specific measure." Physiotherapy Canada 47(4): 258-263.
6. Westaway, M. D., Stratford, P. W., et al. (1998). "The patient-specific functional scale: validation of its use in persons with neck dysfunction." Journal of Orthopaedic and Sports Physical Therapy 27(5): 331-338.
