Abstract
BackgroundLow back pain (LBP) is a common musculoskeletal problem, associated with disability and high societal costs. The Oswestry Disability Index (ODI) is among the most commonly used patient reported outcome measures to measure disability due to LBP. Evidence supporting the reliability and validity of the Nepali Version of Oswestry Disability Index (NODI) exists, but its responsiveness is yet to be assessed.ObjectiveWe aimed to assess the responsiveness of NODI in participants with non-specific low back pain.MethodsThe study included 102 (Male 41, Female 61) participants with non-specific low back pain, attending the physiotherapy outpatient department of a tertiary care hospital and nearby community. The NODI was administered to the patients at baseline and again 2 weeks later along with a 7-item Nepali Version of Global Rating of Change (GROC-NP). Responsiveness of NODI was assessed by plotting Receivers Operating Characteristics (ROC) curve.ResultsThe area under curve (AUC) of NODI was 0.88. The best cut-off point on the NODI for improvement on the GROC-NP or the minimal clinical important change (MIC) was 4.22 and ranged from 3.11 to 6.34. The sensitivity and specificity was 77.4% and 84.2% respectively.ConclusionNODI is a responsive scale which can discriminate between participants whose level of disability due to LBP is stable or improving. The result for minimal clinically important change, sensitivity and specificity are consistent with other cross culturally adopted versions.
Highlights
Low back pain (LBP) is a common musculoskeletal problem, associated with disability and high societal costs
Nepali Version of Oswestry Disability Index (NODI) is a responsive scale which can discriminate between participants whose level of disability due to LBP is stable or improving
We considered that the Area under minimal clinical important change (MIC) Minimum Important Change (Curve) (AUC) of 0.70 or more as acceptable for the ability of NODI to differentiate between the groups that improved [13]
Summary
Low back pain (LBP) is a common musculoskeletal problem, associated with disability and high societal costs. Low back pain (LBP) is the most common musculoskeletal pain leading to high treatment costs, absence from work and individual suffering [1]. The test is considered the ‘gold standard’ among low back functional outcome tools [9] It is a self-administered questionnaire, comprising ten items assessing the extent of the patient’s back pain and their ability to carry out nine different activities of daily living. It has been translated and cross-culturally adapted into multiple languages [10] including the Nepali version (NODI) [11].
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