Oswestry Disability Index Version Research Articles

Psychometric evaluation of the Oswestry Disability Index in patients with chronic low back pain: factor and Mokken analyses

BackgroundDisputes exist regarding the psychometric properties of the Oswestry Disability Index (ODI). The present study was to examine the reliability, validity, and dimensionality of a Chinese version of the ODI version 2.1 in a sample of 225 adult orthopedic outpatients with chronic low back pain [mean age (SD): 40.7 (11.4) years].MethodsWe conducted reliability analysis, exploratory bifactor analysis, confirmatory factor analysis, and Mokken scale analysis of the ODI. To validate the ODI, we used the Short-Form 36 questionnaire (SF-36) and visual analog scale (VAS).ResultsThe reliability, and discriminant and construct validities of the ODI was good. The fit statistics of the unidimensional model of the ODI were inadequate. The ODI was a weak Mokken scale (Hs = 0.31).ConclusionsThe ODI was a reliable and valid scale suitable for measurement of disability in patients with low back pain. But the ODI seemed to be multidimensional that was against the use of the raw score of the ODI as a measurement of disability.

Reliability and validity study of the Gujarati version of the Oswestry Disability Index 2.1a.

Among all musculoskeletal disorders back pain is the most common reason for functional limitation in working age. It is due to low back pain (LBP) that the ODI has become one of the principal outcome measures for evaluation of disability and has been widely used in research as well as in clinical practice. So far, validated Gujarati version of the ODI 2.1a has not been reported. To accomplish the translation and validation of the Oswestry Disability Index (ODI) version 2.1a into the Gujarati language. Cross-sectional study. The validation of the ODI-Gujarati was tested in 120 patients diagnosed with non-specific LBP, who were receiving physiotherapy at a clinic in Gujarat, India. Data was collected at on initial visit and after 48hours. During both visits, patients completed the Oswestry Disability Index-Gujarati (ODI-G), Roland-Morris Disability Questionnaire-Gujarati (RMDQ-G), and Visual Analogue Scale-Pain (VAS-P). Internal consistency was measured by Cronbach's alpha. The Gujarati version indicated high internal consistency (α= 0.96). Test-retest reliability was measured by intra-class correlation coefficient and it revealed very high correlation (ICC = 0.92). Construct validity was confirmed by strong correlation with RMDQ-G (r= 0.76), and concurrent validity indicated moderate correlation with VAS-P (r= 0.50). Factor analysis explained that the ODI was loaded on 1 factor. The Oswestry disability index version 2.1a was successfully translated into Gujarati language, showing excellent psychometric properties. Therefore, it can be used in evaluating the disability amongst Gujarati population with LBP for both clinical and research purposes.

The Usefulness of Selective Nerve Root Block for Failed Back Surgery Syndrome

Purpose: To retrospectively evaluate the improvement of symptoms and diagnosis using selective nerve root block (SNRB) for radiating pain after spine surgery. Materials and Methods: From October 2012 to October 2013, 112 patients with failed back surgery syndrome (41 male and 71 female, with the mean age of 62.4 years and range of 35 to 78 years), who were admitted and underwent SNRB, were included. All patients were followed-up for more than 12 months. Three groups were classified: Group 1 included patients with no improvement or aggravation of symptoms, group 2 included those with improvement of radiating pain, and group 3 included those with recurrence of radiating. Results: Among the 112 patients, there were 15 patients in group 1, 59 patients in group 2, and 38 patients in group 3. Laminectomy was the highest surgical procedure, inducing failed back surgery syndrome. In group 2, the occurrence of failed back surgery syndrome was higher in case that radiating pain was complained more than 1 year before the first surgery. There is statistically significant symptom improvement in accordance with the visual analogue scale and Korean version of Oswestry disability index on every group after SNRB (p＜0.05). Conclusion: It is considered that SNRB is expected to improve the symptoms and to find the cause of symptoms as a diagnostic value even after spine surgery.

Reliability and validity of the Yoruba version of the Oswestry disability index

Low back pain (LBP) is a major cause of disability, and the Oswestry Disability Index (ODI) is a validated assessment tool for evaluating disability in LBP patients. Cross-cultural adaptation of the ODI is important because not all populations are proficient in English. The Yoruba language is an indigenous language spoken by 40 million people in the Western part of Nigeria and some countries in West Africa and Latin America. Currently, no validated Yoruba version of ODI is available. The aim of the study was to translate, culturally adapt and validate the ODI in Yoruba language for participants with LBP. The ODI was translated into Yoruba, and this translated version was analysed in terms of semantics and linguistics. Then, the Yoruba version was translated back into English and both versions administered to 160 participants with LBP. The internal consistency using Cronbach's alpha coefficient, criterion validity and test-retest reliability were assessed using Spearman's rank correlation with significance set at P< 0.05. The inter-rater reliability was evaluated by two different observers and the intra-rater reliability was determined by the same observer, a week apart. The internal consistency of the Yoruba ODI with Cronbach's alpha was 0.97, the intrarater reliability yielded an intraclass correlation coefficient of 0.93 and criterion validity assessed using Spearman's rank correlation was r = 0.92 for highest score and 0.63 for lowest score. The Yoruba ODI is a reliable and valid tool for assessing functional disability in LBP patients.

Effect of Kinesio Taping on Pain and Functional Disability in Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial.

A randomized controlled trial with 2-week Kinesio taping intervention. The aim of the study was to investigate the effectiveness of Kinesio taping application on pain, functional disability, and trunk flexion range of motion (ROM) in patients with chronic nonspecific low back pain (chronic NSLBP). Kinesio taping is a therapeutic tool used for treatment of chronic NSLBP. However, there is little scientific evidence that describes its clinical efficacy. Forty-four patients with chronic NSLBP were randomized into experimental group (n = 21) and placebo group (n = 23). The experimental group was treated with Erector Spinae Taping, whereas the placebo group was treated with placebo taping. The primary endpoint was pain intensity on visual analog scale. Secondary endpoints were functional disability on Arabic version of Oswestry disability index (ODI) and trunk flexion ROM on Modified Schober's test. All measurements were recorded at baseline (W0), after 2-week intervention (W2), and at 4-week (W4) follow-up. Both group were comparable at baseline (P > 0.05). The experimental group had a greater decrease in pain than the placebo group after W2 of intervention (mean between-group difference 2.05 cm, 95% confidence interval [CI] = 1.38-2.71 points). This was maintained to W4 follow-up (2.25 cm, 95% CI = 1.67-2.82 points). At W2, the experimental group had significantly greater improvement in disability, by 3.90 points (95% CI = 1.68-8.54 points). This effect was significant at W4 follow-up (5.6, 95% CI = 2.65-8.54 points). Similarly trunk flexion ROM was significantly better at W2 (-0.71 cm, 95% CI = -0.85 to -0.56) and W4 follow-up (-0.73 cm, 95% CI = -0.88 to -0.58). Kinesio taping reduces pain and disability and improves trunk flexion ROM after 2 weeks of application. However, thesis effects were very small to be considered clinically relevant and meaningful when compared with placebo taping. 2.

Development and analysis of validity and reliability of the Kannada version of Oswestry Disability Index

Study designCross-culture validation study. ObjectiveTo translate, culturally adapt and validate the Kannada version of Oswestry Disability Index (ODI-K), version 2.1(a). Summary of background dataThe Oswestry Disability Index (ODI) has become one of the principle outcome measurement tools and frequently used evaluating disability in patients with low back pain (LBP). Until now no psychometric properties of ODI-K was available. MethodsTranslation and cross-culture adaptation were performed according to the linguistic guideline, which included forward translation, back-translation, revision by committee, and pretesting. 120 LBP patients were included to evaluate psychometric properties. Test–retest reliability was performed by administering ODI-K twice in 24h interval. The validity was tested by comparing ODI-K with Kannada version of Roland–Morris Disability Questionnaire (RMDQ). ResultsThe results showed internal consistency in terms of Cronbach's α (0.99), which was excellent. Test–retest reliability was tested by using the ICC(2,1) (0.98), and it was found excellent. Constructs convergent validity was tested by comparing ODI-K with Kannada version of RMDQ which showed moderate (ρ=0.54, P<0.001) relationship. ConclusionODI-K is reliable and valid tool that can be used in patient oriented outcome studies for evaluating disability related to back pain among Kannada speaking population.

Regression Analysis of the Relationship Among the Level of Pain and Dysfunction and Psychosocial Factors in Patients With Chronic Back Pain

Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at . Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.

The Oswestry Disability Index (version 2.1a): validation of a Dutch language version.

A cross-sectional study on baseline data. To translate the Oswestry Disability Index (ODI) version 2.1a into the Dutch language and to validate its use in a cohort of patients with chronic low back pain in secondary spine care. Patient-reported outcome measures (PROMs) are commonly accepted to evaluate the outcome of spine interventions. Functional status is an important outcome in spine research. The ODI is a recommended condition-specific patient-reported outcome measure used to evaluate functional status in patients with back pain. As yet, no formal translated Dutch version exists. The ODI was translated according to established guidelines. The final version was built into the electronic web-based system in addition with the Roland Morris Disability Questionnaire, the numeric rating scale for pain severity, 36-Item Short Form Health Survey Questionnaire for quality of life, and the hospital anxiety and depression scale. Baseline data were used of 244 patients with chronic low back pain who participated in a combined physical and psychological program. Floor and ceiling effects, internal consistency, and the construct validity were evaluated using quality criteria. The mean ODI (standard deviation) was 39.6 (12.3); minimum 6, maximum 70. Most of the participants (88%) were moderately to severely disabled. Factor analysis determined a 1-factor structure (36% explained variance) and the homogeneity of ODI items is shown (Cronbach α = 0.79). The construct validity is supported as all (6:6) the a priori hypotheses were confirmed. Moreover, the ODI and Roland Morris Disability Questionnaire, showed a strong significant correlation (r = 0.68, P < 0.001) and an overlap: mean difference of -18 (95% limits of agreement: -44 to 8). The Dutch ODI version 2.1a is a valid and valuable tool for the measurement of functional status and disability among Dutch patients with chronic low back pain. This translated condition-specific patient-reported outcome measure version is recommended for use in future back pain research and to evaluate outcome of back care in the Netherlands.

English

Study Design: Methodological Study, translation Objective: To translate the original English version of Oswestry Disability Index Version-2.1a into Hindi language and to assess its content validity, Internal Consistency and Test-Retest reliability. Summary of Background Data: ODI has been validated, and used as an outcome measure for various Low Back Pain conditions and its Hindi version is not available. Methods: The translation was carried out in accordance with the Linguistic validation of a Patient Reported Outcomes Measure, provided by the Mapi institute. Content validity was evaluated through Qualitative (Wallace & McKenzie) and Quantitative methods (Lawshe). Internal Consistency and Test-retest Reliability was examined on 50 patients. Results: Internal consistency for Hindi ODI version 2.1a was excellent with Cronbach s alpha=0.947. The intraclass correlation coefficient of test–retest reliability was 0.900. Conclusion: The results of this study indicate that the Hindi version of the ODI 2.1a is a reliable and valid instrument for the measurement of disability in patients with low back pain.

Adjacent Intervertebral Disc Changes in Patients with Isobar Semirigid Dynamic Stabilization System

Introduction The reported incidence of adjacent segment degeneration (ASD) after lumbar fusion ranges from 8 to &gt; 100%, average 27%. Another literature review reported that 5.2 to 18.5% of patients required surgery for adjacent segment disease after lumbar fusion surgery. Posterior dynamic stabilization systems may prevent the development and progression of ASD after surgery. Hybrid dynamic stabilization with posterior spinal fusion, or “Topping-off surgery,” is applied in patients with preoperative adjacent segment degeneration. The objective of this approach is to protect the degenerative adjacent segment from progressing. Efficacy of this procedure is debated. The objective of this study was to evaluate intervertebral disk changes of the dynamically stabilized spine segment in patients receiving single-level intervertebral fusion and adjacent segment dynamic stabilization using the Isobar (Alphatec Spine, Inc.) semirigid dynamic stabilization system. Materials and Methods Twenty-seven patients with confirmed degenerative disk disease were enrolled in a retrospective study. Patients received single level intervertebral fusion and dynamic stabilization of the adjacent level using the Isobar semi-rigid dynamic stabilization system. Patient outcomes were evaluated by visual analogue scale for pain (VAS) and Chinese version of Oswestry Disability Index (ODI). Intervertebral space ratio (IVS) and range of motion (ROM) were measured on plain radiographs. MRI relative gray-scale values of the central bright area of discs were analyzed by Image J software. Results Of the 27 patients, 16 were male and 11 were female. Ages ranged from 31 to 65 years (average 47 years). Average duration of surgery was 213 (SD = 52) minutes and average blood loss was 225 mL (SD = 105). The average follow-up time was 27 months, ranging from 24 to 40 months. There was no significant change in relative gray-scale value of adjacent disc between preoperative and two year follow-up (23.98 ± 8.86 and 22.22 ± 6.25, respectively, p = 0.46). Relative gray-scale values of first cephalic adjacent disc were reduced at 2 years follow-up compared with baseline (28.63 ± 8.35 and 32.54 ± 10.75, respectively, p = 0.06). Significant difference was found in relative gray-scale value of second cephalic adjacent disc between baseline and 2-year follow-up (35.51 ± 8.15 and 29.29 ± 7.56, respectively, p &lt; 0.01). The inter-vertebral space (IVS) of index level was maintained after the surgery (Table 1). There was no statistical difference between the IVS before the surgery and final follow-up ( p = 0.33). The range of motion (ROM) of the adjacent level was reduced from 6.91 ± 3.14 preoperatively to 2.46 ± 1.03 degrees at the final follow-up ( p &lt; 0.05). There were no significant differences in the index level ROM among any of the follow-up times. VAS and ODI scores significantly improved preoperatively to final follow-up (VAS: 6.12 ± 0.80 and 1.65 ± 0.69, respectively, p = &lt; 0.01; ODI: 54.91 ± 10.96 and 14.61 ± 3.88, respectively, p = &lt;0.01). One patient received a debridement due to wound infection after operation, but the fixation system and interbody cage were not removed. This patient recovered well after the debridement. At the 2-year follow-up, one patient had two screw fractures at S1 level and another patient had two screws loosen. Conclusion Dynamic stabilization of the level adjacent to the fused level using the Isobar TTL Semi-rigid Spinal System seems to prevent progression of degenerative changes in the stabilized spine segment and is associated with favorable patient outcomes. Disclosure of Interest Q. Zhou: Conflict with Third Military Medical University, AO International R. Shi: None declared B. Kopjar: Conflict with AO Foundation, Smith &amp; Nephew, Cerapedics H. Wang: None declared D. Chen: None declared H. Li: None declared N. Di: None declared F. Luo: None declared F. Dai: None declared J. Xu: None declared

Long-term quality of life after en-bloc vertebrectomy: 25 patients followed up for 9 years

ObjectiveAssess quality-of-life results in patients who have undergone extensive curative surgery for spinal tumor and compare them to the general population in France. IntroductionLife expectancy is not the only criterion to assess the outcomes after massive tumor resections. Residual quality of life is also crucial. An indication for major surgery for spinal tumor should take the patient's long-term functional status into account, but the literature is limited on this question. Materials and methodsTwenty-five living patients from a group of 120 operated were assessed, all of whom were operated on by the same surgeon between 1984 and 2007. The mean follow-up was 9 years (range, 3–25 years). The mean age at surgery was 49 years. The patients completed different functional and quality-of-life questionnaires: the Oswestry Disability Index version 2 (ODI), the PROLO, the Karnofsky Index of performance status (KI), the Eastern Cooperative Oncology Group performance status (ECOG), the Short Form-36 Health Survey (SF-36), and the EuroQol-5 Dimensions (EQ5D). In addition, each patient was clinically and radiographically evaluated. Subgroups were identified considering the number of levels resected and histology. Their results on the SF-36 were compared with the results from the general population in France. ResultsThe mean PCS (physical component summary of the SF-36) was 52.4, the MCS (mental component summary, the psychological component of the SF-36) was 47.7, the ODI was 18.2, the PROLO was 7, the ECOG was 1, and the KI was 80%. The resections at three levels were associated with worse results in terms of quality of life, but overall, the results were similar to the French general population data for all categories of the SF-36. ConclusionAppropriate indications for massive spinal resection give good oncological and functional results. Although the expected life expectancy justifies this aggressive surgery, postoperative quality of life shows that it can also be successful on a functional level. Level of evidenceLevel IV; retrospective clinical study.

The effectiveness of endoscopic radiofrequency denervation of medial branch for treatment of chronic low back pain.

ObjectiveThe aim of this study is to evaluate the clinical results of endoscopic radiofrequency ablation of medial branch in patients with chronic low back pain originating from facet joints.MethodsBetween October 2010 and December 2013, 52 consecutive patients had suffering from chronic low back pain had undergone endoscopic radiofrequency denervation of medial branch of dorsal ramus. The clinical outcomes of these 52 patients were reviewed retrospectively. Preoperative and postoperative Visual Analogue Scale (VAS) and Korean version of Oswestry Disability Index (K-ODI), and patients' satisfaction with the procedure were assessed.ResultsThe pain scores on the VAS for back pain had improved significantly from a preoperative mean of 7.1 to a postoperative mean of 2 at the last follow-up (p<0.001). The clinical outcomes based on the K-ODI had also improved significantly from a preoperative mean of 26.5% to postoperative mean of 7.7% at the last follow-up (p<0.001). 80% of patients were satisfied with the procedure. There were no complications associated with the procedure.ConclusionOur preliminary results demonstrate that endoscopic radiofrequency denervation of medial branch could be an effective alternative treatment modality for chronic back pain originating from facet joints that provides long-term pain relief.

비탄력 테이핑을 적용한 요부안정화 운동이 만성요통환자의 통증과 기능에 미치는 영향

PURPOSE: The purpose of this study was to compare the effects of a combined non elastic taping and lumbar stabilizing exercise against lumbar stabilizing exercise only during the lumbar stabilizing exercise in chronic low back pain. METHOD: Thirty-one patients of low back pain were randomly allocated to 2 groups: lumbar stabilizing exercise group (n=16) and nonelastic taping group(n=15) with lumbar stabilizing exercise. Taping and stabilizing exercise were performed twice a week for 4 weeks. The patients were assessed using by visual analog scale (VAS) and Korean version of Oswestry disability index (KODI). The measurements of each patients were measured before the intervention and 2 weeks post-experiment and 4weeks after the intervention. All data were analyzed using by SPSS 12.0 software for Window, the experimental data was analyzed using by paired samples t-test and repeated ANOVA. All statistical tests in this study were conducted at the .05 level of significance. RESULTS: The results of this study are in the nonelastic taping group, significant difference were found in th VAS between pre-test and post-test (p<.05). In addition, there were significant differences in the VAS between the two groups at post-test(p<.05). And in the nonelastic taping group, significant difference were found in the KODI between pre-test and post-test (p<.05). However, there were no significant differences in the KODI between the two groups at post-test (p<.05). CONCLUSION: These findings suggest that combination of nonelastic taping and lumbar stabilizing exercise is more effective for low back pain than stabilizing exercise alone. In conclusion, this study indicates that stabilizing exercise combined with nonelastic taping would be recommended in the clinic.

Measurement precision of the disability for back pain scale-by applying Rasch analysis

BackgroundThe Oswestry Disability Index (ODI) is widely used for patients with back pain. However, few studies have examined its psychometric properties using modern measurement theory. The purpose of this study was to investigate the psychometric properties of the ODI in patients with back pain using Rasch analysis.MethodsA total of 408 patients with back pain participated in this cross-sectional study. Patients were recruited from the orthopedic, neurosurgery, rehabilitation departments and pain clinic of two hospitals. Rasch analysis was used to examine the Chinese version of ODI 2.1 for unidimensionality, item difficulty, category function, differential item functioning, and test information.ResultsThe fit statistics showed 10 items of the ODI fitted the model’s expectation as a unidimensional scale. The ODI measured the different levels of functional limitation without skewing toward the lower or higher levels of disability. No significant ceiling and floor effects and gaps among the items were found. The reliability was high and the test information curve demonstrated precise dysfunction estimation.ConclusionsOur results showed that the ODI is a unidimensional questionnaire with high reliability. The ODI can precisely estimate the level of dysfunction, and the item difficulty of the ODI matches the person ability. For clinical application, using logits scores could precisely represent the disability level, and using the item difficulty could help clinicians design progressive programs for patients with back pain.

척추안정화운동과 도수치료가 급성기 또는 아급성기 허리통증 환자의 통증지수와 오스웨스트리 장애지수에 미치는 영향

이 연구는 척추안정화운동과 도수치료가 급성기 또는 아급성기 허리통증 환자의 통증지수와 장애지수에 미치는 영향을 알아보기 위해 시행되었다. 23명의 허리통증 환자가 자발적으로 참여하였고 무작위로 분류되었다. 도수치료(10명)와 척추안정화운동(13명)은 총 4주간 주 3회, 15분/1회 적용되었다. 각각의 치료 전에 전통적인 치료를 30분간 적용하였다. 치료 전과 후에 시각사상척도와 한국어판 오스웨스트리를 측정하였다. 치료 전에 비해 치료 후 두 치료 모두에서 통중지수와 장애지수가 유의하게 감소하였다(p<.05). 통증지수의 변화율은 도수치료보다 척추안정화운동 시 유의하게 높았지만(p<.05), 장애지수의 변화율은 유의한 차이가 없었다(p>.05). 이상으로 볼 때, 척추안정화운동은 아급성기 또는 급성기 허리통증 환자에서도 통증을 안전하게 줄이는데 도움이 됨을 확인하였다. 따라서 아급성기 이하의 허리통증 환자에서도 통증과 장애를 줄이는데 척추안정화운동이 유용하리라 사료된다. The purpose of this study was to investigate effect of type of physical therapy (spinal stabilization exercise and manual therapy) on pain index and disability index in acute and subacute patients with low back pain (LBP). 23 patients with LBP participated and were randomly assigned. Manual therapy and spinal stabilization exercise was applied for 15-minute sessions occurred 3 sessions a week, for 4 weeks. All subjects received conservative therapy for 30-minute. Visual analogue scale (VAS) and Korean version of Oswestry disability index (ODI-K) were measured before and after treatment. There was significant difference in VAS and ODI-K between before and after both treatment (p<.05). There was significant difference in change rate of VAS between manual therapy and spinal sabilization exercise (p<.05), but not in change rate of ODI-K (p>.05). Thus, it is suggested that spinal stabilization exercise is helpful to reduce pain safely in acute and subacute patients with LBP.

Evolução psicossomática e clínica de pacientes com estenose do canal lombar operados com sistema interespinhoso

OBJETIVO: Procuramos avaliar a eficácia terapêutica de estabilizadores interespinosos na doença degenerativa lombar, e a evolução do índice de depressão e somatização de sintomas preexistentes nesses pacientes. MÉTODOS: Estudamos 20 pacientes com estenose de canal lombar. Considerados diversos critérios de inclusão, os pacientes concordaram em participar do estudo assinando o consentimento livre e esclarecido. Na avaliação clínica e psicossomática utilizamos: Escore Euroqol (EQ-5D); escala visual analógica (EVA) lombar e dos membros inferiores; Oswestry Disability Index versão 2.0 e Modified Somatic Perception Questionnaire (MSPQ) e Zung Self-Rating Depression Scale (ZDS). A análise estatística foi realizada com os testes de Friedman e Wilcoxon, sendo o nível de significância 0,05. RESULTADOS: Existiu uma melhoria em EQ-5D (p&lt;0,001), EVA lombar e dos membros inferiores (p&lt;0,001), ODI (p&lt;0,001), sem alterações significativas no MSPQ (p=0,197). CONCLUSÃO: Em pacientes com doença degenerativa lombar (grau 2 e 3 de Benzel e 3 e 4 de Pfirmann), estáveis em termos psicossomáticos, o uso de estabilizadores interespinosos revelou-se eficaz considerando a evolução clínica e o índice de depressão preexistente relacionado com a patologia diagnosticada.

Reliability and Validity of Simplified Chinese Version of Roland-Morris Questionnaire in Evaluating Rural and Urban Patients with Low Back Pain

ObjectiveThe causes of low back pain in China and Western countries are extremely different. We attempted to analyze the risk factors of low back pain in urban and rural patients under the dual economy with the simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ) to demonstrate that SC-RMDQ could evaluate patients with low back pain arising from different causes.MethodsRoland-Morris disability questionnaire was translated into SCRMDQ according to international guidelines for questionnaire adaptation. In this study, causes of low back pain of 187 outpatients and inpatients (99 urban patients and 88 rural patients) were analyzed. All patients underwent simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ), simplified Chinese Oswestry disability index (SCODI) and visual analogue scale (VAS). Reliability was tested using reproducibility (intraclass coefficient of correlation – ICC) and internal consistency (Cronbach's alpha). Validity was tested using Pearson correlation analysis.ResultsThe leading causes for low back pain were sedentariness (38.4%) and vibration (18.1%) in urban patients and waist bending (48.9%) and spraining (25%) in rural patients. Although causes of low back pain in the two groups of population were completely different, SCRMDQ had high internal consistency (Cronbach's α value of 0.874 in urban patients and 0.883 in rural patients) and good reproducibility (ICC value of .952 in urban patients and 0.949 in rural patients, P<0.01). SCRMDQ also showed significant correlation with Simplified Chinese version of Oswestry disability index (SCODI) and visual analogue scale (VAS) in rural areas (SCRMDQ-SCODI r = 0.841; SCRMDQ -VAS: r = 0.685, P<0.01) and in urban areas (SCRMDQ-SCODI: r = 0.818, P<0.01; SCRMDQ –VAS: r = 0.666, P<0.01).ConclusionsAlthough causes of low back pain are completely different in rural and urban patients, SCRMDQ has a good reliability and validity, which is a reliable clinical method to evaluate disability of rural and urban patients.

Reliability and Validity Study of the Finnish Version 2.0 of the Oswestry Disability Index

Prospective clinical validation study. The aims of this study were to translate into Finnish and culturally adapt and study the psycho-metric properties of the Oswestry Disability Index (ODI) version 2.0. The ODI is one of the most commonly reported back-specific disability questionnaires. It is widely used both in clinical work and in medical studies. To date, no validated Finnish version of the ODI version 2.0 has been reported. The ODI version 2.0 was translated into the Finnish language. A total of 115 patients with back pain, referred by the primary care physician to the outpatient clinic of the department of physical medicine and rehabilitation, were recruited for this study. The patients answered a questionnaire package that included the Finnish ODI 2.0, Back Pain Questionnaire for Visual Analogue Assessment (Million-VAS), Visual Analogue Scales of back and leg pain (VASback, VASleg), the Depressions Scale, and a question on their subjectively perceived health. The package was administered twice; 2 weeks before and at the arrival to the clinic. Reproducibility of the ODI was 0.90 (95% confidence interval [CI] = 0.85-0.94) and the internal consistency was 0.86 (95% CI = 0.81-0.90). Factor analysis showed that the ODI was loaded on 2 factors, which explained 51% of the total variance. In testing convergent validity ODI correlated with Million-VAS, r = 0.75 (95% CI = 0.64-0.84); VASback, r = 0.48 (95% CI = 0.32-0.62); and VAS leg, r = 0.41 (95% CI = 0.23-0.57). The Finnish ODI version 2.0 proved to be a valid and reliable instrument that showed psychometric properties comparable with the original English version. Therefore, it can be used in assessing the disability among Finnish-speaking patients with back pain for both clinical and scientific purposes.

The relationship between health locus of control and quality of life in patients with chronic low back pain

To investigate the relationship between health locus of control and quality of life in patients with chronic low back pain. Pain intensity by visual analog scale, quality of life related to health by the World Health Organization Quality of Life (WHOQOL) assessment and disability level by Turkish version of Oswestry Disability Index (ODI) were evaluated. Multidimensional Health Locus of Control (MHLC) for the perception to responsibility and control of the individual over his/her own health was used. Patients were separated into two groups according to the scores of ODI as group with Low Disability [0-40 minimal/moderate disability; n=53] and group with High Disability [40-100 severe disability /crippled/bedbound/ exaggerating; n=60]. Scores of chance health locus of control (CHLC) in the subscale of MHLC were significantly higher in the patients who had high disability (p < 0.05). Negative correlation between CHLC scores and all domains of WHOQOL, positive correlation between CHLC scores and disability level and pain severity was found (p < 0.05). Quality of life was negatively influenced in the patients with low back pain who had chance health locus of control. LOC is an important parameter in evaluation and treatment of patients with LBP.

Development of a Chinese Version of the Oswestry Disability Index Version 2.1

Cross-cultural adaptation and cross-sectional psychometric testing in a convenience sample of patients with low back pain. To translate and culturally adapt the Oswestry Disability Index version 2.1 (ODI 2.1) into a Mandarin Chinese version and to assess its reliability and validity. The Chinese ODI 2.1 has not been developed and validated. The ODI 2.1 was translated and culturally adapted to the Chinese version. The validity of the translated Chinese version was assessed by examining the relationship between the ODI and other well-known measures. Test-retest reliability was examined in 52 of these patients, who completed a second questionnaire within 1 week. Internal consistency of the ODI 2.1 was excellent with Cronbach's alpha = 0.903. The intraclass correlation coefficient of test-retest reliability was 0.89. The minimal detectable change was 12.8. The convergent validity of the Chinese ODI is supported by its high correlation with other physical functional status measures (Roland Morris Disability Questionnaire and SF-36 physical functioning subscale, r = 0.76 and -0.75, respectively), and moderate correlation with other measures (Visual Analogue Scale, r = 0.68) and certain SF-36 subscales (role-physical, bodily pain, and social functioning, r range: -0.49 to -0.57). As expected, the ODI was least correlated with nonfunctional measures (SF-36 mental subscale and role-emotional subscale, r = -0.25 and -0.33, respectively). The results of this study indicate that the Chinese version of the ODI 2.1 is a reliable and valid instrument for the measurement of functional status in patients with low back pain.