Oswestry Disability Index

What is the Oswestry Disability Index

The Oswestry Disability Index or ODI is an evaluation tool used to measure the level of disability in individuals who experience lower back pain. This index has become one of the standard instruments used by health professionals, especially orthopedists and physiotherapists, in measuring the impact of low back pain on patients' functional abilities.

Oswestry Disability Index Scoring System

The ODI consists of a number of statements that refer to daily activities that are commonly affected by low back pain. Patients are asked to rate the extent to which their pain limits their ability to perform these activities. This index covers 10 activity domains, namely:

1. Pain intensity
2. Personal Care
3. Lifting objects
4. Walk
5. Sit
6. Stand
7. Sleeping
8. Sexual activity (if possible)
9. Social activity
10. Traveling

Each domain is rated by the patient by assigning a score from 0 to 5, where 0 means no disability and 5 means severe disability. If a patient marked more than one statement in a question, the statement with the highest score was recorded as indicating actual disability. The questionnaire took 3.5–5 minutes to complete and approximately 1 minute to score. The total ODI score is calculated by adding up the scores from each domain and converting them into a percentage. The higher the ODI score, the higher the level of disability experienced by the patient.

The score value from ODI for each domain is:

• A          : 0 poin
• B          : 1poin
• C         : 2 poin
• D         : 3 poin
• E          : 4 poin
• F          : 5 poin
• Total skor        : 50 poin

Interpretasi dari skor ODI adalah :

• 0 – 4 points         : No disability
• 5 – 14 points       : mild disability
• 15 – 24 points     : moderate disability
• 25 – 34 points     : severe disability
• > 35 points         : complete disability

The Oswestry Disability Index is an important tool in the field of orthopedics and rehabilitation because it helps in assessing and measuring the impact of low back pain on a patient's quality of life and functional ability. The ODI score can provide an objective view of the level of disability, which can be used as a guide for the treatment of patients with low back pain problems.

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ODI Reliability

POPULATION	CRITERIA	MARK
Lower Back Pain	Test/retest reliability	Test-retest reliability was excellent (n = 33) for ODI walking subsections (ICC = 0.78 (0.60 – 0.88)), sleep (ICC = 0.82 (0.67 – 0.91)), and ODI total score (ICC = 0.88 (0.77 – 0.94) ) ), all with CI 95% Adequate test retest reliability (n = 33) for ODI pain intensity subsections (ICC = 0.65 (0.40 – 0.81)), lifting (ICC = 0.74 (0.53 – 0.87)), sitting (ICC = 0.71 (0.48 – 0.85)), standing (ICC = 0.59 (0.31 – 0.78)), social life (ICC = 0.52 (0.22 – 0.73), and travel (ICC = 0.51 (0.21 – 0.73))Poor test-retest reliability ( n = 33) for ODI sexual activity subsection (ICC = 0.25 (-0.11 – 0.55))Test-retest reliability not established for personal care
	Internal Consistency	Excellent internal consistency for the overall ODI score (Cronbach's alpha = 0.83) Adequate internal consistency for the ODI course section total score correlation (Cronbach's alpha = 0.72) Poor internal consistency for the ODI subsection-total score correlation: pain ( Cronbach's alpha = 0.50), personal hygiene (0.61), lifting (0.58), walking (0.61), sitting (0.34), standing (0.51), sleeping (0.42) , sexual activity (0.53), social activity (0.44)

ODI Validity

POPULATION	CRITERIA	MARK
Neck pain	Criterion  Validity	Poor correlation between baseline score and change in ODI (r = 0.11) Adequate correlation between anchor HTI and change in ODI (rho = 0.35) and between Satisfaction with anchor results and change in ODI (rho = 0.46)
	Construct Validity	Adequate correlation between transition rating index and ODI (version 2.1) (r = 0.47) Very good correlation with: Pelvic Girdle Questionnaire (PGQ) total (r= 0.75), PGQ Activity subscale PGQ (r = 0.72), PGQ Symptom subscale ( r= 0.71), Disability Rating Index (r = 0.71), SF2 – SF2 – Physical Functioning (r = 0.66) Adequate correlation with: Fear-avoidance beliefs questionnaire (r = 0.33), SF1 – General Health ( r = 0.51), SF3 – Role-physical (r = 0.54), SF4 – Body pain (r = 0.56), SF6 – Social functioning (r = 0.52)Poor correlation with: Pain catastrophizing scale (r = 0.26), SF5 – Vitality (r = 0.07), SF7 – Mental health (r = 0.12), SF8 – Role-emotional (r = 0.17) Adequate discriminant validity between ODI and pain localization (ROC = 0.726, 95% CI, 0.621 – 0.830, p = 0.015)Poor discriminant validity between ODI and pregnancy (ROC = 0.63, 95% CI, 0.535 – 0.769, p = 0.001)Very good correlation between low back pain VAS and ODI V2, pre surgery and post-surgery (r= -0.71 and r = -0.75)

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Reference :

1. Mehra A, Baker D, Disney S, Pynsent PB. Oswestry Disability Index scoring made easy. Ann R Coll Surg Engl. 2008 Sep;90(6):497-9. doi: 10.1308/003588408X300984. Epub 2008 Jul 2. PMID: 18598595; PMCID: PMC2647244.
2. Vianin M. Psychometric properties and clinical usefulness of the Oswestry Disability Index. J Chiropr Med. 2008 Dec;7(4):161-3. doi: 10.1016/j.jcm.2008.07.001. PMID: 19646379; PMCID: PMC2697602.
3. Shirley Ryan Ability Lab: Oswestry Disability Index. Diakses melalui https://www.sralab.org/rehabilitation-measures/oswestry-disability-index pada 30 September 2023
4. Physiopedia. Oswestry Disability Index. DIakses melalui https://www.physio-pedia.com/Oswestry_Disability_Index pada 30 september 2023