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

Department of Orthopaedics and Traumatology, Jyväskylä Central Hospital, Jyväskylä, Finland.
Spine (Impact Factor: 2.3). 02/2011; 36(4):332-8. DOI: 10.1097/BRS.0b013e3181cdd702
Source: PubMed


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.

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    • "Subjective disability was measured using the validated Finnish version of the ODI, where 0% represents no disability and 100% extreme debilitating disability [21]–[22], [29]. "
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    ABSTRACT: Purpose To study the predictive value of preoperative magnetic resonance imaging (MRI) findings for the two-year postoperative clinical outcome in lumbar spinal stenosis (LSS). Methods 84 patients (mean age 63±11 years, male 43%) with symptoms severe enough to indicate LSS surgery were included in this prospective observational single-center study. Preoperative MRI of the lumbar spine was performed with a 1.5-T unit. The imaging protocol conformed to the requirements of the American College of Radiology for the performance of MRI of the adult spine. Visual and quantitative assessment of MRI was performed by one experienced neuroradiologist. At the two-year postoperative follow-up, functional ability was assessed with the Oswestry Disability Index (ODI 0–100%) and treadmill test (0–1000 m), pain symptoms with the overall Visual Analogue Scale (VAS 0–100 mm), and specific low back pain (LBP) and specific leg pain (LP) separately with a numeric rating scale from 0–10 (NRS-11). Satisfaction with the surgical outcome was also assessed. Results Preoperative severe central stenosis predicted postoperatively lower LP, LBP, and VAS when compared in patients with moderate central stenosis (p<0.05). Moreover, severe stenosis predicted higher postoperative satisfaction (p = 0.029). Preoperative scoliosis predicted an impaired outcome in the ODI (p = 0.031) and lowered the walking distance in the treadmill test (p = 0.001). The preoperative finding of only one stenotic level in visual assessment predicted less postoperative LBP when compared with patients having 2 or more stenotic levels (p = 0.026). No significant differences were detected between quantitative measurements and the patient outcome. Conclusions Routine preoperative lumbar spine MRI can predict the patient outcome in a two-year follow up in patients with LSS surgery. Severe central stenosis and one-level central stenosis are predictors of good outcome. Preoperative finding of scoliosis may indicate worse functional ability.
    PLoS ONE 09/2014; 9(9):e106404. DOI:10.1371/journal.pone.0106404 · 3.23 Impact Factor
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    • "Subjective disability was measured by the validated Finnish version of the Oswestry Disability Index, where 0% represents no disability and 100% extreme debilitating disability [14-16]. "
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    ABSTRACT: Background To evaluate the clinical significance of lateral lumbar spinal canal stenosis (LLSCS), found by magnetic resonance imaging (MRI), through correlating the imaging findings with patient symptoms, walking capacity and electromyography (EMG) measurements. Method 102 patients with symptoms of LSS referred for operative treatment were studied in this uncontrolled study. Of these patients, subjects with distinct only lateral LSS were included. Accordingly, 140 roots in 14 patients (mean age 58, range 48-76 years, male 43%) were evaluated. In MR images the entrance and mid zones of the lateral lumbar nerve root canal were graded as normal, narrowed but not compressed, or compressed. In quantitative analysis, the minimal widths of the lateral recess and mid zone area were measured. Clinical symptoms were recorded with the Oswestry Disability Index (ODI), overall Visual Analogue Scale (VAS), specific low back pain (LBP; NRS-11), specific leg pain (LP NRS-11), Beck Depression Inventory (BDI) and walking distance in the treadmill test. Lumbar paraspinal (L2- L5) and lower limb (L3 – S1) needle EMG studies were performed. The findings were classified root by root as 1 = normal, 2 = abnormal. The associations between radiological, EMG and clinical findings were tested with each other. Results EMG findings were normal in 92 roots and abnormal in 48 roots. All of the patients had at least one abnormal nerve root finding. Severity of the mid zone stenosis in MRI correlated with abnormal EMG findings (p = 0.015). Patients with abnormal EMG had also higher scores in the VAS (41.9 ± 25.7 vs 31.5 ± 18.1; p = 0.018), NRS leg pain (7.5 ± 1.5 vs 6.3 ± 2.1; p = 0.000) and BDI (9.8 ± 3.8 vs 8.0 ± 3.9; p = 0.014). However, no statistically significant correlations between MRI findings and clinical symptoms or walking capacity were found. Conclusions Among persons previously selected for surgery, lateral stenosis seen on MRI correlates with EMG, and thus may be a clinically significant finding. Our EMG findings were also associated with patient symptoms. However, no relationships between the MRI findings and symptoms or walking capacity were found, suggesting their multifactorial etiology.
    BMC Musculoskeletal Disorders 07/2014; 15(1):247. DOI:10.1186/1471-2474-15-247 · 1.72 Impact Factor
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    • "According to the original publication, the scores are grouped into five categories: 0–20 minimal, 20–40 moderate, 40–60 severe disability; 60–80 crippled and 80–100 indicates that the patient is either bed-bound or exaggerating his or her symptoms [8]. The Finnish validated version 2.0 of the ODI was used [10]. The SF-36 is a generic patient-assessed health outcome measure for health-related quality of life with eight dimensions reflecting patients’ health and welfare. "
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    ABSTRACT: The aim of the present study was to compare one-year-follow-up data on disability and health-related quality of life (HRQoL) between spinal fusion patients and age- and sex-matched general population. The data on fusion patients were collected prospectively using a spinal fusion data base in two Finnish hospitals. A general population sample matched for age, sex and residential area was drawn from the Finnish Population Register. All participants completed a questionnaire and the main outcome measures were the Oswestry Disability Index (ODI) and the Short Form-36 questionnaire (SF-36). Altogether 252 (69% females) fusion patients and 682 (67% females) population sample subjects participated in the study. In general population the mean ODI was 15 (SD 17) in females and 9 (SD 13) in males. The corresponding preoperative ODI values were 47 (SD16) and 40 (SD 15) and one year follow-up values 22 (SD 17) and 23 (SD 20). In both sexes the ODI decreased significantly after surgery but remained higher than in the general population, p < 0.001. The physical component summary score (PCS) of the SF-36 was lower in the patients than general population sample both preoperatively and at one-year follow-up (p < 0.001). The mental component summary score (MCS) was lower preoperatively (p < 0.001), but reached the general population level after one year in both men (p = 0.42) and women (p = 0.61). Disability and HRQoL improved significantly after spinal fusion surgery during a one- year follow-up. However, the patients did not reach the level of the general population in the ODI or in the physical component of HRQoL at that time, although in the mental component the difference disappeared.
    BMC Musculoskeletal Disorders 07/2013; 14(1):211. DOI:10.1186/1471-2474-14-211 · 1.72 Impact Factor
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