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Responsiveness of the Oswestry Disability Index and the Roland Morris Disability Questionnaire in Italian subjects with sub-acute and chronic low back pain

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Abstract

Introduction

An ability to assess longitudinal changes in health status is crucial for the outcome measures used in treatment efficacy trials. The aim of this study was to verify the responsiveness of the Italian versions of the Oswestry Disability Index (ODI) and the Roland Morris Disability Questionnaire (RMDQ) in subjects with subacute or chronic low back pain (LBP).

Material and methods

At the beginning and end of an 8 week rehabilitation programme, 179 patients completed a booklet containing the ODI, the RMDQ, a 0–10 numerical rating scale (NRS), and the 36-item Short-Form Health Survey (SF-36). A global perception of change scale was also completed at the end of the programme, and collapsed to produce a dichotomous outcome (i.e. improved vs. not improved). Responsiveness was assessed by means of distribution methods [minimum detectable change (MDC); effect size (ES); standardised response mean (SRM)] and anchor-based methods (ROC curves).

Results

The MDC for the ODI and RMDQ was, respectively, 13.67 and 4.87; the ES was 0.53 and 0.68; and the SRM was 0.80 and 0.81. ROC analysis revealed an area under the curve of 0.71 for the ODI and 0.64 for the RMDQ, thus indicating discriminating capacity; the best cut-off point for the dichotomous outcome was 9.5 for the ODI (sensitivity 76% and specificity 63%) and 2.5 for the RMDQ (sensitivity 62% and specificity 55%). These estimates were comparable between the subacute and chronic subjects. Both the ODI and the RMDQ moderately correlated with the SF-36 and NRS (Spearman’s and Pearson’s correlation coefficients of >0.30).

Conclusion

The Italian ODI and RMDQ proved to be sensitive in detecting clinical changes after conservative treatment for subacute and chronic LBP. Our findings are consistent with those published in the literature, thus allowing cross-cultural comparisons and stimulating cross-national studies.

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Acknowledgments

The authors would like to thank Silvia Borghi, Annalisa Generali, Caroline O’ Reilly, Sergio Parazza and Antonio Romeo for their assistance, and Kevin Smart for his help in preparing the English version of this paper.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone (Milan), Salvatore Maugeri Foundation, IRCCS, Via Monsignor Bernasconi 16, 20035, Lissone, MI, Italy

    Marco Monticone

  2. Consorzio Valutazioni Biologiche e Farmacologiche, Pavia University, Salvatore Maugeri Foundation, IRCCS, Pavia, Italy

    Paola Baiardi

  3. School of Physiotherapy, Bologna University, Bologna, Italy

    Carla Vanti

  4. Manual Therapy Sciences, Padova University, Padua, Italy

    Silvano Ferrari

  5. Department of Internal Medicine, Geriatrics and Nephrology, University of Bologna, Bologna, Italy

    Paolo Pillastrini & Raffaele Mugnai

  6. Chair of Physical and Rehabilitation Medicine, Tor Vergata University of Rome, Rome, Italy

    Calogero Foti

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  1. Marco Monticone
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  2. Paola Baiardi
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  3. Carla Vanti
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  4. Silvano Ferrari
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  5. Paolo Pillastrini
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  6. Raffaele Mugnai
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  7. Calogero Foti
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Corresponding author

Correspondence to Marco Monticone.

Additional information

IRB approval. Our Institutional Review Board approved the study, which was conducted in conformity with ethical and humane principles of research.

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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 21, 122–129 (2012). https://doi.org/10.1007/s00586-011-1959-3

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  • DOI: https://doi.org/10.1007/s00586-011-1959-3

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