Responsiveness of Nepali version of Oswestry Disability Index (ODI) on individuals with non-specific low back pain

Abstract

Background: Low 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. Objective: We aimed to assess the responsiveness of NODI in participants with non-specific low back pain. Methods: The 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. Results: The 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. Conclusion: NODI 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.