Development of a Modified Disability Questionnaire for Evaluating Disability Caused by Backache in India and Other Developing Countries

Abstract

Study DesignProspective observational study.PurposeTo evaluate the disability domains relevant to Indian patients with low backache and propose a modified disability questionnaire for such patients.Overview of LiteratureThe Oswestry Disability Index (ODI) is a self-reported measurement tool that measures both pain and functional status and is used for evaluating disability caused by lower backache. Although ODI remains a good tool for disability assessment, from the Indian perspective questions related to weight lifting and sexual activity of ODI are questioned in some of the earlier studies. Activities of daily living in Indian patients vary substantially from those in other populations and include activities like bending forwards, sitting in floor and squatting which are not represented in the ODI.MethodsIn this prospective observational study, a seven-step approach was used for the development of a questionnaire. Thirty patients were interviewed to identify the most challenging issue they faced while performing their daily activities (by free listing) and understand how important the questionnaire items were in terms of the standard ODI. Thus, a comprehensive disability questionnaire comprising 14 questions was developed and administered to 88 patients. Both qualitative (interviews) and quantitative methods (to establish the validity, reliability, and correlation with the Visual Analog Scale [VAS] and Rolland Morris disability questionnaire) were used to identify the 10 questions that best addressed the disability domains relevant to Indian patients.ResultsAccording to free listing, four new questions pertaining to bending forward, sitting on the floor, walking on uneven surfaces, and work-related disabilities were included. In the second phase, wherein the questionnaire with 14 items was used, 56.8% patients did not answer the questions related to sexual activity, whereas 23.8% did not answer those related to walking on uneven surfaces. The modified questionnaire demonstrated good internal consistency (Cronbach’s alpha=0.892) and correlation with the Rolland Morris questionnaire (Cronbach’s alpha=0.850, p>0.05), as well as with the VAS score for disability (Cronbach’s alpha=0.712, p>0.05) and pain (Cronbach’s alpha=0.625, p>0.05).ConclusionsA modified disability questionnaire that was designed by adding two questions related to bending forward and work status and removing questions related to sexual activity and weight lifting or traveling (depending on the occupation) can help evaluate disability caused by back pain in Indian population.

Translation of Patient-Related Outcome Measures

“…Among these aspects, there were questions related to mental health, suicide, and sexual life. This is in line with Aithala et al [30] who in their Indian study found that 56.8% of the patients did not answer the questions related to sexual activity. While some of our interviewees expressed a preference for talking about mental problems with members of the healthcare staff, others said they only would discuss such questions with close family member.…”

How Comprehensive and Efficient Are Patient-Reported Outcome Measures for Individuals with Lower Extremity Amputation Undergoing Implantation of Osseointegrated Bone Anchored Limbs?

“…The determined amputation-specific PROMs were tailored toward patients with LEA who use socket- or bone-anchored prostheses and included the Orthotics and Prosthetics User's Survey (OPUS-LEFS) 19 , Prosthesis Evaluation Questionnaire (PEQ) 20 , Trinity Amputation and Prosthesis Experiences Scales (TAPES) 21 , Questionnaire for Persons with a Transfemoral Amputation (Q-TFA) 22 , Prosthetic limb users survey of Mobility (PLUS-M) 23 , Special Interest Group in Amputee Medicine (SIGAM) 24 , Groningen Questionnaire Problems Leg Amputation (GQPLA) 25 , Houghton Scale (HS) 26 , Satisfaction with Prosthesis Questionnaire (SATPRO) 27 , Locomotor Capabilities Index (LCI-5) 28 , Prosthetic Profile of the Amputee (PPA) 29 , Day's Amputee Activity Survey (AAS) 30 , Attitude to Artificial Limb Questionnaire (AALQ) 31 , and the Amputee Body Image Scale (ABIS) 32 . The health-related QoL PROMs included the 36-Short Form (36-SF) 33 , Patient-Reported Outcomes Measurement Information System-Global Health 10 items (PROMIS-GH) 34 , European Quality of Life (EQ-5D-3L) 35 , World Health Organization Quality of Life Assessment Instrument 2.0 (WHO-DAS 2.0) 36 , Modified Oswestry Disability Index (MODQ) 37 , American Academy of Orthopedic Surgeons-Lower Limb Questionnaire (AAOS-LLQ) 38 , LIMB-Q 39 , Functional Assessment Interview (FAI) 40 , Functional Assessment Measure (FAM) 41 , Functional Independence Measure (FIM) 42 , Limb Deformity Modified Scoliosis Research Society (LD-SRS) 43 , Activities-specific Balance Confidence (ABC) Scale 44 , Locomotor Capabilities Index (LCI-5) 28 , Engagement in everyday activities involving revealing the body (EEARB) 45 , International Physical Activity Questionnaire (IPAQ)—Short Form 46 , Multidimensional Body-Self Relations Questionnaire Appearance Evaluation subscale (MBSRQ-AE) 47 , Reintegration to Normal Living Index (RNLI) 48 , Nottingham Health Profile (NHP) 49 , and Functional Independence Measure (FIM) 42 . The Single Assessment Numeric Evaluation (SANE), visual analog scale (VAS), and Numeric Rating Scale (NRS) of pain were excluded because they consisted of only a single number (Table I).…”

Neural Mobilization for Reducing Pain and Disability in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-Analysis

“…The secondary outcome involved assessing changes in disability, measured by the Oswestry Disability Index (ODI) [15], Modified Oswestry Disability Index (MODI) [16], Quebec Back Pain Disability Scale (QBPDS) [17], Roload Morris Disability Questionnaire (RMDQ) [18], 36-Item Short Form Survey (SF-36) [19], and 12-Item Short Form Survey (SF-12). Elaborate explanations are systematically arranged in Table S3 to enhance clarity.…”