Questionnaire 1

This tool, the Oswestry Disability Index (also known as the Oswestry Low Back Pain Disability Questionnaire) is an extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the ‘gold standard’ of low back functional outcome tools.

This questionnaire has been designed to give your clinician information as to how your back pain has affected your ability to manage in every day life. Please answer every question by placing a mark in the one box that best describes your condition today. We realize you may feel that two of the statements may describe your condition, but please mark only the box which most closely describes your current condition.

Name *

First

Last

Sources:
Fairbank JCT & Pynsent, PB (2000) The Oswestry Disability Index. Spine, 25(22):2940-2953.
Davidson M & Keating J (2001) A comparison of five low back disability questionnaires: reliability and responsiveness. Physical Therapy 2002;82:8-24.

Time Commitment: 10 minutes

Questionnaire 1:

Modified Back Pain Disability Questionnaire

Time Commitment: 10 minutes

Questionnaire 1:​Modified Back Pain Disability Questionnaire

Questionnaire 1:

Modified Back Pain Disability Questionnaire