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The Oswestry Disability Index is reflective of pain interference and mobility in children

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Abstract

Purpose

The 9-item Oswestry Disability Index version 2.1a (ODI-9) has never been formally validated in children. Our primary purpose was to evaluate the ODI-9 using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Pain Interference (PI) and Mobility Computer Adapted Test (CAT) and Pain Catastrophizing Scale for Children (PCS-C) as anchors to determine concurrent validity in children.

Methods

We retrospectively reviewed cross-sectional patient-reported outcomes data using a convenience sample of children referred to a tertiary pediatric orthopedic institution for any spine condition from April 2021 to April 2022. The ODI-9, PI, and Mobility were completed at clinic intake in 2,097 children (1453 girls, 644 boys) aged 14.2 ± 2.6 years (range 5–18 years) during the same visit. The ODI-9 was administered when children or caregivers responded “yes” to the presence of back pain. The PCS-C was administered only when pain intensity was rated as “very severe” or “the worst imaginable” on Item 1 of the ODI-9 (n = 51).

Results

Average ODI-9 scores were 18.3% ± 14.8%, indicating minimal disability (ODI-9 ≤ 20%). Moderate, statistically and clinically significant associations were seen between the ODI-9 and PI (r = 0.68, p < 0.001), the ODI-9 and Mobility (r = − 0.68, p < 0.001), and the ODI-9 and PCS-C (r = 0.59, p < 0.001).

Conclusion

Worse ODI-9 scores correlate with worse PROMIS PI scores, worse PROMIS Mobility scores, and worse PCS-C scores. The associations were moderate (PROMIS PI [r = 0.68], PROMIS Mobility [r = − 0.68], PCS-C [r = 0.59]).

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Data availability

Data can be made available in a de-identified manner upon request.

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Acknowledgements

The authors would like to acknowledge Brenda Matthews and Dominic Chittilappilly for assisting with data extraction.

Funding

No funding was received for this work.

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Authors and Affiliations

  1. Scottish Rite for Children, Dallas, TX, USA

    Karina A. Zapata, Chan-Hee Jo & Brandon A. Ramo

  2. Norton Healthcare, Louisville, KY, USA

    Leah Y. Carreon

Authors
  1. Karina A. Zapata
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  2. Leah Y. Carreon
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  3. Chan-Hee Jo
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  4. Brandon A. Ramo
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Contributions

KAZ: made substantial contributions to the conception, study design, data acquisition and interpretation. KAZ drafted and revised the work. LC: made substantial contributions to data interpretation. LYC revised the work critically for important intellectual content. C-HJ: made substantial contributions to the analysis of the data. CHJ revised the work critically for important intellectual content. BAR: made substantial contributions to the study design and interpretation of the data. BAR drafted and revised the work critically for important intellectual content. KAZ, LYC, C-HJ, BAR: Approved the Version to be Published. KAZ, LYC, C-HJ, BAR: Agree to be Accountable for all aspects of the work.

Corresponding author

Correspondence to Karina A. Zapata.

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Conflicts of interest

LC declares the following conflicts: Consulting: National Spine Health Foundation, Orthopaedic Research Foundation, Inc; American Spine Registry (Committee member). Spine Deformity Journal (Deputy Editor), Spine Journal (Associate Editor), University Of Louisville Institutional Review Board (Member). Institutional Support: Alan L. and Jacqueline B. Stuart Spine Research Foundation, Cerapedics, Biom’Up, Empirical Spine, Scoliosis Research Society, Stryker, TSRH, Medtronic. The remaining authors declare no conflicts of interest.

Ethical approval

IRB approval was received from Scottish Rite for Children and from University of Texas Southwestern.

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Zapata, K.A., Carreon, L.Y., Jo, CH. et al. The Oswestry Disability Index is reflective of pain interference and mobility in children. Spine Deform 12, 329–334 (2024). https://doi.org/10.1007/s43390-023-00807-6

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