Validity and reliability of English and Marathi Oswestry Disability Index (version 2.1a) in Indian population

A total of 200 patients with low back pain (LBP) completed an English and Marathi Oswestry Disability Index (ODI) questionnaires (100 each), visual analogue scale, and Roland-Morris Disability Questionnaire.

To validate the English and Marathi versions of ODI (version 2.1a).

Patient-orientated assessment methods are important in the evaluation of treatment outcome. The ODI is one of the condition-specific questionnaires recommended for the use of patients with LBP.

An adaptation of the ODI (version 2.1a) for Marathi language was carried out according to established guidelines.

Average age of patients who answered the English ODI was 42 ± 15, whereas that of Marathi-speaking patients was 52 ± 15 years. About 40% were males. The Cronbach α reliability score was 0.877 for English and 0.943 for Marathi. Forty-seven and 53 of these patients were retested with English and Marathi ODI within 2 weeks (to assess test-retest reliability). The intraclass correlation coefficient (ICC) for the test-retest reliability of the questionnaire was 0.877 and 0.943 for English and Marathi respectively. The ODI scores correlated with visual analogue scale pain intensity (r = 0.67, P < 0.0001) and Roland-Morris Disability Questionnaire score (r = 0.71, P < 0.0001) for English and visual analogue scale (r = 0.325, P < 0.001) and Roland-Morris Disability Questionnaire scores (r = 0.503, P < 0.0001) for Marathi. The receiver operating characteristic curve analysis showed comparable performance in discriminating the existence of sign and symptoms (area under curve = 0.947, P < 0.0001, 95% confidence interval: 0.893-0.999 for English and Marathi (area under curve: 0.834, P < 0.0001, 95% confidence interval: 0.735-0.933) for severe compared with nonsevere LBP proving discriminative validity. Results showed that English ODI is valid and reliable.

The Marathi version of Oswestry questionnaire is reliable and valid, and shows psychometric characteristics as good as the English version. It should represent a valuable tool for use in future patient-orientated outcome studies for population with LBP in India.