Practical challenges and limitations using the Oswestry Disability Low Back Pain Questionnaire in a private practice setting in New Zealand. A clinical audit

Abstract

The Oswestry Disability Low Back Pain Questionnaire (ODQ) is a validated outcome measure responsive to chronic low back pain. In New Zealand, a proportion of private practitioners use this disease specific outcome measure This clinical audit of a solo physiotherapy practice treating patients with chronic low back pain sought to outline the challenges and limitations of maintaining and interpreting the ODQ. Over a period of 9 years and 447 patients, 225 (52.9%) completed the ODQ at discharge and 127 (29.9%) at follow up of 2 months. Analysis of individual categories revealed smaller change scores in those with the highest baseline scores, i.e.; lifting, sitting and activities. Delay to treatment > 3 months reduced change scores and increased treatment numbers (p = 0.001). Outcomes showed improvement of between 53% and 79% at discharge, which was maintained at follow-up. Minimal detectable change was calculated to be 11% but the absence of appropriate data to calculate a minimal important clinical difference (MICD) was a limitation. Collecting and maintaining outcome statistics impacts on the interpretation of the measure. Poor questionnaire return rate and administrative errors also reduced the validity of the data.