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Development of a Chinese Version of the Oswestry Disability Index Version 2.1

Lue, Yi-Jing, PhD*†; Hsieh, Ching-Lin, PhD; Huang, Mao-Hsiung, MD, PhD¶§; Lin, Gau-Tyan, MD∥§; Lu, Yen-Mou, MD∥§

doi: 10.1097/BRS.0b013e31818018d8
Health Services Research

Study Design. Cross-cultural adaptation and cross-sectional psychometric testing in a convenience sample of patients with low back pain.

Objective. To translate and culturally adapt the Oswestry Disability Index version 2.1 (ODI 2.1) into a Mandarin Chinese version and to assess its reliability and validity.

Summary of Background Data. The Chinese ODI 2.1 has not been developed and validated.

Methods. The ODI 2.1 was translated and culturally adapted to the Chinese version. The validity of the translated Chinese version was assessed by examining the relationship between the ODI and other well-known measures. Test–retest reliability was examined in 52 of these patients, who completed a second questionnaire within 1 week.

Results. Internal consistency of the ODI 2.1 was excellent with Cronbach’s α = 0.903. The intraclass correlation coefficient of test–retest reliability was 0.89. The minimal detectable change was 12.8. The convergent validity of the Chinese ODI is supported by its high correlation with other physical functional status measures (Roland Morris Disability Questionnaire and SF-36 physical functioning subscale, r = 0.76 and −0.75, respectively), and moderate correlation with other measures (Visual Analogue Scale, r = 0.68) and certain SF-36 subscales (role-physical, bodily pain, and social functioning, r range: −0.49 to −0.57). As expected, the ODI was least correlated with nonfunctional measures (SF-36 mental subscale and role-emotional subscale, r = −0.25 and −0.33, respectively).

Conclusion. The results of this study indicate that the Chinese version of the ODI 2.1 is a reliable and valid instrument for the measurement of functional status in patients with low back pain.

The aim of this study was to develop a cross-cultural adaptation and to validate the Chinese Oswestry Disability Index (ODI) version 2.1 in patients with low back pain. The results showed high test-retest reliability and validity for the ODI, indicating that the ODI is a valuable instrument for assessing functional status in Mandarin-speaking patients with low back pain.

From the *Faculty of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan; †Department of Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; ‡School of Occupational Therapy, College of Medicine, National Taiwan University, Taiwan; §School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; ¶Department of Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; and ∥Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Acknowledgment date: November 27, 2007. First revision date: March 11, 2008. Second revision date: April 24, 2008. Acceptance date: April 28, 2008.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Institutional funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supported by grants from the Kaohsiung Medical University Research Foundation (M096009).

Address correspondence and reprint requests to Yen-Mou Lu, MD, Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, No, 100, TzYou 1st Rd., Kaohsiung 80708, Taiwan; E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.