Psychometric Validation and Population-Based Normative Values of the Japanese Oswestry Disability Index Version 2.1a: A Nationally Representative Survey.
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引用次数: 0
Abstract
Background context: The Oswestry Disability Index (ODI) is one of the most widely used instruments for assessing disability related to low back pain (LBP). However, population-based normative values are scarce, and the structural validity of Japanese version of the ODI (version 2.1a) has not been sufficiently evaluated.
Purpose: To psychometrically validate the Japanese version of the ODI (version 2.1a) and to establish population-based normative values stratified by age and LBP duration.
Study design/setting: Population-based cross-sectional study using a nationwide survey in Japan.
Patient sample: A nationally representative sample of community-dwelling adults in Japan selected through a two-stage stratified random sampling design. A total of 5,000 individuals were invited to participate.
Outcome measures: Self-report measures: Disability related to low back pain assessed using the Japanese version of the ODI (version 2.1a).
Methods: Japan was stratified into 65 strata, from which 250 sampling points were randomly selected, and 20 residents were randomly sampled per point. Psychometric properties of the ODI version 2.1a were evaluated among respondents using factor analyses. Response-adjusted, survey-weighted normative values were estimated for the general population and for individuals with LBP, stratified by age group and pain duration subtype (acute, subacute, and chronic).
Results: Of the 5,000 individuals invited, 2,188 responded (response rate 43.8%). Among respondents, 1,270 had complete ODI data and were included in the psychometric analysis, including 173 individuals with LBP. The estimated population prevalence of LBP was 14.7% (95% confidence interval [CI] 13.1-16.4%), comprising acute 2.5% (95% CI 1.9-3.3%), subacute 1.1% (95% CI 0.7-1.7%), and chronic 11.1% (95% CI 9.8-12.5%). Factor analyses demonstrated a unidimensional structure of the ODI version 2.1a. Among individuals with LBP, the survey-weighted mean ODI score was 20.23 (95% CI 18.32-22.13). Normative values varied by pain duration (acute: 12.54 [95% CI 8.87-16.22]; subacute: 13.54 [95% CI 8.78-18.31]; chronic: 22.74 [95% CI 20.56-24.92]) and increased with advancing age.
Conclusion: This study provides psychometric validation of the Japanese ODI version 2.1a and establishes age- and pain duration-specific normative values. These findings support the use of ODI version 2.1a as a single total score for profiling disability in everyday life and for evaluating the management of LBP in both clinical practice and research.
背景背景：Oswestry残疾指数（ODI）是评估下腰痛（LBP）相关残疾最广泛使用的工具之一。然而，基于人口的规范性值很少，日本版ODI （2.1a版）的结构有效性尚未得到充分评估。目的：从心理测量学上验证日本版ODI （2.1a版），并建立基于人群的按年龄和LBP持续时间分层的规范值。研究设计/设置：采用日本全国调查的基于人群的横断面研究。患者样本：通过两阶段分层随机抽样设计选择日本社区居住成年人的全国代表性样本。总共有5000人被邀请参加。结果测量：自我报告测量：使用日本版ODI （2.1a版）评估与腰痛相关的残疾。方法：将日本分为65个分层，随机抽取250个采样点，每个采样点随机抽取20名居民。采用因子分析对ODI 2.1a版的心理测量特性进行评价。根据年龄组和疼痛持续时间亚型（急性、亚急性和慢性）对一般人群和LBP患者进行反应调整、调查加权的规范化值估计。结果：在被邀请的5000人中，有2188人回复了，回复率为43.8%。在被调查者中，有1,270人有完整的ODI数据，并被纳入心理测量分析，其中173人患有LBP。估计人群LBP患病率为14.7%(95%可信区间[CI] 13.1-16.4%)，包括急性2.5% (95% CI 1.9-3.3%)，亚急性1.1% （95% CI 0.7-1.7%）和慢性11.1% （95% CI 9.8-12.5%）。因子分析表明ODI 2.1a版本具有单维结构。在LBP患者中，调查加权平均ODI得分为20.23 （95% CI 18.32-22.13）。标准值随疼痛持续时间的不同而变化（急性：12.54 [95% CI 8.87-16.22]；亚急性：13.54 [95% CI 8.78-18.31]；慢性：22.74 [95% CI 20.56-24.92]），并随着年龄的增长而增加。结论：本研究提供了日本ODI 2.1a版本的心理测量验证，并建立了年龄和疼痛持续时间特异性的规范值。这些发现支持使用ODI 2.1a版本作为分析日常生活中残疾和评估临床实践和研究中腰痛管理的单一总分。
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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