Charles Philip Gabel1, Antonio Cuesta-Vargas2, Meihua Qian3, Rok Vengust4, Ulrich Berlemann5, Emin Aghayev6, Markus Melloh7,8,9. 1. Coolum Physiotherapy Sunshine Coast, Coolum Beach, Queensland, Australia. 2. Department of Physiotherapy, Faculty of Medicine, Malaga University, Malaga, Spain. 3. Department of Education and Human Development, College of Education, Clemson University, 410 Tillman Hall, Clemson, SC, 29634, USA. mqian@g.clemson.edu. 4. Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia. 5. dasRückenzentrum, Standort Salem-Spital, Bern, Switzerland. 6. Swiss RDL, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. 7. Institute for Health Sciences, School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland. 8. Faculty of Health Sciences, Curtin University, Perth, Australia. 9. Centre for Medical Research, University of Western Australia, Nedlands, Australia.
Abstract
PURPOSE: To analyze the factor structure of the Oswestry Disability Index (ODI) in a large symptomatic low back pain (LBP) population using exploratory (EFA) and confirmatory factor analysis (CFA). METHODS: Analysis of pooled baseline ODI LBP patient data from the international Spine Tango registry of EUROSPINE, the Spine Society of Europe. The sample, with n = 35,263 (55.2% female; age 15-99, median 59 years), included 76.1% of patients with a degenerative disease, and 23.9% of the patients with various other spinal conditions. The initial EFA provided a hypothetical construct for consideration. Subsequent CFA was considered in three scenarios: the full sample and separate genders. Models were compared empirically for best fit. RESULTS: The EFA indicated a one-factor solution accounting for 54% of the total variance. The CFA analysis based on the full sample confirmed this one-factor structure. Sub-group analyses by gender achieved good model fit for configural and partial metric invariance, but not scalar invariance. A possible two-construct model solution as outlined by previous researchers: dynamic-activities (personal care, lifting, walking, sex and social) and static-activities (pain, sleep, standing, travelling and sitting) was not preferred. CONCLUSIONS: The ODI demonstrated a one-factor structure in a large LBP sample. A potential two-factor model was considered, but not found appropriate for constructs of dynamic and static activity. The use of the single summary score for the ODI is psychometrically supported. However, practicality limitations were reported for use in the clinical and research settings. Researchers are encouraged to consider a shift towards newer, more sensitive and robustly developed instruments.
PURPOSE: To analyze the factor structure of the Oswestry Disability Index (ODI) in a large symptomatic low back pain (LBP) population using exploratory (EFA) and confirmatory factor analysis (CFA). METHODS: Analysis of pooled baseline ODI LBP patient data from the international Spine Tango registry of EUROSPINE, the Spine Society of Europe. The sample, with n = 35,263 (55.2% female; age 15-99, median 59 years), included 76.1% of patients with a degenerative disease, and 23.9% of the patients with various other spinal conditions. The initial EFA provided a hypothetical construct for consideration. Subsequent CFA was considered in three scenarios: the full sample and separate genders. Models were compared empirically for best fit. RESULTS: The EFA indicated a one-factor solution accounting for 54% of the total variance. The CFA analysis based on the full sample confirmed this one-factor structure. Sub-group analyses by gender achieved good model fit for configural and partial metric invariance, but not scalar invariance. A possible two-construct model solution as outlined by previous researchers: dynamic-activities (personal care, lifting, walking, sex and social) and static-activities (pain, sleep, standing, travelling and sitting) was not preferred. CONCLUSIONS: The ODI demonstrated a one-factor structure in a large LBP sample. A potential two-factor model was considered, but not found appropriate for constructs of dynamic and static activity. The use of the single summary score for the ODI is psychometrically supported. However, practicality limitations were reported for use in the clinical and research settings. Researchers are encouraged to consider a shift towards newer, more sensitive and robustly developed instruments.
Authors: Caroline B Terwee; Sandra D M Bot; Michael R de Boer; Daniëlle A W M van der Windt; Dirk L Knol; Joost Dekker; Lex M Bouter; Henrica C W de Vet Journal: J Clin Epidemiol Date: 2006-08-24 Impact factor: 6.437
Authors: M Guermazi; M Mezghani; S Ghroubi; M Elleuch; A Ould Sidi Med; S Poiraudeau; F Mrabet; J Dammak; J Fermanian; S Baklouti; S Sellami; M Revel; M H Elleuch Journal: Ann Readapt Med Phys Date: 2005-02
Authors: Miranda L van Hooff; Maarten Spruit; Jeremy C T Fairbank; Jacques van Limbeek; Wilco C H Jacobs Journal: Spine (Phila Pa 1976) Date: 2015-01-15 Impact factor: 3.468
Authors: Lukas P Staub; Christoph Ryser; Christoph Röder; Anne F Mannion; Jeffrey G Jarvik; Max Aebi; Emin Aghayev Journal: Spine J Date: 2015-12-07 Impact factor: 4.166
Authors: Caroline B Terwee; Lidwine B Mokkink; Dirk L Knol; Raymond W J G Ostelo; Lex M Bouter; Henrica C W de Vet Journal: Qual Life Res Date: 2011-07-06 Impact factor: 4.147
Authors: Jacquelyn S Pennings; Clinton J Devin; Inamullah Khan; Mohamad Bydon; Anthony L Asher; Kristin R Archer Journal: Qual Life Res Date: 2019-06-06 Impact factor: 4.147
Authors: Charles Philip Gabel; Hamid Reza Mokhtarinia; Jonathan Hoffman; Jason Osborne; E-Liisa Laakso; Markus Melloh Journal: BMJ Open Date: 2018-08-08 Impact factor: 2.692
Authors: Luca Barni; María Ruiz-Muñoz; Manuel Gonzalez-Sanchez; Antonio I Cuesta-Vargas; Jose Merchan-Baeza; Marco Freddolini Journal: Health Qual Life Outcomes Date: 2021-11-22 Impact factor: 3.186
Authors: Fabíola Costa; Dora Janela; Maria Molinos; Robert G Moulder; Jorge Lains; Virgílio Bento; Justin Scheer; Vijay Yanamadala; Fernando Dias Correia; Steven P Cohen Journal: J Pain Res Date: 2022-07-03 Impact factor: 2.832
Authors: Hamid Reza Mokhtarinia; Azadeh Hosseini; Azam Maleki-Ghahfarokhi; Charles Philip Gabel; Majid Zohrabi Journal: Health Qual Life Outcomes Date: 2018-05-15 Impact factor: 3.186