NECK AND BACK PAIN OUTCOME ASSESSMENTS

This questionnaire has been designed to give the doctor information as to how your neck pain has affected your ability to manage in everyday life. Please answer every section and mark in each section only ONE box which applies to you. We realize you may describes consider that your two of the statements in any one section relate to you, but please just mark the box which MOST CLOSELY problem.

Scoring: Questions are scored on avertical scale of 0-5. Total scores and multiply by 2. Divide by number of sections answered multiplied by 10. A score of 22% or more is considered a significant activities of daily living disability.

Modified Oswestry Low Back Pain Disability Questionnaire

This questionnaire has been designed to give your doctor information as to how your back pain has affected your ability to manage in everyday life. Please answer every section and mark in each section only ONE box that best describes your condition today. We realize you may feel that two of the statements may describe your condition, but please mark only the box that MOST CLOSELY describes your current condition.

FOR OFFICE USE ONLY

Score: /50 x 100 = % points

Scoring: For each section the total possible score is 5: if the first statement is marked the section score = 0, if the last statement is marked it= 5. If all ten sections are completed the score is calculated as follows: Example:
16(total scored) / 50 (total possible score) x 100 = 32%
If one section is missed or not applicable the score is calculated:
16( 16 (total scored) / 45 (total possible score) x 100 = 35.5%
Minimum Detectable Change (90% confidence): 10% points (Change of less than this amount may be attributed to error in the measurement.)