The disability rating index: An instrument for the assessment of disability in clinical settings

Salen, Bo A.; L.^Nygren, Erik V. SpangfortÅke; Nordemar, Rolf

doi:10.1016/0895-4356(94)90086-8

Cited by 335 publications

(261 citation statements)

References 21 publications

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“…All self-estimation scales had been used in an earlier study [21]. Lumbar back and pelvic pain were defined as in our earlier studies [16] (see Table 1).…”

Section: Methodsmentioning

confidence: 99%

Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up

et al. 2001

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IntroductionBack pain is an abundant problem in normal pregnancy and sick leave for that reason accounts for the majority of all social insurance expenses from work absenteeism during pregnancy in several countries [8,10,22]. The type of disability behind that absenteeism has not been identified, with the diagnosis most often used being "back pain" [22]. Earlier publications have reported that 70% of all pregnant women have some kind of back pain [2,9,11,14,15] and that 20% of all women are on sick leave for that reason for an average of 7 weeks during pregnancy [8,10,13,22].The incidence of women with some kind of residual back pain 6 years post partum was 20% in one study [18], while serious residual pain has been estimated to affect 7% percent of all pregnant women 18 months post partum [13].Back pain in pregnancy is not one single pain type, but should be separated into at least lumbar back pain and posterior pelvic pain, and treated accordingly [1,5,6,7,9,14,15,17]. This would reduce sick leave during pregnancy [10,15], and may even have a long-term effect [18].Abstract This study is a prospective, consecutive, 3-year cohort study of women with back pain in an index pregnancy. The aim was to describe the physical status and disability among women with back pain 3 years after delivery. Pain was identified as lumbar back pain, posterior pelvic pain or combined lumbar as well as posterior pelvic pain. Previous studies have established that all three types of pain can be reduced by structured physiotherapy during pregnancy, and the beneficial effect may last for several years. Though it is known that some women have residual pain for a long time, the relative incidence of the three pain types and their degree of disability associated with each have never been reported. Neither has any study presented findings of a physical examination of women 3 years post partum with a focus on the type of pain. All women who were registered as having experienced back pain during an index pregnancy were interviewed by mail 3 years post partum. Women who had residual back pain filled in an additional questionnaire and were physically examined. Out of 799 pregnant women, 231 had some type of back pain during the index pregnancy, and 41 women had pain 3 years later. Women with combined lumbar and posterior pelvic pain were significantly more disabled (P<0.05) and had significantly lower endurance in the lumbar back and hip abduction muscles (P<0.01). Some 5% of all pregnant women, or 20% of all women with back pain during pregnancy, had pain 3 years later. The key problem may be poor muscle function in the back and pelvis.

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“…All self-estimation scales had been used in an earlier study [21]. Lumbar back and pelvic pain were defined as in our earlier studies [16] (see Table 1).…”

Section: Methodsmentioning

confidence: 99%

Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up

et al. 2001

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“…It was developed in the 1980s and later validated by a group including a member of the spinal research group at Karolinska University Hospital, Huddinge, Sweden [43]. The score is the mean of 12 functional VAS concerning different daily activities (dressing, outdoor walking, climbing stairs, sitting for longer time, standing bent over a sink, carrying a bag, making a bed, running, light work, heavy work, lifting heavy objects and participation in exercise/sports).…”

Section: Outcome Measurementsmentioning

confidence: 99%

A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration

et al. 2009

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The existence and importance of an accelerated adjacent segment disc degeneration (ASD) after lumbar fusion have previously not been demonstrated by RCTs. The objectives of this study were, to determine whether lumbar fusion in the long term accelerates degenerative changes in the adjacent disc and whether this affects the outcome, by using a prospective randomised design. A total of 111 patients, aged 18-55, with isthmic spondylolisthesis were randomised to exercise (EX, n = 34) or posterolateral fusion (PLF, n = 77), with (n = 37) or without pedicle screw instrumentation (n = 40). The minimum 10 years FU rate was 72%, with a mean FU time of 12.6 years (range 10-17 years). Three radiographic methods of ASD quantification were used, i.e. two digital radiographic measurement methods and the semi quantitative UCLA grading scale. One digital measurement method showed a mean disc height reduction by 2% in the EX group and by 15% in the PLF group (p = 0.0016), and the other showed 0.5 mm more disc height reduction in the PLF compared to the Ex group (ns). The UCLA grading scale showed normal discs in 100% of patients in the EX group, compared to 62% in the PLF group (p = 0.026). There were no significant differences between instrumented and non-instrumented patients. In patients with laminectomy we found a significantly higher incidence of ASD compared to non laminectomised patients (22/47 vs. 2/16 respectively, p = 0.015). In the longitudinal analysis, the posterior and anterior disc heights were significantly reduced in the PLF group, whereas in the EX group only the posterior disc height was significantly reduced. Except for global outcome, which was significantly better for patients without ASD, the clinical outcome was not statistically different in patients with and without ASD. In conclusion, the long-term RCT shows that fusion accelerates degenerative changes at the adjacent level compared with natural history. The study suggests that not only fusion, but also laminectomy may be of pathogenetic importance. The clinical importance of ASD seems limited, with only the more severe forms affecting the outcome.

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“…The Disability Rating Index (DRI) (Salén et al 1994) requires the patient's own assessment of his/ her ability to perform ADL and IADL activities. 7 of the 12 original DRI items were used: dressing, standing bent over a sink, sitting for 30 min, making a bed, climbing stairs, outdoor walks and light work.…”

Section: Questionnairesmentioning

confidence: 99%

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

2006

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BackgroundIt is not known whether postoperative occupational therapy is of value for hip fracture patients. In this randomized trial we evaluated the effects of an individualized, postoperative, occupational training (OT) program on the patient's self-reported health-related quality of life (HRQL) and self-reported abilities to perform activities of daily living (ADL) and instrumental activities of daily living (IADL).Patients and methods 100 eligible patients (aged ≥ 65 years) were randomized 50:50 to an OT or control group (termed the C group: conventional care). The OT group received individualized OT from day 3 or 4 after surgery and until discharge, and also a home visit. The patients answered the Swedish Health-Related Quality of Life questionnaire (SWED-QUAL) and the modified Disability Rating Index (DRI) three times: 3-4 days after surgery, at discharge, and at follow-up after 2 months.Results We found no statistically significant differences between the groups at discharge and at follow-up regarding mean SWED-QUAL scores. However, on comparing each group over time, 2 months after the fracture the OT group had regained their self-reported pre-fracture HRQL status in 10 of 12 SWED-QUAL subscales, and the C group in 6 subscales. Statistically significant differences (p < 0.05) were found between the groups after 2 months regarding self-reported IADL (moving around indoors, performance of light housework, and getting in and out of a car).Interpretation Our findings indicate that the individualized occupational training improved the ability to

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The disability rating index: An instrument for the assessment of disability in clinical settings

Cited by 335 publications

References 21 publications

Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up

Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up

A prospective randomised study on the long-term effect of lumbar fusion on adjacent disc degeneration

Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: A randomized trial

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