title: The Disability Rating Index: an instrument for the assessment of disability in clinical settings.
abstract: The purpose of this study was to evaluate an instrument for assessment of physical disability, mainly intended for clinical settings, the Disability Rating Index (DRI). Healthy persons (n = 1092), both white and blue collar workers, and patients (n = 366) with different levels of physical capacity, were assessed. Most of the patients (n = 303) underwent rehabilitation programmes for neck/shoulder/low-back pain but some (n = 47) were arthritis patients waiting for hip or knee replacement surgery, or wheelchair patients with multiple sclerosis (n = 16). The reliability was investigated by test-retest studies, intra- and inter-rater and internal consistency studies. Five construct validity tests were carried out: a discrimination study; a converging validity test; a test for sensitivity to small alterations in health status; and two correlational validity tests. Correlation of the self-reported DRI to the actual performance in similar activities was carried out. Responsiveness was tested by correlation of the DRI before/after replacement surgery for arthritis. The test-retest correlations were 0.83-0.95 in the studies, including correlation of different versions. The intra- and inter-rater reproducibility was 0.98 and 0.99 respectively. The Kruskal-Wallis test in the discrimination study yielded p < 0.0001. More than 90% of the respondents completed the questionnaire correctly. Correlation of the DRI to the Functional Status Questionnaire was 0.46. The responsiveness was excellent, p = 0.0001. The DRI proved to be a robust, practical clinical and research instrument with good responsiveness and acceptability for assessment of disability caused by impairment of common motor functions.
authors.affiliation: Department of Orthopaedics, Karolinska Institute/Hospital, Sweden.
authors.forename: B A
authors.initials: BA
authors.lastname: Salén
authors.forename: E V
authors.initials: EV
authors.lastname: Spangfort
authors.forename: A L
authors.initials: AL
authors.lastname: Nygren
authors.forename: R
authors.initials: R
authors.lastname: Nordemar
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000503:physiopathology; D001416:Back Pain / Q000175:diagnosis; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology; D009333:Neck; D010146:Pain; D015203:Reproducibility of Results; D012782:Shoulder; D011795:Surveys and Questionnaires