A Valid and Reliable Instrument: A One Minute Spinal Index

This post comes from Ron Feise of the Institute of Evidence-Based Chiropractic:

An instrument, the Functional Rating Index (FRI), combines the content of the  Oswestry Low Back Disability Questionnaire and the Neck Disability Index in a format which reduces administrative burden. The FRI instrument contains ten items which measure both pain and function of the spinal musculoskeletal system.  Of these 10 items, 8 refer to activities of daily living that might be adversely affected by a spinal condition, and 2 refer to different attributes of pain.  Because many spinal disabilities are most likely a combination of loss of function and pain and/or the fear of pain, employing both pain and function allows for a wider view of a patient's disability.

The FRI has been tested, and the results have been published in several peer reviewed journals (Spine, European Spine Journal, Aging Clinical and Experimental Research). Based on the research, FRI  demonstrates good reliability, validity and responsiveness with chiropractic interventions and significantly reduces administrative burden. On average, the FRI requires only about one minute for a patient to complete and about 20 seconds for a health care worker to score.  Additionally, this is the first instrument that can be used with cervical, thoracic or lumbar conditions, which reduces the need for multiple instruments for spine-related conditions. The FRI is available royalty-free for non-commercial use by solo practitioners and small groups of health care providers.  You can download the instrument at http://www.chiroevidence.com/FRI.html.Reference:
Feise RJ, Michael Menke J.  Functional rating index: a new valid and reliable instrument to measure the magnitude of clinical change in spinal conditions.  Spine 2001 Jan 1;26(1):78-86. 
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Outcome Assessment Questionnaires (Chiropractic)

Yesterday I had a question from a chiropractor about the Oswestry Low Back Pain Questionnaire.  I often get questions like this, from clinicians wanting to locate such instruments/outcomes forms to use in their practices. Well, some instruments are in the public domain and can be used by anyone, but the questions are seldom reproduced in their entirety in articles. I went to our clinic to ask about this and my esteemed colleague RR directed me to a Web site where some of these instruments can be downloaded.

The Chiropractic Resource Organization (site map) supports FCER and the ICPA, and the page of outcome forms is on the chiro.org Web site. They include this statement:

The Outcome Forms actually stored on our website have been approved by the owners (or copyright holders) for use in your clinical practice. If you plan to use them for research or publication, please Google those owners, and ask them for permission.

Here is the URL: http://www.chiro.org/LINKS/outcome.shtml#QA

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Does ne1 e-mail? GAL [Does anyone e-mail? Get a life!]

Yesterday when I returned to work I had over 500 junk e-mails to sift through. I spend a large chunk of every day dealing with e-mail, and when I read news items like the one below, I feel like an old fossil [despite my lovely blog photo]. Perhaps I should get a life [GAL] and learn some of the new technologies …

From The Buffalo News:

When Adam Elder wants to chat with a friend, he grabs his cell phone and punches out a quick text message. If that fails, he tries calling the friend's cell. As a last resort, he might go online and send an instant message.

You know what he never does?

Send an e-mail.

If you think that's surprising, then – excuse our bluntness – you clearly are not in your teens or early 20s.

In that age group, e-mail is now considered by many to be an old-school technology useful mostly for communicating with parents and teachers.

"I've probably sent maybe 50 e-mails in my entire life," said Elder, 20, a busboy at the Buffalo Chop House and a University at Buffalo student. "I hate e-mail."

The tool of choice for teens today is, by far, text message and instant message. One-third of teens are texting now, a recent national study found, and two-thirds of all teens use an online instant messaging function to chat – 48 percent of them every day.

Text and instant messaging, according to young people in Western New York, are better because they are quicker, easier and more casual.

E-mail, they say, is archaic and slow – as well as more formal.

Read the full text here.