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Functional Rating Index: Introduction

A New Valid and Reliable Instrument - The One Minute Index
Although chiropractors may continue their traditional emphasis on the structure of the body, it is vitally important for them to understand the everyday functioning and pain of the patient and to have a method of quantifying those items. Patient-centered outcome instruments are now widely recognized as valuable assessment tools for researchers, doctors, patients and payors. In fact, a patient’s self-evaluation may be more accurate than the clinical, biochemical, or physiological indexes that we have traditionally relied upon (Epstein 1990). The need to measure the function of the neck and back and to demonstrate clinical effectiveness has resulted in many reliable and valid patient report instruments being produced in the last 20 years. Yet, existing self-reporting instruments measuring spinal pain and dysfunction require too much time for patients to answer (5 to 10 minutes per instrument) and health care workers to score (1 to 5 minutes per instrument) and, therefore, are underutilized in daily practice.

A new 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. FRI has recently been tested, and the results have been published in Spine (Feise 2001). Based on the initial research, FRI demonstrates excellent reliability, validity, and responsiveness, and significantly reduces administrative burden. On average, FRI requires only about one minute for a patient to complete and about 20 seconds for a health care worker to score. Additionally, this instrument can be used with cervical, thoracic or lumbar conditions, which reduces the need for multiple instruments for spine-related conditions.


A Scientific Review 

Medical Science Monitor published a scientific review of 10 studies on the Functional Rating Index. The researchers found that the Functional Rating Index demonstrates favorable measurement properties of reliability, validity and responsiveness. A download of the entire study is complementary online at Medical Science Monitor (Volume 16, Number 2, 2010).  Click here to go the web site for this review.  Look under reviews at the bottom of the page. The study is titled, “Functional Rating Index: Literature review.” Click on the FULL TEXT. 

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