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.
Note: Since the initial testing,
several independent research teams have confirmed/endorsed
the reliability
and validity of the FRI (Bayar 2004; Childs 2005;
Chansirinukor 2005; Hush 2006; Lee 2006).
Abstract
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