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  • Back Index - Bcoreptfcbbcomb

Get Back Index - Bcoreptfcbbcomb

Fill Out & Print. Form Cannot Be Saved. Back Index Form BI100 ACN Group, Inc. Use Only rev 3/27/2003 Patient Name Date This questionnaire will give your provider information about how your back.

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How to fill out the Back Index - Bcoreptfcbbcomb online

This guide provides clear instructions on how to complete the Back Index - Bcoreptfcbbcomb online. It is designed to assist users in effectively conveying their back condition and the impact it has on their daily lives.

Follow the steps to accurately complete the form.

  1. Click 'Get Form' button to access the form and open it in your preferred editing tool.
  2. Begin by entering your full name and the date at the top of the form. This information helps identify your submission.
  3. Proceed to the 'Pain Intensity' section. Review each statement carefully and select the one that best describes your pain level.
  4. Move to the 'Sleeping' section. Again, read each statement and choose the one that most accurately reflects your sleep experience related to pain.
  5. Continue to the 'Sitting' section. Select the appropriate statement regarding how pain affects your ability to sit.
  6. In the 'Standing' section, indicate the statement that corresponds to your ability to stand without pain.
  7. Go to the 'Walking' section. Choose the statement that best represents your experience with walking and any associated pain.
  8. Next, fill out the 'Personal Care' section. Mark the statement that aligns with how your back condition impacts daily personal care activities.
  9. Proceed to the 'Lifting' section. Select the statement that describes your capability to lift various weights due to your condition.
  10. In the 'Traveling' section, choose the statement that reflects how pain affects your ability to travel.
  11. Complete the 'Social Life' section by selecting the statement that best illustrates the impact of pain on your social activities.
  12. In the 'Changing degree of pain' section, choose the statement that indicates the current trend of your pain levels.
  13. Finally, calculate your index score by summing all selected statements, dividing by the number of sections completed, and multiplying by 100.
  14. Review your responses for accuracy and completeness, then proceed to save, download, print, or share the form as needed.

Complete your document online to ensure accurate and timely information submission.

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Each section is scored on a 0–5 scale, 5 representing the greatest disability. The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage.

Scoring the Neck and Back Indexes Beneath the heading of each section are 6 statements describing increasing levels of disability or severity of pain. A value ranging from 0 (no disability or pain) to 5 (total disability or severe pain) is assigned to each statement.

The sum of the seven items equals the total score of the PDI, which ranges from 0 to 70, with higher scores reflecting higher interference of pain with daily activities. The PDI measures family / home responsibilities, recreation, social activity, occupation, sexual behavior, self-care and life support activity [3].

The Neck Disability Index and Oswestry Back Index are self-administered questionnaires that have been designed for us to assess the impact of specific conditions (i.e. neck pain, low-back pain) on our patients' ability to perform typical daily functions (personal care, walking, sitting).

SCORE DISABILITY LEVEL 0 - 4 No disability 5 - 14 Mild disability 15 - 24 Moderate disability 25 - 34 Severe disability 35 - 50 Completely disabled The Oswestry Disability Index (aka the Oswestry Low Back Pain Disability Questionnaire) is an ex- tremely important tool that researchers and disability evaluators use to ...

The NDI has become a standard instrument for measuring self-rated disability due to neck pain and is used by clinicians and researchers alike. Each of the 10 items is scored from 0 - 5. The maximum score is therefore 50. The obtained score can be multiplied by 2 to produce a percentage score.

The Oswestry Disability Index (also known as the Oswestry Low Back Pain Disability Questionnaire) is an extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the “gold standard” of low back functional outcome tools.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232