Neck Disability Index

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* 1. Client Name: Surname, First Name

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* 2. Who is your Physiotherapist?

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* 3. This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life.

Please answer every section and mark in each section only the one box that applies to you.

We realise you may consider that two or more statements in any one section relate to you, but please just mark the box that most closely describes your problem.

Section 1: Pain Intensity

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* 4. Section 2: Personal Care (Washing, Dressing, etc.)

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* 5. Section 3: Lifting

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* 6. Section 4: Reading

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* 7. Section 5: Headaches

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* 8. Section 6: Concentration

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* 9. Section 7: Work

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* 10. Section 8: Driving

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* 11. Section 9: Sleeping

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* 12. Section 10: Recreation

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* 13. Interpretation of scores (for office use only)

Score: (add up scores from each section) = ________                MDC (90% confidence): 5 points                  SCORE RANGE = 0 (no disability) to 50 (max disability)

NDI developed by: Vernon, H. & Mior, S. (1991). The Neck Disability Index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics. 14, 409-415

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