NDI, Neck Disability INdex - Therapy SPOT

Name*
First Last
Date*
MM slash DD slash YYYY
1. Pain Intensity*
- 0- I have no pain at the moment.
- 1- The pain is very mild at the moment.
- 2- The pain is moderate at the moment.
- 3- The pain is fairly severe at the moment.
- 4- The pain is very severe at the moment.
- 5- The pain is the worst imaginable at the moment.
2. Personal Care*
- 0- I can look after myself normally without causing extra pain.
- 1- I can look after myself normally, but it causes extra pain.
- 2- It is painful to look after myself, and I am slow and careful.
- 3- I need some help but manage most of my personal care.
- 4- I need help every day in most aspects of self-care.
- 5- I do not get dressed. I wash with difficulty and stay in bed.
3.Lifting*
- 0- I can lift heavy weights without causing extra pain.
- 1- I can lift heavy weights, but it gives me extra pain.
- 2- Pain prevents me from lifting heavy weights off the floor but I can manage if items are conveniently positioned, ie. on a table.
- 3- Pain prevents me from lifting heavy weights, but I can manage light weights if they are conveniently positioned.
- 4- I can lift only very light weights.
- 5- I cannot lift or carry anything at all.
4. Work*
- 0- I can do as much work as I want.
- 1- I can only do my usual work, but no more.
- 2- I can do most of my usual work, but no more.
- 3- I can't do my usual work.
- 4- I can hardly do any work at all.
- 5- I can't do any work at all.
5. Headaches*
- 0- I have no headaches at all.
- 1- I have slight headaches that come infrequently.
- 2- I have moderate headaches that come infrequently.
- 3- I have moderate headaches that come frequently.
- 4- I have severe headaches that come frequently.
- 5- I have headaches almost all the time.
6. Concentration*
- 0- I can concentrate fully without difficulty.
- 1- I can concentrate fully with slight difficulty.
- 2- I have a fair degree of difficulty concentrating.
- 3- I have a lot of difficulty concentrating.
- 4- I have a great deal of difficulty concentrating.
- 5- I can't concentrate at all.
7. Sleeping*
- 0- I have no trouble sleeping.
- 1- My sleep is slightly disturbed for less than 1 hour.
- 2- My sleep is mildly disturbed for up to 1-2 hours.
- 3- My sleep is moderately disturbed for up to 2-3 hours.
- 4- My sleep is greatly disturbed for up to 3-5 hours.
- 5- My sleep is completely disturbed for up to 5-7 hours.
8. Driving*
- 0- I can drive my car without neck pain.
- 1- I can drive as long as I want with slight neck pain.
- 2- I can drive as long as I want with moderate neck pain.
- 3- I can't drive as long as I want because of moderate neck pain.
- 4- I can hardly drive at all because of severe neck pain.
- 5- I can't drive my car at all because of neck pain.
9. Reading*
- 0- I can read as much as I want with no neck pain.
- 1- I can read as much as I want with slight neck pain.
- 2- I can read as much as I want with moderate neck pain.
- 3- I can't read as much as I want because of moderate neck pain.
- 4- I can't read as much as I want because of severe neck pain.
- 5- I can't read at all.
10. Recreation*
- 0- I have no neck pain during all recreational activities.
- 1- I have some neck pain with all recreational activities.
- 2- I have some neck pain with a few recreational activities.
- 3- I have neck pain with most recreational activities.
- 4- I can hardly do recreational activities due to neck pain.
- 5- I can't do any recreational activities due to neck pain.
NDI Score
Score is presented as a percentage of 100

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