Roland‐Morris Disability Questionnaire

Original Editors - Nele Postal Top Contributors - Nele Postal, Admin, Rachael Lowe, Yvonne Yap, Kim Jackson, Evan Thomas, Elaine Lonnemann, Uchechukwu Chukwuemeka, WikiSysop, Amrita Patro, Lauren Lopez, Lucinda hampton and Nupur Smit Shah

Objective

First published in 1983 and reviewed in 2000, the Roland-Morris Disability Questionnaire (RMDQ) is designed to assess self-rated physical disability caused by low back pain.

Intended Population

The Roland-Morris Disability Questionnaire is most sensitive for patients with mild to moderate disability due to acute, sub-acute, or chronic low back pain. 0The Sickness Impact Profile (SIP), a 136-item health status assessment spanning all facets of physical and mental function, served as the foundation for the Roland-Morris Disability Questionnaire. The original authors chose 24 elements from the SIP because they were explicitly relevant to bodily processes that low back pain was expected to influence.
For patients with severe disability the Oswestry Disability Indexis recommended.

Method of Use and Scoring Interpretation

There are different questionnaires available, which differ from each other in the number of statements: 24-, 18- and 11-item questionnaires. It has also been adapted across cultures and translated for use in different countries.

The patient is asked to tick a statement when it applies to him that specific day, this makes it possible to follow changes in time. The end score is the sum of the ticked boxes. The score ranges from 0 (no disability) to 24 (max. disability) depending on the questionnaire used. Roland and Morris omitted describing the various levels of disability (for example, 40%–60% of disability is severe). Based on the study of serial questionnaire scores, clinical changes over time can be rated. We would calculate an 80% improvement (12/15 x 100) if, for instance, a patient had a score of 15 at the start of therapy and a score of 3 at the end (12 points of improvement).

Questions

It can be administered face-to-face, electronically, or over the phone. There are questionnaires in different languages, available online for free for clinicians to use via the website of the Roland Morris Disability Questionnaire.

1. I stay at home most of the time because of my back.
2. I change position frequently to try and get my back comfortable.
3. I walk more slowly than usual because of my back.
4. Because of my back I am not doing any of the jobs that I usually do around the house.
5. Because of my back, I use a handrail to get upstairs.
6. Because of my back, I lie down to rest more often.
7. Because of my back, I have to hold on to something to get out of an easy chair.
8. Because of my back, I try to get other people to do things for me.
9. I get dressed more slowly than usual because of my back.
10. I only stand for short periods of time because of my back.
11. Because of my back, I try not to bend or kneel down.
12. I find it difficult to get out of a chair because of my back.
13. My back is painful almost all the time.
14. I find it difficult to turn over in bed because of my back.
15. My appetite is not very good because of my back pain.
16. I have trouble putting on my socks (or stockings) because of the pain in my back.
17. I only walk short distances because of my back.
18. I sleep less well because of my back.
19. Because of my back pain, I get dressed with help from someone else.
20. I sit down for most of the day because of my back.
21. I avoid heavy jobs around the house because of my back.
22. Because of my back pain, I am more irritable and bad tempered with people than usual.
23. Because of my back, I go upstairs more slowly than usual.
24. I stay in bed most of the time because of my back.

Reliability

Macedo et al. (2011) looked at the results from different studies for the reliability of the 24-, 18- and 11-item RMDQ:

• Test-retest reliability 24-item: intraclass correlation (ICC) ranges from 0.42 – 0.91
• Test-retest reliability 18-item Stratford: ICC ranges from 0.68 – 0.75
• Test-retest reliability 11-item: ICC ranges from 0.89

Validity

Content validity:

• The RMDQ is limited as it only covers specific physical problems, not psychological or social ones. In case these problems should be investigated as well, other measuring of these functions is advised.
  

Construct validity:

• Construct validity defines the degree to which the test measures the variables it is supposed to measure.

The RMDQ correlates well with other tests which measure physical disability:

• Physical subscales of SF-36
• Physical subscales of Sickness Impact Profile
• Quebec Low Back Scale
• Oswestry Disability Questionnaire
• Pain ratings

Responsiveness

Internal responsiveness:

• Internal responsiveness shows the ability of a test to measure differences in time.
• Using effect sizes:
  • 24-item: ranges from 0.63-0.71
  • 18-item Stratford: ranges from 0.73-0.82
  • 11-item: ranges from 0.61-0.69
    

External responsiveness:

• External responsiveness gives the relation between the results measured with RMDQ and the results measured with the Global Perceived Effect Scale (GPE scale)
• Pearson correlation with GPE Scale:
  • 24-item: ranges from 0.45-0.54
  • 18-item Stratford: ranges from 0.44-0.53
  • 11-item: ranges from 0.39-0.49
    

Resources

• Roland-Morris Disability Questionnaire webpage