Abstract
BackgroundRobust outcome measures are needed to assess and monitor the impact of chronic low back pain (CLBP) on physical functioning. The Roland Morris Disability Questionnaire (RMDQ) is a well-established measure designed to capture the impacts of back pain on everyday functioning, with a particular emphasis on physical functioning. It has documented evaluation of psychometric properties. However, there is no documented qualitative evidence to confirm the content validity of the tool, nor have changes made for electronic administration been debriefed in participants with CLBP.MethodsIn-depth, semi-structured, concept elicitation and cognitive debriefing interviews were conducted with 23 US participants with confirmed CLBP. Interviews allowed participants to describe the impact of CLBP on their day-to-day functioning and discuss comprehension and suitability of the RMDQ. Interviews were transcribed verbatim and analyzed using thematic analysis.ResultsConcept elicitation and cognitive debriefing revealed the substantial burden associated with CLBP, highlighting 15 key areas of functional impact. These were grouped into overarching themes of mobility (walking, stairs, sitting/standing, bending/kneeling, lifting, lying down), activities (chores/housework, dressing, washing, driving, work) and other (relationships/socializing, mood, sleep, appetite), which are consistent with those evaluated within the RMDQ.All participants found the RMDQ to be relevant with most reporting that the instructions, recall period, and response options were suitable. A few suggested minor changes, however, none were consistent or necessary to support content validity. Updates to the measure for electronic administration and to clarify the response options were well received.ConclusionThe qualitative data from individuals with CLBP confirmed that the RMDQ has content validity and, alongside documented psychometric evidence, supports the use of the RMDQ as a reliable and valid tool to assess the impact of CLBP on physical functioning.
Highlights
Robust outcome measures are needed to assess and monitor the impact of chronic low back pain (CLBP) on physical functioning
The Roland Morris Disability Questionnaire (RMDQ) was developed to capture the everyday functional impact of CLBP. It does include some broader concepts than might traditionally fall within a strict definition of physical functioning, due to the nature of the condition, it is primarily focussed on physical functioning [6, 15]
The mean time since diagnosis was 7.86 years, none had undergone surgery for CLBP, and 22 were currently receiving treatment
Summary
Robust outcome measures are needed to assess and monitor the impact of chronic low back pain (CLBP) on physical functioning. The Roland Morris Disability Questionnaire (RMDQ) is a well-established measure designed to capture the impacts of back pain on everyday functioning, with a particular emphasis on physical functioning It has documented evaluation of psychometric properties. In research demonstrating construct validity, strongest correlations have been reported with other measures of self-reported disability and health-related quality of life (the Oswestry Disability Index: 0.79–0.8023 and SF-36: 0.60–0.85) [22] and weakest correlations are reported with objective tests of physical function [23, 24] such as fingertip to floor (r = 0.27) [23], straight leg raise (r = 0.44) [23], and 15 m walk test (r = 0.37) [24] These correlations reflect the pattern of relationships that would be expected for a measure of self-reported physical function in CLBP. The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) guidelines include the RMDQ as an example of a diseasespecific measure that has been developed to evaluate physical function in CLBP [16]
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