Abstract
ObjectiveThe causes of low back pain in China and Western countries are extremely different. We attempted to analyze the risk factors of low back pain in urban and rural patients under the dual economy with the simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ) to demonstrate that SC-RMDQ could evaluate patients with low back pain arising from different causes.MethodsRoland-Morris disability questionnaire was translated into SCRMDQ according to international guidelines for questionnaire adaptation. In this study, causes of low back pain of 187 outpatients and inpatients (99 urban patients and 88 rural patients) were analyzed. All patients underwent simplified Chinese version of Roland-Morris disability questionnaire (SC-RMDQ), simplified Chinese Oswestry disability index (SCODI) and visual analogue scale (VAS). Reliability was tested using reproducibility (intraclass coefficient of correlation – ICC) and internal consistency (Cronbach's alpha). Validity was tested using Pearson correlation analysis.ResultsThe leading causes for low back pain were sedentariness (38.4%) and vibration (18.1%) in urban patients and waist bending (48.9%) and spraining (25%) in rural patients. Although causes of low back pain in the two groups of population were completely different, SCRMDQ had high internal consistency (Cronbach's α value of 0.874 in urban patients and 0.883 in rural patients) and good reproducibility (ICC value of .952 in urban patients and 0.949 in rural patients, P<0.01). SCRMDQ also showed significant correlation with Simplified Chinese version of Oswestry disability index (SCODI) and visual analogue scale (VAS) in rural areas (SCRMDQ-SCODI r = 0.841; SCRMDQ -VAS: r = 0.685, P<0.01) and in urban areas (SCRMDQ-SCODI: r = 0.818, P<0.01; SCRMDQ –VAS: r = 0.666, P<0.01).ConclusionsAlthough causes of low back pain are completely different in rural and urban patients, SCRMDQ has a good reliability and validity, which is a reliable clinical method to evaluate disability of rural and urban patients.
Highlights
Low back pain is very common in clinical practice
Roland et al selected 24 items closely related with low back pain from sickness impact profile (SIP) to compose Roland-Morris disability questionnaire (RMDQ) questionnaire and attached the premise ‘‘due to low back pain’’ in every item to distinguish disability arising from other causes
It was shown that the causes of low back pain were very different between rural and urban patients: waist bending (48.9%) and spraining (25%) for rural patients and sedentariness (38.4%) and vibration (18.1%) for urban patients (Table 2)
Summary
More than 1/3 of patients visit orthopedic clinic due to low back pain [1]. Still 1.3% patients had disability after one year and need to be evaluated with a proper method such as Roland-Morris disability questionnaire (RMDQ) [4] and Oswestry disability index (ODI) [5] in western countries. RMDQ was firstly designed in 1983 by English scholars Roland and Morris to assess function of patients with low back pain and the contents were derived from 136-item sickness impact profile (SIP). SIP is a questionnaire reflecting general health status of patients. Roland et al selected 24 items closely related with low back pain from SIP to compose RMDQ questionnaire and attached the premise ‘‘due to low back pain’’ in every item to distinguish disability arising from other causes. The final score is defined as the sum of all scores with
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