Roland-Morris Questionnaire Score Research Articles

Effect of Hamstring Tightness, Back Pain and Disability on Sleep Quality

Background: Chronic low back pain (CLBP), defined as pain persisting for more than three months, is associated with disability, functional limitations, musculoskeletal issues, and sleep disturbances in many individuals worldwide. Objective: The main objective of this study was to determine the effect of hamstring tightness, pain intensity, and disability on sleep quality in patients with chronic low back pain. Methods: This cross-sectional study included 387 individuals aged 25-55 years, recruited from various orthopedic units. Data were collected using the Roland-Morris Questionnaire (RMQ) for disability, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Active Knee Extension (AKE) test for hamstring tightness, and the Numeric Pain Rating Scale (NPRS) for pain intensity. Statistical analysis was conducted using SPSS version 25. Descriptive statistics, including means and standard deviations, were calculated for quantitative variables, while frequencies and percentages were calculated for qualitative variables. Chi-square tests were performed to examine the associations between NPRS, RMQ, AKE scores, and PSQI scores, with a p-value of less than 0.05 considered statistically significant. Results: The mean age of the 387 participants was 41.67 ± 13.38 years; 233 were females (60.2%), and 154 were males (39.8%). The mean RMQ score was 11.45 ± 2.34, the mean PSQI score was 8.58 ± 2.60, and the mean NPRS score was 4.97 ± 1.37. The AKE test was positive in 34.6% of participants. Chi-square tests showed a significant positive association between NPRS and PSQI scores (p = 0.001), and between RMQ and PSQI scores (p = 0.048). However, the association between AKE scores and PSQI scores was not significant (p = 0.400). Conclusion: This study highlights the significant association between pain intensity, disability, and sleep quality in patients with chronic nonspecific low back pain. Pain and disability adversely affect sleep quality, while hamstring tightness does not appear to have a significant impact. These findings underscore the importance of addressing pain and disability to manage sleep disturbances in this patient population.

A comparison of pulsed radiofrequency and radiofrequency denervation for lumbar facet joint pain

BackgroundLumbar facet joint pain is a common disorder. The main symptom is chronic lumbar pain, which can reduce quality of life. Radiofrequency has often been used to treat lumbar facet joint pain. However, the effectiveness of this technique has been controversial. This study was conducted to compare the effectiveness of pulsed radiofrequency (PRF) and radiofrequency denervation (RD) for lumbar facet joint pain.MethodsOne hundred and forty-two patients with lumbar facet joint pain were allocated to two treatment groups: PRF group (N = 72) and RD group (N = 70). Patients enrolled in the study were assessed using a visual analogue scale (VAS), Roland-Morris questionnaire (RMQ), Oswestry disability index (ODI) and Short-Form 36 (SF-36) questionnaire before therapy, 3 months and 12 months later.ResultsThere were no significant differences in VAS, RMQ score, ODI score and SF-36 score at 3 months (p > 0.05). Significant differences in pain control were observed in both groups at 12 months (3.09 ± 1.72 vs. 2.37 ± 1.22, p = 0.006). There was a significant difference in RMQ score (11.58 ± 3.58 vs. 8.17 ± 2.34, p < 0.001) and ODI score (43.65 ± 11.01 vs. 35.42 ± 11.32, p < 0.001) at 12 months. The total SF-36 score was higher in the RD group than in the PRF group at 12 months (58.45 ± 6.97 vs. 69.36 ± 6.43, p < 0.001). In terms of complications, skin numbness occurred in three patients. Mild pain such as burning and pinking at the puncture site in two patients. One patient experienced a decrease in back muscle strength and back muscle fatigue. These complications disappeared in 3 weeks without any treatment. There were no serious adverse events in the PRF group.ConclusionRadiofrequency is an effective and safe treatment option for patients with lumbar facet joint pain. RD could provide good and lasting pain relief, with significant improvement in lumbar function and quality of life at long-term follow-up.

Individualized Homeopathic Medicines for Low Back Pain in Lumbar Spondylosis: Double-Blind, Randomized, Placebo-Controlled Trial.

Lumbar spondylosis (LS) is a degenerative disorder of the lumbar spine. Despite substantial research efforts, no gold-standard treatment for LS has been identified. The efficacy of individualized homeopathic medicines (IHMs) in LS has remained under-researched. In this study, the efficacy of IHMs was compared with identical-looking placebos in the treatment of low back pain associated with LS. A double-blind, randomized (1:1), placebo-controlled trial was conducted at the National Institute of Homoeopathy, West Bengal, India. Patients were randomized to receive IHMs or placebos, along with standardized concomitant care for both the groups. The Oswestry low back pain and disability questionnaire (ODQ) was the primary outcome; the Roland-Morris questionnaire (RMQ) and the short form of the McGill pain questionnaire (SF-MPQ) were the secondary outcomes. Each was measured at baseline and every month for 3 months. The intention-to-treat (ITT) sample was analyzed to detect any inter-group differences using two-way repeated measures analysis of variance models overall and by unpaired t-tests at different time points. Enrolment was stopped prematurely because of time restrictions; 55 patients were randomized (verum: 28; control: 27); 49 were analyzed by ITT (verum: 26; control: 23). Inter-group differences in ODQ (F 1, 47 = 0.001, p = 0.977), RMQ (F 1, 47 = 0.190, p = 0.665) and SF-MPQ total score (F 1, 47 = 3.183, p = 0.081) at 3 months were not statistically significant. SF-MPQ total score after 2 months (p = 0.030) revealed inter-group statistical significance, favoring IHMs against placebos. Some of the SF-MPQ sub-scales at different time points were also statistically significant: e.g., the SF-MPQ average pain score after 2 months (p = 0.002) and 3 months (p = 0.007). Rhus toxicodendron, Sulphur and Pulsatilla nigricans were the most frequently indicated medicines. Owing to failure in detecting a statistically significant effect for the primary outcome and in recruiting a sufficient number of participants, our trial remained inconclusive. CTRI/2019/11/021918.

Abstract No. : ABS2592: Medial branch block versus medial branch radiofrequency ablation in patients with lumbar facet joint pain

Background and Aims:Lumbar facet joint related pain is reported to have a prevalence of 15-45%.This prospective study was conducted to compare the efficacy of medial branch block with medial branch radiofrequency(RF) ablation in patients with lumbar facet joint pain.Methods:Forty-six participants were randomised to Group-I (n=24) or Group-II (n=22). In Group-I, patients received fluoroscope guided medial branch block with 2ml drug solution comprising of 0.25% bupivacaine plus 10mg of triamcinolone and in Group-II, patients received fluoroscope guided medial branch radiofrequency ablation at a temperature of 80°C for 90 seconds using a RF generator. Patients were followed up for a period of three months. Numeric Rating Scale (NRS) Oswestry Disability Index (ODI) and Roland-Morris Questionnaire (RMQ) score were compared between the groups.Results:NRS and ODI scores were found comparable between the two groups at all the time intervals (p>0.05). Significant reduction (RMQ score was found in Group-II at two weeks (p=0.003) and at one month (p=0.01) ; whereas, at two months and three months the scores were found comparable between the groups(p>0.05). Pain at injection/RF site was significantly less in Group-II (p=0.006). None of the patients reported any serious complications.Conclusion:Both medial branch block and medial branch radiofrequency ablation provide good pain relief and improvement of disability in patients with lumbar facet joint pain. However, improvement in disability is early with medial branch radiofrequency ablation.

Differences in movement limitations in different low back pain severity in functional tests using an RGB-D camera

Low back pain (LBP) can lead to motor control disturbance which can be one of the causes of reoccurrence of the complaint. It is important to improve our knowledge of movement related disturbances during assessment in LBP and to classify patients according to the severity. The aim of this study is to present differences in kinematic variables using a RGB-D camera in order to classify LBP patients with different severity. A cross-sectional study was carried out. Subjects with non-specific subacute and chronic LBP were screened 6 weeks following an episode. Functional tests were bending trunk test, sock test and sit to stand test. Participants performed as many repetitions as possible during 30 s for each functional test. Angular displacement, velocity and acceleration, linear acceleration, time and repetitions were analysed. Participants were divided into two groups to determine their different LBP severity with a k-means clusters according to the results obtained in Roland Morris questionnaire (RMQ). Comparing different severity groups based on RMQ score (high impact = 17.15, low impact = 7.47), bending trunk test obtained significative differences in linear acceleration (p = 0.002–0.01). The differences of total linear acceleration during the Sit to Stand test were significative (p = 0.004–0.02). Sock test showed not significative differences between groups (p > 0.05). Linear acceleration variables during Sit to Stand test and Bending trunk test were significatively different between the different severity groups. RGB-D camera system and functional tests can detect kinematic differences in different type of LBP according to the functionality.Trial registration: ClinicalTrials.gov NCT03293095 “Functional Task Kinematic in Musculoskeletal Pathology” September 26, 2017.

Comparative effect of driving side on low back pain due to Repetitive Ipsilateral Rotation.

Objective:To determine the effects of repetitive ipsilateral rotation on low back pain among the taxi drivers of right and left hand drive.Methods:A total of 1200 (600 Iran+600 Pakistan) male taxi drivers, aged between 20-60 years with work experience of more than one year were randomly selected and interviewed in Tehran (Iran) & Lahore (Pakistan) to fill self-administered questionnaires in Persian and Urdu languages which contained socio-demographic, work related and LBP characteristics. Chi-square test and multiple logistic regression models were employed for statistical analyses.Results:Point, one week, one year and lifetime prevalence of LBP among right hand drive taxi drivers was 26.7%, 35.5%, 49.8% and 77.7% respectively. Point, one week, one year and lifetime prevalence of LBP among left hand drive taxi drivers was 37%, 42.7%, 53.5% and 72.3% respectively. Mean Numeric Pain rating scale (NPRS) score was 4.15 (SD=1.42) in Pakistan, while in Iran it was 4(SD=1.57). There was no significant difference regarding pain intensity (p=0.123) between drivers from both countries. Mean Roland-Morris Questionnaire (RMQ) score among drivers in Pakistan with LBP was 7.76(SD= 2.50), while in Iranian drivers who had LBP, mean RMQ score was 7.71(SD=2.99).Conclusion:Static or less dynamic muscles are more prone to LBP due to lower endurance. Lack of exercising habit, work as a driver for more number of years, driving within city, more driving hours in a day, forward bending, lifting, no seat comfort, lack of awareness regarding ergonomics and lower satisfaction level of job were the main reasons of LBP.

The impacts of rest breaks and stretching exercises on lower back pain among commercial truck drivers in Iran

Purpose. This study aimed to determine the impacts of rest breaks and stretching exercises on lower back pain (LBP) in commercial truck drivers. Methods. This quasi-experiment was carried out on 92 truck drivers suffering from chronic LBP. Subjects were categorized into three groups (stretching exercises and rest breaks, rest breaks only and reference). Pain severity and related disability were measured at the beginning of the survey and after 6 and 12 weeks. The latter was assessed using the Oswestry low back pain disability questionnaire (OLBPDQ) and the Roland Morris questionnaire (RMQ). Results. At the end of the intervention, the mean pain scores in the three groups were 2.72 ± 1.44, 4.11 ± 0.86 and 4.90 ± 1.31 respectively (p < 0.001). The OLBPDQ scores in group 1 (stretches and resting time breaks) were significantly lower than those in group 2 (rest break) (p = 0.009). The RMQ scores showed a significant reduction in group 1 compared with the other two groups (p = 0.001). Drivers in group 2 improved more significantly than those in group 3 regarding visual analog scale pain score (p = 0.049), OLBPDQ score (p = 0.024) and RMQ score (p = 0.011). Conclusion. This study provided converging results that supplementary exercises during break periods consistently help to minimize LBP and disability.

Anterior Trunk Mobility Does Not Predict Disability in Elderly Women With Acute Low Back Pain: Brazilian Back Complaints in the Elders (BACE-Brazil) Study Results.

Cross-sectional, ancillary study of an international multicenter epidemiological study. To investigate the relationship of the anterior trunk mobility with self-report and physical performance measures in elderly women with acute low back pain (LBP). LBP is one of the most prevalent pain complaints in the elderly population. It is postulated that the increased range of motion of limited joints of the trunk may improve LBP and functionality of patients. Recent studies have, however, questioned the association between trunk range of motion and the functional status. The present study included a convenience sample of elderly women from the community aged 60 years and older who presented with a new (acute) episode of LBP. Volunteers with severe diseases and visual, hearing and mobility losses, or cognitive impairment were excluded. Trunk mobility was assessed by the fingertip-to-floor test. Functionality was assessed by the Roland-Morris Questionnaire (RMQ) and gait speed test. Statistical analysis was performed by using hierarchical linear regression model. Data from 459 elderly women, mean age of 69.0 (6.1) years old, were used to describe this report. The additional predictive value for the inclusion of independent variable trunk mobility was only 4.4% in the RMQ score and 1.5% in the gait speed test, respectively. A reduced hierarchical linear regression model showed that the significant predictors for RMQ and gait speed test were body mass index, pain intensity, and trunk mobility. This was the first study to investigate the relationship between trunk mobility and functionality in elderly women with acute LBP. The results suggest that these clinical parameters are independent from each other. N/A.

Mapping between the Roland Morris Questionnaire and Generic Preference-Based Measures

ObjectivesThe Roland Morris Questionnaire (RMQ) is a widely used health status measure for low back pain (LBP). It is not preference-based, and there are currently no established algorithms for mapping between the RMQ and preference-based health-related quality-of-life measures. Using data from randomized controlled trials of treatment for LBP, we sought to develop algorithms for mapping between RMQ scores and health utilities derived using either the EuroQol five-dimensional questionnaire (EQ-5D) or the six-dimensional health state short form (derived from Medical Outcomes Study 36-Item Short-Form Health Survey) (SF-6D). MethodsThis study is based on data from the Back Skills Training Trial in which data were collected from 701 patients at baseline and subsequently at 3, 6, and 12 months postrandomization using a range of outcome measures, including the RMQ, the EQ-5D, and the Short Form 12 item Health Survey (SF-12) (from which SF-6D utilities can be derived). We used baseline trial data to estimate models using both direct and response mapping approaches to predict EQ-5D and SF-6D health utilities and dimension responses. A multistage model selection process was used to assess the predictive accuracy of the models. We then explored different techniques and mapping models that made use of repeated follow-up observations in the data. The estimated mapping algorithms were validated using external data from the UK Back Pain Exercise and Manipulation trial. ResultsA number of models were developed that accurately predict health utilities in this context. The best performing model for RMQ to EQ-5D mapping was a beta regression with Bayesian quasi-likelihood estimation that included 24 dummy variables for RMQ responses, age, and sex as covariates (mean squared error 0.0380) based on repeated data. The model selected for RMQ to SF-6D mapping was a finite mixture model that included the overall RMQ score, age, sex, RMQ score squared, age squared, and an interaction term for age and RMQ score as covariates (mean squared error 0.0114) based on repeated data. ConclusionsIt is possible to reasonably predict EQ-5D and SF-6D health utilities from RMQ scores and responses using regression methods. Our regression equations provide an empirical basis for estimating health utilities when EQ-5D or SF-6D data are not available. They can be used to inform future economic evaluations of interventions targeting LBP.

The study of the variability of anticipatory postural adjustments in patients with recurrent non-specific low back pain

Intrinsic variability is present in all actions, including repetitive tasks. The aim of this study was to evaluate the variability of anticipatory postural adjustments (APAs) of trunk muscles in participants with low back pain (LBP). The study included 21 participants with recurrent non-specific LBP (15 men, 6 women) and 21 healthy volunteers. Standard deviation of electromyographic activity of the external oblique (EO), transverse abdominis/internal oblique (TrA/IO), and erector spinae (ES) muscles onset relative to deltoid muscle onset was recorded in 75 rapid arm flexions, and the correlation with the participants' avoidance belief (the FABQ score) and disability (the Roland-Morris Questionnaire score) was statistically analyzed. participants with LBP exhibited less variability in timing of APAs of the TrA/IO muscle compared with the control group (P=0.047). The timing of APAs of the TrA/IO muscle was significantly correlated with the FABQ score (P=0.006). There was no significant correlation between this variable and disability (P=0.09). Decrease in variability of the timing of APA of the EO (P=0.45) and ES (P=0.6) muscles was not significant. The variability of the postural responses of participants with LBP decreased. Restoring variability in postural control responses might be a goal in rehabilitating these patients.

The usefulness of ICG video angiography in the surgical treatment of superior cluneal nerve entrapment neuropathy

Superior cluneal nerve (SCN) entrapment neuropathy is a known cause of low back pain. Although surgical release at the entrapment point of the osteofibrous orifice is effective, intraoperative identification of the thin SCN in thick fat tissue and confirmation of sufficient decompression are difficult. Intraoperative indocyanine green video angiography (ICG-VA) is simple, clearly demonstrates the vascular flow dynamics, and provides real-time information on vascular patency and flow. The peripheral nerve is supplied from epineurial vessels around the nerve (vasa nervorum), and the authors now present the first ICG-VA documentation of the technique and usefulness of peripheral nerve neurolysis surgery to treat SCN entrapment neuropathy in 16 locally anesthetized patients. Clinical outcomes were assessed with the Roland-Morris Disability Questionnaire before surgery and at the latest follow-up after surgery. Indocyanine green video angiography was useful for identifying the SCN in fat tissue. It showed that the SCN penetrated and was entrapped by the thoracolumbar fascia through the orifice just before crossing over the iliac crest in all patients. The SCN was decompressed by dissection of the fascia from the orifice. Indocyanine green video angiography visualized the SCN and its termination at the entrapment point. After sufficient decompression, the SCN was clearly visualized on ICG-VA images. Low back pain improved significantly, from a preoperative Roland-Morris Questionnaire score of 13.8 to a postoperative score of 1.3 at the last follow-up visit (p < 0.05). The authors suggest that ICG-VA is useful for the inspection of peripheral nerves such as the SCN and helps to identify the SCN and to confirm sufficient decompression at surgery for SCN entrapment.

Clinical correlation of radiological spinal stenosis after standardization for vertebral body size

To determine the relationship between the degree of radiographic lumbar spinal stenosis, adjusted with an internal control for vertebral body size, and disability from lumbar stenosis. one hundred and twenty-three consecutive patients with clinical and radiological confirmation of neural impingement secondary to lumbar stenosis were enrolled prospectively. Thecal sac anteroposterior (AP) diameter (TSD) and cross-sectional area (CSA), and vertebral body AP dimension (VBD) were determined. These parameters were then correlated with patients' symptoms using the modified Roland-Morris questionnaire (RMQ) disability score. No statistically significant inverse correlation was found between the TSD and RMQ score (p=0.433), between the CSA and RMQ score (p=0.124), or between the TSD:VBD ratio and RMQ score (p=0.109). There was a significant positive correlation between the CSA:VBD ratio and RMQ score (p=.036), and therefore, there was no statistical support for an inverse relationship between the two. There was a significant difference in mean RMQ scores when the patients were divided into those with CSA greater than or equal to 70 mm(2) and those less than 70 mm(2), with T=-2.104 and p=0.038. The degree of radiographic lumbar spinal stenosis, even with the use of an internal control of vertebral body size and standardized disability questionnaires, does not correlate with clinical symptoms. However, patients with more severe stenosis below a CSA critical threshold of 70 mm(2), have significantly greater functional disability.

Is Spinal Stenosis Better Treated Surgically or Nonsurgically?

For patients with clinical and radiographic lumbar spinal stenosis, is surgery or continued nonsurgical treatment a better option for improvements in baseline disability scores; and what proportion of patients treated surgically and nonsurgically get better, worse, or remain the same with time? We prospectively evaluated 125 consecutive patients for this non-randomized cohort study. Of the patients choosing surgery, 54 underwent decompression only and 42 had decompression and fusion for preexisting spondylolisthesis; twenty-nine patients declined surgery. At 2 years followup, the average improvements in Roland-Morris questionnaire score in the decompression only, decompression with fusion, and nonsurgical groups were 6.9, 6.1, and 1.2, respectively. The percentages of patients who were better, worse, or the same were similar for those who had decompression only (63.3%, 4.1%, and 32.7%, respectively) and decompression with fusion (61.5%, 2.6%, and 35.9%, respectively) but different from those treated without surgery (25.0%, 12.5%, and 62.5%, respectively). We observed no occurrences of cauda equina syndrome or severe neurologic dysfunction in any of the groups after 2 years. A majority of patients declining surgery had persistent symptoms. The majority of patients who choose surgery will be improved but will have residual symptoms and therefore should be counseled about realistic expectations.

Management of Symphysis Pubis Dysfunction During Pregnancy Using Exercise and Pelvic Support Belts

Symphysis pubis pain is a significant problem for some pregnant women. The purpose of this study was to investigate the effects of exercise, advice, and pelvic support belts on the management of symphysis pubis dysfunction during pregnancy. Ninety pregnant women with symphysis pubis dysfunction were randomly assigned to 3 treatment groups. A randomized masked prospective experimental clinical trial was conducted. Specific muscle strengthening exercises and advice concerning appropriate methods for performing activities of daily living were given to the 3 groups, and 2 of the groups were given either a rigid pelvic support belt or a nonrigid pelvic support belt. The dependent variables, which were measured before and after the intervention, were a Roland-Morris Questionnaire score, a Patient-Specific Functional Scale score, and a pain score (101-point numerical rating score). After the intervention, there was a significant reduction in the Roland-Morris Questionnaire score, the Patient-Specific Functional Scale score, and the average and worst pain scores in all groups. With the exception of average pain, there were no significant differences between groups for the other measures. The findings indicate that the use of either a rigid or a nonrigid pelvic support belt did not add to the effects provided by exercise and advice.

Validation of the Japanese version of the Roland-Morris Disability Questionnaire

The study was designed to validate a translated, culturally adapted questionnaire. We examined the reliability, validity, and responsiveness of the Japanese version of the Roland-Morris Questionnaire (RDQ) when assessing disability in Japanese patients with low back pain. The RDQ is a reliable, validated scale used to measure disability caused by low back pain. However, no validated Japanese version of this questionnaire is available. A series of 214 outpatients with low back pain participated in this validation study. The patients were given the RDQ and the SF-36, and assessed their pain and global rating of health. Among them, 57 who were clinically stable were given the RDQ again 2 weeks later. The reliability was examined based on the test-retest method and internal consistency. Sufficient reliability was demonstrated with a Chronbach’s α coefficient of 0.85, and the reproducibility for the 30 patients was r = 0.91. The principal component analysis showed unidimensionality. The RDQ score of the 133 patients was significantly improved after treatment. The Japanese version of the RDQ is a useful scale that is easy to use with reliability, validity, and responsiveness when assessing patients with low back pain.

Physical therapy utilization by patients with acute low back pain.

The purposes of this study were (1) to describe the demographic and clinical characteristics of a group of patients with acute low back pain (LBP), (2) to describe those patients who were being treated by physical therapists, and (3) to analyze their use of physical therapy services. The study sample consisted of 1,580 patients with acute LBP who were treated by 208 practitioners in North Carolina. The initial providers were primary care physicians, chiropractors, orthopedic surgeons, and primary care providers at a health maintenance organization. A telephone interview was conducted after the initial office visit to assess demographics and medical history, health care services utilization, and functional status. Follow-up telephone interviews were also conducted 2, 4, 8, 12, and 24 weeks later. One hundred ninety-nine (12.6%) of the subjects reported that they saw a physical therapist either by any provider referral or by direct access. Therapeutic exercise was the most commonly reported treatment procedure. Post-high-school education, receipt of Workers' Compensation, prior physical therapy for LBP, LBP and pain below the knee in one or both legs, and a higher baseline Roland-Morris Questionnaire score were associated with being treated by physical therapists. In this study, physical therapists were utilized in the treatment of patients with greater severity of LBP. The findings demonstrate the importance of controlling for baseline characteristics when comparing outcomes of LBP when treated by different types of providers.