Cross-cultural Adaptation of the Roland-Morris Disability Questionnaire for Individuals with Low Back Pain in Myanmar: Psychometric Validation Study
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Abstract
Introduction: Self-reported subjective measures are important for the assessment and treatment of low back pain (LBP) individuals. The Roland-Morris Disability Questionnaire is a widely used and validated questionnaire for measuring disability due to LBP. This study aimed to develop a cross-culturally adapted Myanmar version of the Roland-Morris Disability Questionnaire (M-RMDQ) and examine its reliability and validity in individuals with LBP.
Methods: The M-RMDQ was developed based on the established guidelines and underwent prefinal testing on 20 individuals with LBP resulting in minor adaptations. The adapted M-RMDQ was conducted on 99 individuals with LBP for internal consistency, test-retest reliability, ceiling and floor effects, and concurrent and construct validity. Reliability was evaluated with Cronbach's alpha and intraclass correlation coefficient (ICC), while concurrent and construct validity were determined through correlations with the Myanmar version of the Oswestry Disability Questionnaire (M-ODQ), visual analog scale (VAS), back performance scale (BPS), and the Stark Quality of Life (QoL) questionnaire.
Results: The M-RMDQ had good internal consistency (Cronbach’s alpha = 0.70, n=99) and test-retest reliability (ICC2, 1 = 0.868; n=83). The M-RMDQ was moderately positive correlated with the M-ODQ (rho = 0.525; n=99) and showed a fair positive correlation with VAS (rho = 0.252; n=99) and BPS (rho = 0.265; n=99), and fair negative correlation with the physical component of the Stark QoL questionnaire (rho = - 0.323; n=99). No correlation was demonstrated with the mental component of the Stark QoL questionnaire (rho = - 0.179; n=99).
Conclusion: The M-RMDQ exhibited favorable psychometric properties, establishing it as a reliable and valid measure for assessing LBP-related disability in the Myanmar population. It is recommended for use in both clinical settings and research studies among Myanmar individuals with LBP.
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References
Sheahan PJ, Nelson-Wong EJ, Fischer SL. A review of culturally adapted versions of the Oswestry Disability Index: the adaptation process, construct validity, test-retest reliability, and internal consistency. Disability and Rehabilitation. 2015;37(25):2367-74
Popescu A, Lee H. Neck pain and lower back pain. Medical Clinics. 2020;104(2):279-92.
Doualla M, Aminde J, Aminde LN, Lekpa FK, Kwedi FM, Yenshu EV, et al. Factors influencing disability in patients with chronic low back pain attending a tertiary hospital in sub-Saharan Africa. BMC Musculoskeletal Disorders. 2019;20:1-11
Kovacs FM, Abraira V, Zamora J, Teresa Gil del Real M, Llobera J, Fernández C, et al. Correlation between pain, disability, and quality of life in patients with common low back pain. Spine (Phila Pa 1976). 2004;29(2):206-10.
Krismer M. Tulder M van, The low back pain group of the bone and joint health strategies for Europe Project (2007) Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific). Best Pract Res Clin Rheumatol.21:77-91.
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the global burden of disease 2010 study. Annals of the Rheumatic Diseases. 2014;73(6):968-74.
Walker BF, Muller R, Grant WD. Low back pain in Australian adults: prevalence and associated disability. J Manipulative Physiol Ther. 2004;27(4):238-44.
Beattie P, Maher C. The role of functional status questionnaires for low back pain. Aust J Physiother. 1997;43(1):29-38.
Rimmer JH. Use of the ICF in identifying factors that impact participation in physical activity/rehabilitation among people with disabilities. Disabil Rehabil. 2006;28(17):1087-95.
De Beer N, Stewart A, Becker P. Validation of the Tswana versions of the roland-morris disability questionnaire, Quebec disability scale, and waddell disability index. South African Journal of Physiotherapy. 2008;64(3):23-30
Smeets R, Köke A, Lin CW, Ferreira M, Demoulin C. Measures of function in low back pain/disorders: Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI), Progressive Isoinertial Lifting Evaluation (PILE), Quebec Back Pain Disability Scale (QBPDS), and Roland-Morris Disability Questionnaire (RDQ). Arthritis Care & Research. 2011; 63: S158-73.
Roland M, Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976). 1983;8(2):141-4.
Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976). 2000;25(24):3115-24.
Opara J, Szary S, Kucharz E. Polish cultural adaptation of the Roland-Morris Questionnaire for evaluation of quality of life in patients with low back pain. Spine. 2006;31(23):2744-6.
Kovacs FM, Llobera J, Del Real MTG, Abraira V, Gestoso M, Fernández C. Validation of the Spanish version of the Roland-Morris questionnaire. Spine. 2002;27(5):538-42.
Costa LOP, Maher CG, Latimer J, Ferreira PH, Pozzi GC, Ribeiro RN. Psychometric characteristics of the Brazilian-Portuguese versions of the functional rating index and the Roland Morris disability questionnaire. Spine. 2007;32(17):1902-7.
Raheem S, Ibrahim AA, Ganiyu SO, Faruk AU, Akindele MO. Translation, cross-cultural adaptation and psychometric evaluation of the Hausa Roland-Morris disability questionnaire in mixed rural and urban Nigerian populations with low back pain. Spine. 2021;46(11):E639-E47.
Suzukamo Y, Fukuhara S, Kikuchi S, Konno S, Roland M, Iwamoto Y, et al. Validation of the Japanese version of the Roland-Morris disability questionnaire. Journal of Orthopaedic Science. 2003;8:543-8.
Valasek T, Varga PP, Szövérfi Z, Bozsodi A, Klemencsics I, Fekete L, et al. Validation of the Hungarian version of the Roland–Morris disability questionnaire. Disability and Rehabilitation. 2015;37(1):86-90.
Küçükdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain. Spine. 2001;26(24):2738-43.
Chala MB, Donnelly C, Wondie Y, Ghahari S, Miller J. Cross-cultural adaptation and validation of the Amharic version of Roland Morris Disability Questionnaire in people with low back pain in Ethiopia. Disability and Rehabilitation. 2022;44(19):5638-48.
Yao M, Zhu S, Tian ZR, Song YJ, Yang L, Wang YJ, et al. Cross-cultural adaptation of Roland-Morris Disability Questionnaire needs to assess the measurement properties: a systematic review. J Clin Epidemiol. 2018;99:113-22.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-91.
Souza ACd, Alexandre NMC, Guirardello EdB. Psychometric properties in instruments evaluation of reliability and validity. Epidemiologia E Servicos De Saude. 2017;26:649-59.
Davidson M, Keating JL. A comparison of five low back disability questionnaires: reliability and responsiveness. Physical Therapy. 2002;82(1):8-24.
Smith H, Lim R, Harkins IB. 01 Thailand Migration Profile. Migration Report. 2019:9
Tomita S, Arphorn S, Muto T, Koetkhlai K, Naing SS, Chaikittiporn C. Prevalence and risk factors of low back pain among Thai and Myanmar migrant seafood processing factory workers in Samut Sakorn Province, Thailand. Industrial Health. 2010;48(3):283-91.
Monticone M, Baiardi P, Ferrari S, Foti C, Mugnai R, Pillastrini P, et al. Development of the Italian version of the Oswestry Disability Index (ODI-I): A cross-cultural adaptation, reliability, and validity study. Spine. 2009;34(19):2090-5
Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross‐cultural health care research: a clear and user‐friendly guideline. Journal of Evaluation in Clinical Practice. 2011;17(2):268-74.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
Fairbank J, Pynsent P. The Oswestry disability index. Spine (Phila Pa 1976) 2000;25: 2940–2952.
Boonstra AM, Preuper HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International Journal of Rehabilitation Research. 2008;31(2):165-9.
Hardt J. A new questionnaire for measuring quality of life-the Stark QoL. Health and Quality of Life Outcomes. 2015;13:1-7.
Strand LI, Moe-Nilssen R, Ljunggren AE. Back Performance Scale for the assessment of mobility-related activities in people with back pain. Physical Therapy. 2002;82(12):1213-23.
Al Amer HS, Alanazi F, M EL, Honin A. Cross-cultural adaptation and psychometric testing of the Arabic version of the Modified Low Back Pain Disability Questionnaire. PLoS One. 2020;15(4):e0231382.
Mbada CE, Oguntoyinbo OE, Fasuyi FO, Idowu OA, Odole AC, Ayanniyi O, et al. Cross-cultural adaptation and psychometric evaluation of the Yoruba version of Oswestry disability index. PLoS One. 2020;15(1):e0221138.
Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-63
Mâaroufi H, Benbouazza K, Faïk A, Bahiri R, Lazrak N, Abouqal R, et al. Translation, adaptation, and validation of the Moroccan version of the Roland Morris Disability Questionnaire. Spine. 2007;32(13):1461-5.
Brouwer S, Kuijer W, Dijkstra PU, Göeken LN, Groothoff JW, Geertzen JH. Reliability and stability of the Roland Morris Disability Questionnaire: intra class correlation and limits of agreement. Disability and Rehabilitation. 2004;26(3):162-5.
Maki D, Rajab E, Watson PJ, Critchley DJ. Cross-cultural translation, adaptation, and psychometric testing of the Roland-Morris disability questionnaire into modern standard Arabic. Spine. 2014;39(25):E1537-E44