Roland Morris Disability Questionnaire (RMDQ)

A license-free low back pain evaluation tool

The Roland Morris Disability Questionnaire (RMDQ) is a validated 24-item instrument that assesses physical disability due to low back pain.

The items concentrate on a limited range of physical ability as well as activities of daily living. It has been applied in several studies assessing patient outcomes in patients with vertebral fractures and lumbar spinal stenosis.

In comparison with the Oswestry Disability Index (ODI), another measure for assessing low back pain, the RMDQ has advantages for evaluating patients with mild to moderate disability, whereas the ODI may be preferred for assessing patients with severe conditions.

(Roland Martin and Jeremy Fairbank. “The Roland–Morris disability questionnaire and the Oswestry disability questionnaire.” Spine 25.24 (2000): 3115-3124)

Indication

The RMDQ is used to measure physical function in patients with low back pain 1. It has been used in osteoporosis patients with vertebral compression fractures 3, in cancer patients with vertebral fractures 4, in patients with chronic low back pain of unknown genesis 2 and in patients with lumbar spinal stenosis 5.

Items - Dimension - Completion time

The patient has to select from 1 of 2 response options (yes/no or checking/not checking the box) regarding 24 statements. The measure focuses on physical functional capacity, including walking, bending over, sitting, lying down, dressing, sleeping, self-care and daily activities. Additionally, mood and appetite are included parameters. Beurskens et al. measured a mean completion time of 5 minutes. 6

Scoring method

Every item that is answered with “yes” or a checked box is counted as 1 point. The items are not weighted differently. The RMDQ score is the total number of items checked and thus ranges from a minimum of 0 to a maximum of 24.

Score interpretation

The higher the score, the worse the patient’s back-related functional status. Ostelo et al. showed that the minimal important change on the RMDQ score is 5 points. 7

The RMDQ has been validated in a large number of languages. A German source document is available. 2 8 9 10
Dr. Martin Roland, professor emeritus of health services research, Department of Public Health and Primary Care, University of Cambridge, U.K. 11

There are no licensing fees or other costs. 

The RMDQ has an easy and intuitive scoring method, and although there are many items, the completion time is rather short. In comparison to the Oswestry Disability Index (ODI), there are fewer incomplete or ambiguous responses 12. Moreover, it is more discriminative than the ODI in patients who have less severe disability 1. Additionally, no ceiling or floor effects have been observed 13 14.

The RMDQ has a weakness in detecting change in patients with severe disability.

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References

  1. Roland, Martin, and Jeremy Fairbank. “The Roland–Morris disability questionnaire and the Oswestry disability questionnaire.” Spine 25.24 (2000): 3115-3124.
  2. Burbridge, Claire, et al. “Measuring the impact of chronic low back pain on everyday functioning: content validity of the Roland Morris disability questionnaire.” Journal of Patient-Reported Outcomes 4.1 (2020): 1-15.
  3. SKallmes, David F., et al. “A randomized trial of vertebroplasty for osteoporotic spinal fractures.” New England Journal of Medicine 361.6 (2009): 569-579
  4. Berenson, James, et al. “Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial.” The lancet oncology 12.3 (2011): 225-235.
  5. Friedly, Janna L., et al. “A randomized trial of epidural glucocorticoid injections for spinal stenosis.” New England Journal of Medicine 371.1 (2014): 11-21.
  6. Beurskens, Anna J., et al. “Efficacy of traction for non-specific low back pain: a randomised clinical trial.” The Lancet 346.8990 (1995): 1596-1600.
  7. Ostelo, Raymond WJG, et al. “Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change.” Spine 33.1 (2008): 90-94.
  8. Wiesinger, Günther F., et al. “Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain.” Spine 24.11 (1999): 1099-1103.
  9. Küçükdeveci, Ayse A., et al. “Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain.” Spine 26.24 (2001): 2738-2743.
  10. Kovacs, Francisco M., et al. “Validation of the Spanish version of the Roland-Morris questionnaire.” Spine 27.5 (2002): 538-542.
  11. http://www.rmdq.org/Download.htm
  12. Stratford, Paul W., et al. “Assessing change over time in patients with low back pain.” Physical Therapy 74.6 (1994): 528-533.
  13. Turner, Judith A., et al. “Comparison of the Roland–Morris disability questionnaire and generic health status measures: a population-based study of workers’ compensation back injury claimants.” Spine 28.10 (2003): 1061-1067.
  14. Costa, Leonardo Oliveira Pena, et al. “Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best?.” Spine 33.22 (2008): 2459-2463.