Roland-Morris Disability Questionnaire

Post Lumbar Disc Surgery:

(Ostelo, 2004; n = 97; mean age=43.3 (8.8); 6 weeks post surgery; questionnaires completed before and after three months of treatment) 

• SEM = 2.0 (1.5-2.9) scale points (95% CI) 

Outpatients with low back pain diagnosed with a musculoskeletal origin:

(Stratford et al, 1996; n = 60; mean age=41 (12); questionnaires given at initial evaluation and four and six week follow-ups.)

• SEM = 1.79 

Participants classified: as unchanged (Davidson et al, 2002, version = RMDQ-24)

• "Unchanged" (n = 47): SEM (95% CI) = 3.7 (2.9–4.6)
• "About the same" (n = 16) SEM (95% CI) = 4.1 (2.7–5.6)

Post Lumbar Disc Surgery:

(Ostelo, 2004) 

• MDC = 5.4 (4.2-8.0) scale points (95% CI)

Chronic Low Back Pain: (Dutch version) 

(Brouwer et al, 2004; n = 30, mean age=40 (8.1); The duration of pain was between 5-10 years; questionnaire was filled out before beginning therapy and at two weeks follow-up) 

• MDC = 5.4 (95% CI)

Outpatients with low back pain diagnosed with a musculoskeletal origin:

(Stratford et al, 1996) 

• MDC = 5 points at 95% CI for scores located in the central portion of the scale. (4 RMQ points are required to detect improvement in patients with initial scores of 4-11 RMQ points and in patients with scores greater than 16 points.) 

Outpatients with low back pain diagnosed with a musculoskeletal origin:

(Stratford et al, 1996) 

• The Journal of the American Physical Therapy Association found that the MDC for the two groups study found that 8.6 or 9.5 point was needed based on the reliability estimates for these groups.

Chronic and Acute Low Back Pain: (Italian version) 

(Monticone et al, 2012; n = 179; mean age=47.7 (12.3); patients had a median duration of pain of 6 months; questionnaires were administered at the beginning and end of eight weeks of rehabilitation.) 

• MDC = 4.87 

Participants classified as Unchanged  (Davidson et al, 2002)

• "Unchanged" (n = 47) MDC (95% CI) = 8.6 (6.7–10.6)
• "About the same" (n = 16) MDC (95% CI) = 9.5 (6.3–13)

Subjects seeking treatment for low back pain from general practitioner:

(Jordan et al, 2006; n = 443; mean age=46.8 (8.12); questionnaires at consultation and 6 months later.) 

• 30% of baseline score is considered the cut-off point for detecting change, or 3 point change. 
• If the patient has a score of greater than 7, then the MCID = 3 points. 
• If the score is less than 7, then the MCID = 30% change in score. 

Subjects seeking treatment for low back pain from general practitioner:

(Jordan et al, 2006) 

• A change of 5 points has been recommended as the smallest change that is important for patients with low back pain after 3-6 weeks of treatment using global change or treatment goals as the reference standard.

Patients with lower back pain: (Stratford et al, 1996; n = 226; mean age = 40 (13) years; experience of back pain <6 weeks; all participants were receiving therapy during the study; version = RMDQ-24) 

• A change of 5 points

Review of prior research: (Ostelo & de Vet, 2005)

• MCID for all types of low back pain (acute, sub acute and chronic) = 3.5 points

Subjects seeking treatment for low back pain from general practitioner:

(Roland and Morris, 1883, Part I; n =237; mean age= 40.6; questionnaires given at consultation, and one and four week follow-ups) 

• Poor outcome is a score of 14 or more on the Disability Questionnaire following therapy. 

Post Lumbar Disc Surgery:

(Ostelo, 2004) 

• For patients 6-weeks post lumbar disc surgery between 18 and 65 years and are limited in ADLs and have not returned to work, the cut-off score is 3.5 with a sensitivity of 94.6% and a specificity of 88.2% 

Chronic and Acute Low back Pain: (Italian version)

(Monticone et al, 2012) 

• Cut-Off Score = 2.5

Chronic and Acute Low back Pain: (Italian version)

(Monticone et al, 2012)

• Patients who improved: 
  • Initial: 5.69 (3.73)
  • 8 week follow-up: 1.79 (2.80) 
• Patients who were unchanged:
  • Initial: 6.80 (4.63) 
  • 8 week follow-up: 4.64 (4.05) 

Post Lumbar Disc Surgery:

(Ostelo, 2004) 

• Patients who improved: 
  • Initial: 13.0
  • 3 month follow-up: 4.3
• Patients who were unchanged: 
  • Initial: 15.4
  • 3 month follow-up: 14.3 

Subjects seeking treatment for low back pain from general practitioner:

(Jordan et al, 2006) 

• Initial 9.1 (6.37)
• 6 month follow-up 6.6 (6.56) 

(Roland and Morris, 1883, Part II) 

• Median score initial: 11
• 1 week follow-up: 8
• 4 week follow-up: 4 

Outpatients with low back pain diagnosed with a musculoskeletal origin:

(Stratford et al, 1996) 

• Initial visit: 11.5
• 4-6 weeks follow-up: 6.6

Chronic Low Back Pain:

(Brouwer et al, 2004) 

• Initial visit: 13.0(4.8)
• 2 weeks follow-up: 12.1(5.0) 

Patients with low back pain undergoing physical therapy:

(Davidson and Keating, 2002) 

• Patients who were unchanged: 
  • Initial visit: 9.0 (5.2) 
  • 6 weeks later: 8.2 (5.2)
• Patients who were improved: 
  • Initial visit: 9.5 (5.9) 
  • 6 weeks later: 3.8 (4.1)

Subjects seeking treatment for low back pain from general practitioner: 

(Roland and Morris, 1883, Part I) 

• 13/20 patients reported the same score immediately following their initial consultation and later that day. 
• The correlation coefficient was 0.91 

Post Lumbar Disc Surgery:

(Ostelo, 2004) 

• ICC = 0.74 (0.51-0.87)  

Outpatients with low back pain diagnosed with a musculoskeletal origin:

(Stratford et al, 1996) 

• Less than 2 weeks: ICC = 0.91
• 3 to 6 weeks: ICC = 0.86 

Chronic Low Back Pain: 

(Brouwer et al, 2004) 

• ICC: 91 (.82-.96 with 95% CI)

Subjects seeking treatment for low back pain from general practitioner:

(Jordan et al, 2006) 

• ICC: 0.83 from two week test-retest study of back pain patients.

Doctor Determined Mechanical Spine Problem: 

(Deyo, 1986; n = 136; mean age=38; 79% with acute back pain and 14 with pain for longer than 3 months; questionnaire at consultation and 3 week follow-up) 

• Patients reporting they have not resumed full activities (n = 47), r=.76 on the Roland Scale

Patient's with lower back pain (Davidson et al, 2002) 

• Participants classified as either changed or unchanged (initial assessment provided at the recruitment site and followed up 6 weeks later)
  • "Unchanged" (n = 47) ICC (95% CI) = .53 (.29–.71)
  • "About the same" (n = 16) ICC (95% CI) = .42 (-.07–.75)
• Test-retest data reported by Davidson:
  • Excellent: Same day test-retest (ICC = .91)
  • Excellent: 1 to 14 day test-retest (ICC = .93)
  • Adequate: 3 to 6 week test-retest (ICC = .86)

Doctor Determined Mechanical Spine Problem:

(Deyo, 1986) 

• Patients w/ pain rated unchanged by both patient and clinician (n = 10), r =.83 on the Roland Scale

Outpatients with low back pain diagnosed with a musculoskeletal origin: 

(Stratford et al, 1996) 

• Previously established values of .90, .84, .89, .92  

Workers Compensation- Systematic Review of Outcome Measures: 

(Spanjer et a, 2011; Systematic review of 10 RCTs to determine psychometric properties of instruments used to assess functional limitations in worker’s compensation claims)

• Cronbach’s a= 0.95

Patient's with lower back pain: (Mousavi 2006; mean age = 40.14 (range = 17 to 68) n = 100; average years of education = 10.8 years; Persian language sample)

• Excellent internal consistency (Cronbach's alpha = 0.83)

Doctor Determined Mechanical Spine Problem: 

(Deyo, 1986) 

• The Roland Scale correlated well with the physical dimension of the SIP (Sickness Impact Profile), r =.89

Concurrent validity of back pain scales: (Kopec et al, 1995; n = 242)

• Excellent: RMDQ and the Quebec Back Pain Disability Scale (r= 0.77)

Workers Compensation- Systematic Review of Outcome Measures:

(Spanjer et a, 2011) 

• Good with positive correlations with the Numeric Rating Scale (NRS-101) and the SF-12 and SF-36, r = 0.70-0.85

Patient's with lower back pain: (Mousavi 2006; Persian language sample)

Outpatients with low back pain diagnosed with a musculoskeletal origin: 

(Stratford et al, 1996)

• No improvement detected for scores lower than 4
• No decline in scores equal to 20

Post Lumbar Disc Surgery: 

(Ostelo, 2004) 

• AUC: very good 
• Scale width (improvement/deterioration): good/good

Workers Compensation- Systematic Review of outcome measures:

(Spanjer et a, 2011) 

• Moderate to large responsiveness (response mean 0.78-0.84 for improvement) 

Chronic and Acute Low Back Pain: (Italian version)

(Monticone et al, 2012) 

• Responsiveness for Italian version of RMDQ ranged from 2.5 to 5 points without any significant clinical differences. 

Patients experiencing lower back pain: (Davidson et al, 2002

• Standard Response Mean = 0.55 (95% CI = -0.54 to 1.64)
  ROC = .77 (95% CI = 0.68 to 0.87)