Validation of the Tunisian version of the Roland-Morris questionnaire

Abstract

IntroductionLow back pain (LBP) is a ubiquitous health problem. It represents the most frequent illness in humans. LBP lifetime prevalence ranges 60-90%, and the annual incidence is 5% [6]. It is reported to be the leading cause of disability in people under 45 years of age and the third cause of disability in those over 45 [21]. High costs associated with LBP and its socio-economic impact have made this so-called self-limited and benign condition a considerable health-care policy challenge, especially in industrial countries [1,7,20,21]. LBP may have an impact on the functional status of the patient, interfering with basic activities like standing, walking, dressing and many work-related activities, leading to pain and disability. Measuring the disability is important. First, as an outcome measure, it is an important indicator of the of the patient's quality of life. In addition, this outcome can be used for planning and monitoring therapy, clinical and epidemiological reAbstract Our aim was to validate a culturally adapted, Tunisian-language version of the Roland-Morris Disability Questionnaire (RMDQ), which is a reliable evaluation instrument for low-back-pain disability. A total of 62 patients with low back pain were assessed by the questionnaire. Reliability for the 1-week test/re-test was assessed by a construction of a Bland Altman plot. Internal construct validity was assessed by Cronbach's αtest. External construct validity was assessed by association with pain, the Schober test and the General Function Score. Sensitivity to change was determined using a t-test for paired data to compare RMDQ scores at inclusion and at completion of the therapeutic sequence of local corticosteroid injections. We also compared the questionnaire score with the General Function Score, both taken after completion of the therapeutic sequence. The constructed Bland Altman plot showed good reliability. Internal consistency of the RMDQ was found to be very good and the Cronbach's α test was 0.94, indicating a good internal construct validity. The questionnaire is correlated with the pain visual analogue scale (r=33; p=0.0001), with the Schober test (r=0.27; p=0.0001) and the General Function Score (r=56; p=0.0001) indicating an adequate external construct validity. The RMDQ administered after the therapeutic sequence is sensitive to change (r=0.83; p=0.000). Comparison of the questionnaire score to the General Function Score, after completion of the therapeutic sequence, was satisfactory (r=0.75; p=0.000). We conclude that the Tunisian version of the Roland-Morris questionnaire has good reliability and internal consistency. Furthermore, it has a good internal-and external construct validity and high sensitivity to change. It is an adequate and useful tool for assessing low-back-pain disability.

Translation, Adaptation, and Reliability of Modern Standard Arabic Version of the Roland Morris Disability Questionnaire

“…The construction of the questionnaire was preserved, and the 24 items were maintained in a fashion similar to the original and other versions of the questionnaire. The Cronbach's alpha of 0.948 is a good measure of internal consistency of the Modern Standard Arabic version of the RMDQ, and is in accordance with other translated versions, 0.81 [8], 0.837 [9], 0.904 [13], 0.85 [14], 0.96 [15], 0.94 [16], 0.826 [19]. Positive correlation in the analysis for convergent validity was observed between both the RMDQ and FFL and VAS.…”

“…Modern Standard Arabic largely follows the grammatical standards of Quranic Arabic and uses much of the same vocabulary [20]. Although the Moroccan [15] and Tunisian [16] translations of the RMDQ provide an Arabic version of the questionnaire, these translations used colloquial text that would be very difficult to understand by citizens of the other Arabic-speaking countries.…”

“…The original English RMDQ has adequate reliability, validity, and responsiveness [7]. The RMDQ has been translated and culturally adapted into many languages including German [8], Spanish [9], Italian [10], French [11], Brazilian [12], Argentinean [13], Turkish [14], Moroccan [15], Tunisian [16], Japanese [17], Korean [18] and Chinese [19].…”

Adaptación cultural y validación de la versión chilena del Cuestionario de Discapacidad Roland-Morris

“…La magnitud de esta correlación entre dolor y discapacidad en nuestro trabajo es menor que la reportada en trabajos previos, como en la validación tunesina 5 , coreana 11 , así como también en el trabajo original de Roland y Morris 14 . A diferencia de estos trabajos, nuestra muestra no estaba constituida por personas con dolor crónico en el momento de la evaluación, lo que puede explicar la menor relación observada entre discapacidad y dolor en nuestros pacientes.…”

“…Estas validaciones han mostrado buenos indicadores psicométricos, por lo que se cuenta con un instrumento adecuado para evaluar discapacidad por dolor lumbar en diferentes países. Citamos por ejemplo la versión alemana 4 , tunesina 5 , española 6 , brasilera 7 , china 8 , gujarati (India) 9 , japonesa 10 y coreana 11 . Sin embargo, carecemos de una versión validada en Chile, que nos permita usar con propiedad este instrumento en nuestro país.…”