Background & Aims
Chronic low back pain (CLBP) is one of the top four listed major causes of years lived with disability among 354 diseases across 195 countries. To accurately assess disability caused by CLBP and the effectiveness of interventions, there is a need to have a standardized self-administered standardized questionnaires that can measure the change in the condition of the patient over time. These questionnaires should be available in the native language of the patients, otherwise, the physician may be compelled to self-translate or interpret the scale. This can affect the essential construct of the scale. RMDQ is one such questionnaire that has been translated into Hindi (world’s fourth most widely spoken and a native language of India). However, its validity in the Hindi language in CLBP patients has never been investigated. The main aim was to assess the validity and reliability of the Hindi version of the Roland Morris Disability Questionnaire (Hi-RMDQ) for chronic low back pain.
Methods
The primary objective of this study was to conduct cross-cultural validation and reliability of the Hindi version of RMDQ (Hi RMDQ) in CLBP patients. The secondary objectives were to correlate Hi RMDQ with other validated disability scales which are Hi ODQ and Hi QBPDS, as well as with the pain verbal numeric rating scale (VNRS).
This study was carried out in the pain clinic of a tertiary care hospital in north India. After institutional ethics committee approval and trial was registered prospectively in the national registry (CTRI/2021/06/034049).120 patients aged 18-65 years with nonspecific LBP with or without leg pain, who were Indian residents and could understand, read and write the Hindi language, were recruited. After written informed consent, patients were asked to fill up the Hi-RMDQ questionnaire sheet and Hi-ODI, Hi-QBPDS, and VNRS. For test-retest reliability, Hi RMDQ was re-administered 3 days after.Reliability and validity of RMDQ were assessed.
Results
Of the 142 patients with CLBP 132 met the inclusion criteria. Twelve patients did not provide consent to participate. Thus, the final sample comprised 120 patients. The translated questionnaire showed excellent internal consistency (Cronbach ? = 0.989) and retest reliability (ICC = 0.978) of the Hi-RMDQ scale was found to be excellent. The resultrevealed that the difference between test and retest scores for Hi-RMDQ was within 95% confidence interval in almost all cases, indicating good test-retest agreement. Convergent validity was assessed by comparing the Hi-RMDQ with the pain (VNRS), and it showed a good positive correlation (Pearson correlation coefficient, r = 0.713 and 0.629. There was a positive and statistically significant association between the Hi-RMDQ, modified Oswestry Disability Index Questionnaire (r = 0.807; P < 0.01), Quebec Back Pain Disability Score (r = 0.839; P < 0.01), and Verbal Numeric Rating Scale (r = 0.713; P < 0.01).
Conclusions
TThe Hi-RMDQ version is an easy-to-use, acceptable, reliable and valid tool to measure disability in the Indian population with nonspecific back pain with or without leg pain. It exhibited good internal consistency, strong test-retest reliability, and good convergent and concurrent validity. Hence, we recommend its use in future clinical practice and research studies in India.
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Presenting Author
Rajni Sharma
Poster Authors
Rajni Sharma
PhD
Postgraduate Institute of Medical Education and Research Chandigarh
Lead Author
Anjali Mohan,MD
Postgraduate Institute of Medical Education and Research Chandigarh, India
Lead Author
BABITA GHAI,MBBS
MD
Postgraduate Institute of Medical Education and Research Chandigarh
Lead Author
VISHAL KUMAR,MS
Postgraduate Institute of Medical Education and Research Chandigarh
Lead Author
JEETINDER MAKKAR
MD
Postgraduate Institute of Medical Education and Research Chandigarh
Lead Author
Topics
- Assessment and Diagnosis