Cited by 3,395Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPregnancy-related medical research

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A Study of the Natural History of Back Pain: Part I

ROLAND, MARTIN, MORRIS, RICHARD·1983·Spine

DOI 10.1097/00007632-198303000-00004

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Abstract

One of the problems in mounting a trial of treatment of back pain is the lack of suitable outcome measures. This paper describes the development and validation of a questionnaire designed to measure selfrated disability due to back pain. The questionnaire is short, simple, sensitive, and reliable. It would be suitable for use in future trials of treatment.

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Method
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“Questionnaires include, for example, the Roland and Morris Disability Questionnaire (RMDQ), which was developed to specifically measure disability reported by patients with low-back pain.(12) These outcome measures appear to have face validity in terms of what we believe to be important consequences of low-back pain.”
Influential
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“(2) Roland disability questionnaire: Back-specific functional impairment was assessed using the modified Roland disability scale (Roland and Morris, 1983).”
Method
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“…Arthritis Index (WOMAC) function score (Bellamy et al., 1988) in the knee pain trials (TOPIK, APEX); Roland Morris Disability Questionnaire (RMDQ) (Roland and Morris, 1983) in the LBP trials (STarT Back, LBP trial); Northwick Park Neck Pain Questionnaire (NPPQ) (Leak et al., 1994) in the neck…”
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“We estimated that 250 patients were needed to provide 90% power at the 5% significance level based on a 2 point difference in RDQ scores between groups and a standard deviation of 5.”
MethodInfluential
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“The RMD questionnaire is a disability questionnaire that measures the functional status of patients with back pain [24,25].”
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“The RDQ has shown good psychometric properties in different studies of CLBP patients (Roland and Morris, 1983; Stratford et al., 1994, 1998; Roland and Fairbank, 2000).”
Method
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“As expected, significant differences were apparent between the two groups’ pain intensity and RMDQ scores, indicating that high kinesiophobia participants experienced more pain and greater interference with daily functioning as a result of back pain symptoms.”
Influential
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“…measures were collected at baseline interviews and included health status aside from injury, pain intensity (any pain in the last week) (Von Korff et al. 1992), and Roland-Morris disability questionnaire score, which assesses disability specific to LBP (Roland and Morris 1983; Turner et al. 2003).”
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Background
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“A weighted mean of 43.3 for chronic LBP sufferers and 10.2 for people without low back pain has been reported previously [ 16 ].”
Influential
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“Participants with a score of 7 on the Roland Morris Disability Scale [15] were considered to meet the eligibility criterion of moderate functional impairment.”
BackgroundMethodInfluential
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Background
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“The condition-attribution approach is to take generic questions and modify them so that the respondent answers them only with regard to the condition [27, 37, 38].”
Background
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“Reliability and Validity The level of reliability of eight questionnaires (24,25,54,57,58,60,61,63) and four functional tests (28,72,75,79) was high.”
BackgroundInfluential
Contralateral Recurrent Lumbar Disc Herniation
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Differentiating temporal electromyographic waveforms between those with chronic low back pain and healthy controls
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Operative Treatment for Coccygodynia
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“Both been shown to provide reliable measures of activity limitation [1, 3]; however, there is some uncertainty regarding their responsiveness.”
BackgroundMethodInfluential
The Pain Self‐Efficacy Questionnaire: Cross‐Cultural Adaptation into Italian and Assessment of Its Measurement Properties
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Rasch analysis supports the use of the Depression, Anxiety, and Stress Scales to measure mood in groups but not in individuals with chronic low back pain
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Modification of attentional biases in chronic pain patients: a preliminary study
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THE ADOLESCENT BACK
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The Effect of Surgical Weight Reduction on Functional Status in Morbidly Obese Patients with Low Back Pain
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Validity, Reliability, Feasibility, and Usefulness of Pain Monitor: A Multidimensional Smartphone App for Daily Monitoring of Adults With Heterogenous Chronic Pain
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Condition-specific outcome measures for low back pain
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Patients' experiences of the impact of chronic back pain on family life and work
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Correlation of Low Back Pain With Functional Status, General Health Perception, Social Participation, Subjective Happiness, and Patient Satisfaction
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Effects of Pilates and trunk strengthening exercises on health-related quality of life in women with chronic low back pain
Kofotolis, N. D., Kellis, E., Vlachopoulos, S. P., Gouitas, I., & Theodorakis, Y. (2016) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-160665 · Cited by 74
“LBP-related functional disability was assessed using the Roland Morris Disability Questionnaire [21] with scores ranging from 0 (no disability) to 24 (maximum disability).”
Quality of Life Assessment in Obesity: Physical, Psychological, and Social Function
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Work Evaluations: Critique of the State of the Art of Functional Assessment of Work
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“The Oswestry Low Back Pain Disability Questionnaire (Fairbank, DaVies, Cooper, & O'Brien, 1980), using a slightly different methodology, also attempts to capture the person's perception of his or her level of pain and how it affects daily functioning.”
Background
Are tactile acuity and clinical symptoms related to differences in perceived body image in patients with chronic nonspecific lower back pain?
Nishigami, T., Mibu, A., Osumi, M., Son, K., Yamamoto, S., Kajiwara, S., Tanaka, K., Matsuya, A., & Tanabe, A. (2014) · Manual Therapy · doi:10.1016/j.math.2014.06.010 · Cited by 72
Translation and discriminative validation of the STarT Back Screening Tool into Danish
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Detecting insomnia in patients with low back pain: accuracy of four self-report sleep measures
Alsaadi, S. M., McAuley, J. H., Hush, J. M., Bartlett, D. J., Henschke, N., Grunstein, R. R., & Maher, C. G. (2013) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-14-196 · Cited by 73
“The Roland and Morris Disability questionnaire [13] is a 24-item self-administered questionnaire designed to measure the effect of LBP on a patient’s normal activities of daily living.”
BackgroundMethodInfluential
Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: A randomized controlled trial
Weiner, D. K., Perera, S., Rudy, T. E., Glick, R. M., Shenoy, S., & Delitto, A. (2008) · Pain · doi:10.1016/j.pain.2008.09.005 · Cited by 75
Pain-Related Attentional Biases: The Importance of the Personal Relevance and Ecological Validity of Stimuli
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Depressive symptoms in patients with chronic pain
Nicholas, M. K., Coulston, C. M., Asghari, A., & Malhi, G. S. (2009) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2009.tb02473.x · Cited by 73
Can Supervised Group Exercises Including Ergonomic Advice Reduce the Prevalence and Severity of Low Back Pain and Pelvic Girdle Pain in Pregnancy? A Randomized Controlled Trial
Eggen, M. H., Stuge, B., Mowinckel, P., et al. (2012) · Physical Therapy · doi:10.2522/ptj.20110119 · Cited by 72
Are Patient-reported Outcome Measures in Orthopaedics Easily Read by Patients?
El-Daly, I., Ibraheim, H., Rajakulendran, K., Culpan, P., & Bates, P. (2015) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-015-4595-0 · Cited by 75
“The Roland-Morris Disability Questionnaire had the highest readability score (FRES 93), while the University of California-Los Angeles (UCLA) Activity Scale, Knee Outcome Survey, Iowa Pelvic Score, and Majeed Pelvic Score had the lowest (FRES 0) (Table 4).”
Management of Chronic Nonspecific Low Back Pain in Primary Care: A Descriptive Study
van Tulder, M. W., Koes, B. W., Bouter, L. M., & Metsemakers, J. F. M. (1997) · Spine · doi:10.1097/00007632-199701010-00013 · Cited by 72
Biopsychosocial Screening Questionnaire for Patients With Low Back Pain: Preliminary Report of Utility in Physiotherapy Practice in Northern Ireland
Hurley, D. A., Dusoir, T. E., McDonough, S., Moore, A. P., Linton, S. J., & Baxter, D. G. (2000) · Clinical Journal of Pain · doi:10.1097/00002508-200009000-00007 · Cited by 71
Prognostic factors for perceived recovery or functional improvement in non-specific low back pain: secondary analyses of three randomized clinical trials
Helmhout, P. H., Staal, J. B., Heymans, M. W., Harts, C. C., Hendriks, E. J. M., & de Bie, R. A. (2010) · European Spine Journal · doi:10.1007/s00586-009-1254-8 · Cited by 71
“• functional disability, measured with the 24-item Roland–Morris Disability Questionnaire (RMDQ) [49]; • duration of LBP complaints at baseline, categorized as: 4–6 weeks; 6–12 weeks; 3–6 months; 6–12 months; 1 year or more.”
Method
Risk Factors Associated with Low Back Pain among A Group of 1510 Pregnant Women
Bryndal, A., Majchrzycki, M., Grochulska, A., et al. (2020) · Journal of Personalized Medicine · doi:10.3390/jpm10020051 · Cited by 71
Effect of collagen hydrolysate in articular pain: A 6-month randomized, double-blind, placebo controlled study
Bruyère, O., Zegels, B., Leonori, L., et al. (2012) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2011.12.007 · Cited by 71
A history of low back pain associates with altered electromyographic activation patterns in response to perturbations of standing balance
Jacobs, J. V., Henry, S. M., Jones, S., Hitt, J. R., & Bunn, J. Y. (2011) · Journal of Neurophysiology · doi:10.1152/jn.00296.2011 · Cited by 71
Five-year outcome of surgical decompression of the lumbar spine without fusion
Mannion, A. F., Denzler, R., Dvorak, J., & Grob, D. (2010) · European Spine Journal · doi:10.1007/s00586-010-1535-2 · Cited by 71
Predictors of Outcome in Patients With (Sub)Acute Low Back Pain Differ Across Treatment Groups
Jellema, P., van der Horst, H. E., Vlaeyen, J. W. S., Stalman, W. A. B., Bouter, L. M., & van der Windt, D. (2006) · Spine · doi:10.1097/01.brs.0000224179.04964.aa · Cited by 71
Foraminal Stenosis and Single-Level Degenerative Disc Disease
Hallett, A., Huntley, J. S., & Gibson, J. N. A. (2007) · Spine · doi:10.1097/brs.0b013e318064520f · Cited by 71
A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: A randomised controlled trial with one-year follow-up
Saner, J., Kool, J., Sieben, J. M., Luomajoki, H. A., Bastiaenen, C. H. G., & de Bie, R. A. (2015) · Manual Therapy · doi:10.1016/j.math.2015.02.005 · Cited by 73
“…months (measured with the subscales “Characteristic Pain Intensity” of the Graded Chronic Pain Scale (GCPS) (Turk & Melzack, 2011) (v. 2.0)) and disability (measured with the subscales “Disability Score” of the GCPS and the RolandeMorris Disability Questionnaire (RMDQ) (Roland and Morris, 1983)).”
MethodInfluential
Work-related outcome assessment instruments
Elfering, A. (2005) · European Spine Journal · doi:10.1007/s00586-005-1047-7 · Cited by 71
The role of an integrated back stability program in patients with chronic low back pain
Norris, C. M., & Matthews, M. J. (2008) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2008.06.001 · Cited by 71
Are Pain Intensity and Pain Related Fear Related to Functional Capacity Evaluation Performances of Patients with Chronic Low Back Pain?
Reneman, M. F., Preuper, H. R. S., Kleen, M., Geertzen, J. H. B., & Dijkstra, P. U. (2007) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-007-9078-z · Cited by 70
Predictive validity of the Chronic Pain Coping Inventory in subacute low back pain
Truchon, M., & Côté, D. (2005) · Pain · doi:10.1016/j.pain.2005.04.003 · Cited by 70
“Disability was assessed with the Roland-Morris disability questionnaire (RMDQ) (Roland and Morris, 1983).”
Method
Validity and Reliability of the French Version of the STarT Back Screening Tool for Patients With Low Back Pain
Bruyère, O., Demoulin, M., Beaudart, C., Hill, J. C., Maquet, D., Genevay, S., Mahieu, G., Reginster, J., Crielaard, J.-M., & Demoulin, C. (2013) · Spine · doi:10.1097/brs.0000000000000062 · Cited by 66
Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study
Hensel, K., Buchanan, S., Brown, S. K., Rodríguez, M., & Cruser, D. A. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.07.043 · Cited by 70
An educational approach based on a non-injury model compared with individual symptom-based physical training in chronic LBP. A pragmatic, randomised trial with a one-year follow-up
Sørensen, P. H., Bendix, T., Manniche, C., Korsholm, L., Lemvigh, D., & Indahl, A. (2010) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-11-212 · Cited by 73
“Roland Morris Disability Questionnaire (RMQ)[43]”
Reflexology for the treatment of pain in people with multiple sclerosis: a double-blind randomised sham-controlled clinical trial
Hughes, C., Smyth, S., & Lowe-Strong, A. S. (2009) · Multiple Sclerosis Journal · doi:10.1177/1352458509345916 · Cited by 69
Treadmill walking with body weight support is no more effective than cycling when added to an exercise program for lumbar spinal stenosis: a randomised controlled trial
Pua, Y., Cai, C., & Lim, K.-C. (2007) · Australian Journal of Physiotherapy · doi:10.1016/s0004-9514(07)70040-5 · Cited by 70
Comparison of the Roland–Morris Disability Questionnaire and Generic Health Status Measures
Turner, J. A., Fulton‐Kehoe, D., Franklin, G. M., Wickizer, T. M., & Wu, R. (2003) · Spine · doi:10.1097/01.brs.0000062007.95197.08 · Cited by 70

Authors: ROLAND, M., & MORRIS, R.
Affiliations: St Thomas' Hospital (GB)
Corresponding author: ROLAND, MARTIN
ORCID: ROLAND, MARTIN
MORRIS, RICHARD
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1983-03
Volume: 8
Issue: 2
Pages: 141-144
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/00007632-198303000-00004
OpenAlex: W2118516436
Cited by: 3,395
References: 0
Citations by year: 2026: 80 · 2025: 90 · 2024: 88 · 2023: 105 · 2022: 136 · 2021: 148 · 2020: 137 · 2019: 128 · 2018: 125 · 2017: 124 · 2016: 130 · 2015: 125 · 2014: 127 · 2013: 145 · 2012: 146
FWCI: 5.03
Type: journal article
Language: en
Open access: closed
Locations: Spine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: back pain, natural history (disease), self-rated disability, questionnaire development, outcome measures, disability assessment, treatment trials
MeSH terms: Activities of Daily Living, Adolescent, Adult, Back Pain, Disability Evaluation, Humans, Middle Aged, Movement

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A Study of the Natural History of Back Pain: Part I

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