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Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis
Open accessAbstract
BACKGROUND: Physical functioning is a core outcome domain to be measured in nonspecific low back pain (NSLBP). A panel of experts recommended the Roland-Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) to measure this domain. The original 24-item RMDQ and ODI 2.1a are recommended by their developers. PURPOSE: The purpose of this study was to evaluate whether the 24-item RMDQ or the ODI 2.1a has better measurement properties than the other to measure physical functioning in adult patients with NSLBP. DATA SOURCES: Bibliographic databases (MEDLINE, Embase, CINAHL, SportDiscus, PsycINFO, and Google Scholar), references of existing reviews, and citation tracking were the data sources. STUDY SELECTION: Two reviewers selected studies performing a head-to-head comparison of measurement properties (reliability, validity, and responsiveness) of the 2 questionnaires. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to assess the methodological quality of these studies. DATA EXTRACTION: The studies' characteristics and results were extracted by 2 reviewers. A meta-analysis was conducted when there was sufficient clinical and methodological homogeneity among studies. DATA SYNTHESIS: Nine articles were included, for a total of 11 studies assessing 5 measurement properties. All studies were classified as having poor or fair methodological quality. The ODI displayed better test-retest reliability and smaller measurement error, whereas the RMDQ presented better construct validity as a measure of physical functioning. There was conflicting evidence for both instruments regarding responsiveness and inconclusive evidence for internal consistency. LIMITATIONS: The results of this review are not generalizable to all available versions of these questionnaires or to patients with specific causes for their LBP. CONCLUSIONS: Based on existing head-to-head comparison studies, there are no strong reasons to prefer 1 of these 2 instruments to measure physical functioning in patients with NSLBP, but studies of higher quality are needed to confirm this conclusion. Foremost, content, structural, and cross-cultural validity of these questionnaires in patients with NSLBP should be assessed and compared.
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“A priori hypotheses were formulated by the review team to evaluate the results of studies on construct validity and responsiveness, based on the results of a previous systematic review on instruments for LBP [40].”
From Evidence on the measurement properties of health-related quality of life instruments is largely missing in patients with low back pain: A systematic review (2018) · cites this paper as [40]
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Metadata
- Authors
- Chiarotto, A., Maxwell, L. J., Terwee, C. B., Wells, G. A., Tugwell, P., & Ostelo, R. W.
- Affiliations
- Amsterdam Public Health (NL)
- Ottawa Hospital Research Institute (CA)
- University of Ottawa (CA)
- Corresponding author
- Chiarotto, Alessandro
- ORCID
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-10-01
- Volume
- 96
- Issue
- 10
- Pages
- 1620-1637
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- OpenAlex
- W2336018145
- Cited by
- 290
- References
- 98
- Citations by year
- 2026: 30 · 2025: 32 · 2024: 41 · 2023: 35 · 2022: 38 · 2021: 26 · 2020: 23 · 2019: 25 · 2018: 18 · 2017: 14 · 2016: 5
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Koninklijk Nederlands Genootschap voor Fysiotherapie
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- non-specific low back pain, Roland-Morris Disability Questionnaire, Oswestry Disability Index, physical function, measurement properties, test-retest reliability, construct validity, responsiveness, internal consistency, questionnaire comparison
- MeSH terms
- Disability Evaluation, Humans, Pain Measurement, Psychometrics, Reproducibility of Results, Low Back Pain
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