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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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Chiarotto, A., Maxwell, L. J., Ostelo, R., Boers, M., Tugwell, P., & Terwee, C. B. (2018) · Journal of Pain · doi:10.1016/j.jpain.2018.07.009 · Cited by 780
Core outcome measurement instruments for clinical trials in nonspecific low back pain
Chiarotto, A., Boers, M., Deyo, R. A., Buchbinder, R., Corbin, T. P., Costa, L. O. P., Foster, N. E., Grotle, M., Koes, B. W., Kovacs, F. M., et al. (2018) · Pain · doi:10.1097/j.pain.0000000000001117 · Cited by 461
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Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective
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Chiarotto, A., Ostelo, R., Boers, M., & Terwee, C. B. (2017) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2017.11.005 · Cited by 141
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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