Search

Background The global prevalence of low back pain is gradually increasing, and it is the main cause of disability, sick leave, and unemployment, posing a heavy burden on individuals and society. Assessing the degree of disability in patients with chronic low back pain is crucial for evaluating the efficacy of clinical interventions and clinical epidemiology. The Roland-Morris Disability Questionnaire (RMDQ) is currently the main tool for evaluating disability in patients with low back pain, but the applicability of its measurement performance in the Chinese population remains unclear. Objective To evaluate the applicability of RMDQ in the Chinese population with low back pain and provide evidence for clinical practice and research application. Methods CNKI, Wanfang Data Knowledge Service Platform, SinoMed, PubMed, Embase and Web of Science were searched from inception to 2023-10-01, to establish a literature base for the performance of the low back pain scale, and then select research on the measurement performance of RMDQ from it. The measurement performance of the RMDQ scale was evaluated according to the COSMIN system evaluation guidelines, and the evidence evaluation level was used to grade the evidence. Results A total of six RMDQ documents were included, with insufficient methodological quality for RMDQ content validity and adequate measurement performance. The quality of internal consistency methodology was very good with uncertainty and measurement performance was adequate; the methodological quality of retesting was uncertain, and the measurement performance was sufficient; the methodological quality of measurement error was uncertain, and the measurement performance was sufficient; the methodological quality of criterion validity was uncertain, and the measurement performance was insufficient; hypothesis testing methodological quality was very good with uncertain, and the measurement performance was sufficient and uncertain; the quality of reactivity methodology was very good, with sufficient and insufficient, while the measurement performance was sufficient with insufficient. According to the GRADE evidence quality rating results, there is low quality evidence to prove uncertainty in content validity, and moderate quality evidence to prove sufficient retesting reliability and internal consistency; there is sufficient evidence of low quality to prove the measurement error and reactivity. There is very low quality evidence of insufficient calibration validity when using the Oswestry Dysfunction Index (ODI) and the Visual Analog Scale (VAS) as calibrators; hypothesis testing had moderate quality evidence of uncertainty. Conclusion The methodological quality of the RMDQ scale is not high, with acceptable measurement performanceand low quality of evidence, and needs to be used cautiously in clinical practice or trials of low back pain in China. Although there is sufficient evidence of moderate quality to prove the reliability and internal consistency of retesting, the research content and methods are not standardized. In future research, attention should be paid to standardization to more accurately assess its applicability in the Chinese population.

Background: College students are required to sit for long periods of time in their classrooms. Prolonged sitting is defined as sitting for more than 2 hours continuously, students usually sit in classrooms on an average of 6 to 8 hours per day. Prolonged sitting has become a major risk factor causing low back pain especially among university students. The recurrence of LBP at old age also increases if the person is found to have LBP at an early stage. Purpose: The objective of this research is to establish the gradual development from functional limitations in non-specific low back pain (NSLBP) among college students after spinal extension exercise and ergonomic advice. Materials and Methods: Based on inclusion and exclusion criteria, the subjects were identified. They were provided with an explanation of the study. A group of 60 subjects were recruited for this research and divided into 3 groups, in which the first group was given spinal extension exercise (n=20), the second group (n=20) was given ergonomic advice and the third group (n=20) was given combination of both the interventions. The Roland-Morris Disability Questionnaire is a 24-item self-report tool for assessing function. The entire process was performed from November 2022 to April 2023. Result: From statistical analysis, the group that received spinal extension exercise combined with ergonomic advice has better outcomes. (p=0.001) Conclusion: The spinal extension exercise given along with ergonomic advice is effective in the treatment of NSLBP for university students. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods: This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results: Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion: The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain. [ABSTRACT FROM AUTHOR]

Introduction: Low Back Pain (LBP) is the most common health problem among elderly individuals, leading to pain and disability. Alongside pain, psychosocial factors have a significant impact on patients with LBP. Kinesiophobia is defined as a fear of physical movement and activity, which can result in avoidance of activities and movement, leading to deconditioning. The relationship between kinesiophobia and pain severity is complex and interrelated, with each affecting the other and restricting the patient’s participation in daily activities. Aim: To investigate the relationship between kinesiophobia, pain severity, and functional disability in older people with LBP. Materials and Methods: A total of 49 participants over 60 years old with LBP were recruited for this cross-sectional study at the Department of Physiotherapy, Nitte Institute of Physiotherapy, Deralakatte, Mangaluru, Karnataka, India. Subjects were recruited from March 2022 to February 2023 based on inclusion criteria. Screened participants completed a self-reported questionnaire, The subjects themselves filled out the outcome tools. including the Tampa Scale of Kinesiophobia (TSK) Questionnaire, the Roland Morris Disability Questionnaire tool, and the Numerical Pain Rating Scale (NPRS) to assess various aspects of kinesiophobia, functional disability, and pain severity. Pearson’s correlation coefficient was used to determine the correlation between kinesiophobia, pain severity, and functional disability. A p-value

Kyoung Sun Park,1 Changnyun Kim,2 Joo Won Kim,3 Sang‐Don Kim,4 Jee Young Lee,5 Yoon Jae Lee,5 Jinho Lee,1 Min Ji Kim,6 Young Eun Choi,6 Changsop Yang,7 Chang-Hyun Han,7,8,&ast; In-Hyuk Ha5,&ast; 1Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea; 2Daejeon Jaseng Hospital of Korean Medicine, Daejeon, Republic of Korea; 3Bucheon Jaseng Hospital of Korean Medicine, Bucheon, Republic of Korea; 4Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea; 5Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea; 6Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; 7Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; 8Korean Convergence Medical Science, Korea Institute of Oriental Medicine School, University of Science & Technology, Daejeon, Republic of Korea&ast;These authors contributed equally to this workCorrespondence: Chang-Hyun Han, Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea, Tel +82 42 868 9498, Email chhan@kiom.re.kr In-Hyuk Ha, Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea, Tel +82 2 2222 2740, Email hanihata@gmail.comPurpose: Chronic lower back pain (LBP) is a major global health concern. Pharmacopuncture has been widely used to treat LBP in Korea; however, randomized clinical trials (RCT) or active control have not been conducted to evaluate its effectiveness. Therefore, this RCT aimed to compare the effectiveness of pharmacopuncture and physical therapy (PT) for the treatment of chronic LBP.Patients and Methods: A two-arm, parallel, and multicenter RCT was conducted at four hospitals of Korean medicine. Participants with chronic LBP were randomly assigned at a 1:1 ratio using block randomization to undergo 10 sessions of pharmacopuncture or PT over 5 weeks and followed up for 25 weeks. The numerical rating scale (NRS) and visual analog scale scores of LBP and radiating leg pain and the Oswestry disability index (ODI), 5-level EuroQol-5 dimension (EQ-5D-5L), and the patient global impression of change were recorded at baseline and at 6, 13, and 25 weeks. An intention-to-treat analysis was conducted as the primary analysis using a linear mixed model.Results: One-hundred patients (mean age, 49.27 years; 58 women) were recruited. At 6 weeks after randomization, pharmacopuncture showed statistically superior results compared with PT in LBP (difference in NRS, 1.54; 95% CI, 0.94– 2.13), function (difference in ODI, 4.52%; 95% CI, 0.93– 8.11%), and quality of life (difference in EQ-5D-5L) scores (− 0.05; 95% CI, − 0.08 to − 0.01). This effect persisted for 25 weeks. In the survival analysis for participants with at least a 50% reduction in the NRS scores of LBP during the 182-day follow-up, the pharmacopuncture group showed significantly faster recovery than the PT group (P< 0.001, Log rank test).Conclusion: Pharmacopuncture significantly reduced pain and improved functional outcomes and quality of life in patients with low back pain compared with physical therapy. Based on the findings of this study, pharmacopuncture could be recommended as a treatment for patients with chronic low back pain.Keywords: low back pain, pharmacopuncture, physiotherapy, Oswestry disability index, Roland–Morris disability questionnaire, pragmatic randomized controlled trial

BackgroundSubstantial investment has gone into research on the efficacy and effectiveness of pharmaceutical and nonpharmacologic interventions for chronic pain. However, synthesizing this extensive literature is challenging because of differences in the outcome measures used in studies of similar or competing interventions. The absence of a common metric makes it difficult to replicate findings, pool data from multiple studies, resolve conflicting conclusions, or reach consensus when interpreting findings.MethodsThis study has a seven-member Advisory Council of chronic pain experts. Preliminary analyses will be performed on data from several large existing datasets; intermediate analyses will be performed using primary data collected from Amazon's Mechanical Turk (MTurk); and cross-validation will use primary data collected from a nationally-representative, probability-based panel. Target sample size for both primary datasets is 1500. The three study aims are as follows: Aim 1 will develop and evaluate links between the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS®-29) and legacy measures used for chronic pain such as the Roland-Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI). We will assess the best method of score linking and create crosswalk tables. Aim 2 will evaluate and refine the Impact Stratification Score (ISS) based on 9 PROMIS-29 items and proposed by the NIH Research Task Force on chronic low back pain. We will evaluate the ISS in terms of other indicators of condition severity and patient prognosis and outcomes and identify cut-points to stratify chronic pain patients into subgroups. Aim 3 will evaluate the strengths and limitations of MTurk as a data collection platform for estimating chronic pain by comparing its data to other data sources.DiscussionThe accomplishment of Aims 1 and 2 will allow direct comparison of results across past and future studies of chronic pain. These comparisons will help us to understand different results from seemingly similar studies, and to determine the relative effectiveness of all pharmaceutical and nonpharmacologic interventions for chronic pain across different trials. Aim 3 findings will provide valuable information to researchers about the pros and cons of using the MTurk platform for research-based data collection.Trial registrationClinicalTrials.gov: NCT04426812 ; June 10, 2020.

Introduction: Low Back Pain (LBP) is the most common health problem among elderly individuals, leading to pain and disability. Alongside pain, psychosocial factors have a significant impact on patients with LBP. Kinesiophobia is defined as a fear of physical movement and activity, which can result in avoidance of activities and movement, leading to deconditioning. The relationship between kinesiophobia and pain severity is complex and interrelated, with each affecting the other and restricting the patient's participation in daily activities. Aim: To investigate the relationship between kinesiophobia, pain severity, and functional disability in older people with LBP. Materials and Methods: A total of 49 participants over 60 years old with LBP were recruited for this cross-sectional study at the Department of Physiotherapy, Nitte Institute of Physiotherapy, Deralakatte, Mangaluru, Karnataka, India. Subjects were recruited from March 2022 to February 2023 based on inclusion criteria. Screened participants completed a self-reported questionnaire, The subjects themselves filled out the outcome tools. including the Tampa Scale of Kinesiophobia (TSK) Questionnaire, the Roland Morris Disability Questionnaire tool, and the Numerical Pain Rating Scale (NPRS) to assess various aspects of kinesiophobia, functional disability, and pain severity. Pearson's correlation coefficient was used to determine the correlation between kinesiophobia, pain severity, and functional disability. A p-value <0.05 was considered statistically significant. Results: The age of the elderly participants ranged from 60 to 84 years, with a mean age of 70.9±6.5 years. positive correlation was found between kinesiophobia and functional disability (r value=0.464, p-value=0.001), while no correlation was observed between kinesiophobia and pain intensity. Conclusion: It is concluded that kinesiophobia may contribute to disability, as a positive relationship between kinesiophobia and functional disability was observed in individuals with LBP. However, no correlation was found between kinesiophobia and pain intensity. [ABSTRACT FROM AUTHOR]

Study Design.: Retrospective study. Objective.: The aim was to clarify the health-related quality of life (QOL) of patients who had adolescent idiopathic scoliosis (AIS) at a minimum of 40 years after surgery. Summary of Background Data.: The postoperative health-related QOL of middle-aged patients with AIS has been reported to be good, but that of middle-aged and older patients with AIS has yet to be completely explored. Materials and Methods.: We included 179 patients with AIS who underwent spinal fusion(s) between 1968 and 1982. We conducted three surveys in 2009, 2014, and 2022. Patients self-administered both the Scoliosis Research Society-22 and the Roland-Morris Disability questionnaires three times (in 2009, 2014, and 2022) and the Oswestry Disability Index (ODI) questionnaire was self-administered in 2014 and 2022. We considered patients who responded to all three surveys in 2009, 2014, and 2022. Results.: For the Scoliosis Research Society-22 questionnaires, no significant differences were detected among the three time points (2009, 2014, and 2022) for total scores, function domain, pain domain, self-image domain, mental domain, or satisfaction domain. The results of the Roland-Morris Disability Questionnaire were also not significantly different among the surveys over time. The ODI questionnaires revealed a significant worsening of the 2022 results compared with the 2014 results. Eight patients (29.6%) who had an ODI deterioration of 10% or more had numerically fewer mobile lumbar disks than those with <10% deterioration of the ODI, although the difference did not reach statistical significance. Conclusion.: Among patients with AIS who underwent spinal fusion(s) between 1968 and 1982, we found health-related QOL to be maintained over the last 13 years. Relatively good QOL was appreciated in this population of patients who are now middle-aged and older. [ABSTRACT FROM AUTHOR]

Treatment for lumbar spinal canal stenosis (LSCS) is mainly classified into conservative and surgical therapies. Among conservative therapies, pharmacological treatment is commonly prescribed for LSCS. Meanwhile, surgical treatment is the last option for LSCS. This study aimed to examine the impact of lumbar surgery on pharmacological treatment for patients with LSCS. Consecutive patients aged ≥ 40 years who underwent lumbar surgery for LSCS were identified. A total of 142 patients were retrospectively reviewed for preoperative and 6-month and 1-year postoperative LSCS medications. The results showed that the number of LSCS medications significantly decreased after lumbar surgery. The proportion of the patients taking non-steroidal anti-inflammatory drugs, pregabalin/mirogabalin, opioids, prostaglandin E1 analogs, and neurotropin was significantly decreased after lumbar surgery, but that of the patients taking mecobalamin, acetaminophen, and serotonin-noradrenalin reuptake inhibitors was not significantly changed. Additionally, around 15% of the participants showed an increase in LSCS medications even after lumbar surgery. Multivariable analysis revealed that individuals without improvements in walking ability (RR: 2.7, 95% CI: 1.3–5.9) or social life (RR: 2.3, 95% CI: 1.1–5.0) had a greater risk of a postoperative increase in LSCS medications. The study results may provide physicians with beneficial information on treatment for LSCS. [ABSTRACT FROM AUTHOR]

Background: Lumbar spinal stenosis (LSS) is one of the important health problems in an aging society because it can significantly impair quality of life (QOL) and active daily living (ADL). However, the natural history or long-term change of LSS symptoms is still unclear. The purpose of this study was to clarify the 10-year course of lumbar spinal stenosis (LSS) symptoms in community-dwelling residents of more than 1000 people with prospective data collection. Methods: A total of 1149 subjects were analyzed for the time course of LSS symptoms for ten years. LSS symptoms were assessed using a questionnaire specially designed and validated to detect LSS symptoms without image information such as magnetic resonance imaging. Results: The prevalence of positive LSS symptoms was about 16% in the initial survey and 10-year follow-up. Of the subjects who were LSS positive at the initial survey, 40% showed positive LSS symptoms at follow-up and 60% switched to negative LSS symptoms. According to the multivariable logistic regression analysis, severe depression and positive LSS symptoms were extracted as predictors of the presence of LSS symptoms after a 10-year follow-up. Conclusion: The statistical predictor of the presence of LSS symptoms at 10 years was the presence of LSS symptoms at the initial survey; however, 60% of those who were positive for LSS symptoms at the initial survey were not determined to have LSS symptoms at the 10-year follow-up. This was the same result as at the 1-year and 6-year follow-up. [ABSTRACT FROM AUTHOR]

Study Design: A prospective cohort study.Objective: To investigate construct validity by examining the convergent and discriminative validity of the Patient-Reported Outcomes Measurement Information System Physical Function 4a (PROMIS-PF4) questionnaire in low back pain (LBP) patients seeking care from Danish chiropractors.Summary Of Background Data: The Roland-Morris Disability Questionnaire (RMDQ) is often used to assess physical functioning in LBP. However, it consists of 24 items, which is time consuming to complete in clinical practice. The PROMIS-PF4 questionnaire has only four items and may be more applicable for clinical use.Materials and Methods: Patients with LBP seeking care from chiropractors in Denmark completed the PROMIS-PF4, RMDQ, Subgroups for Targeted Treatment (STarT) Back screening tool, and Numeric Pain Rating Scale (NPRS) in advance of their first appointment with the chiropractor. Convergent validity was assessed using Spearman correlation coefficients between the PROMIS-PF4 and RMDQ and NPRS, respectively. Discriminative validity of the PROMIS-PF4 was assessed by calculating the area under the receiver operating characteristic curve (AUC) when plotting the PROMIS-PF4 t score against a reference case for RMDQ; NPRS; and high and low risk groups using the STarT Back screening tool.Results: Among 356 patients the PROMIS-PF4 questionnaire had strong convergent validity with the RMDQ ( r =-0.76) and moderate convergent validity with the NPRS ( r =-0.42). The PROMIS-PF4 had good and acceptable discriminative validity for disability (AUC=0.88) and high risk of persisting disability (AUC=0.72), and poor or no discriminative validity for pain intensity (AUC=0.66) and low-risk of persisting disability (AUC=0.26), respectively.Conclusion: As hypothesized, for convergent validity the PROMIS-PF4 has stronger correlation with the RMDQ than the NPRS and good discriminative validity for identifying patients with pain-related disability and at high risk of persisting disability but not for identifying pain intensity or low-risk of persisting disability. Consequently, the PROMIS-PF4 has adequate construct validity for measuring pain-related disability in an LBP population in chiropractic care. [ABSTRACT FROM AUTHOR]

Objective: To generate crosswalk equations and tables for 4 pain impact measures: the Impact Stratification Score (ISS), Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and the Pain, Enjoyment of Life and General Activity Scale (PEG)., Design: Cross-sectional survey assessing demographics and pain impact. Crosswalks were developed using item-response theory (IRT) cocalibrations and linear regressions between the ISS, ODI, RMDQ, and PEG., Setting: Online panel., Participants: Population-based sample of United States adults aged 18 and older. Eligibility criteria were reporting current back pain, not reporting 2 fake health conditions, and having data for 2 or more pain measures (N=1530; 37% of sample). Crosswalks were developed (n=1030) and cross-validated in a subsample of 500 participants (n=125 randomly sampled from each ISS quartile)., Interventions: Not applicable., Main Outcome Measures: ISS, ODI, RMDQ, and the PEG., Results: Associations of the ISS with the PEG and ODI met the criteria for IRT cocalibration. Other measure pairs were crosswalked using regression. Associations were strongest between the PEG and the ISS (r=0.87, normalized mean absolute error [NMAE]=0.38) and between the ODI and the ISS (r=0.85, NMAE=0.39). Associations were weakest between the PEG and the RMDQ (r=0.69, R 2 =0.48, NMAE: 0.55-0.58). Regression equations and IRT accounted for 48%-64% of the variance (NMAE: 0.38-0.58) in corresponding pain measures in the cross-validation sample., Conclusions: The crosswalks between the ISS and common legacy pain measures created in this study of a nationally representative sample of United States adults with back pain can be used to estimate 1 pain impact measure from another. Further evaluation in clinical samples is recommended., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Lumbar paraspinal muscle (LPM) is important in spinal stabilization in patients with chronic low back pain (CLBP). However, the electrical properties of LPM in patients with CLBP remain unclear. Electrical impedance myography (EIM) is a novel and non-invasive technique that provides a simple quantitative evaluation of electrical properties of the LPM. Purpose: This study aimed to apply EIM to assess the electrical properties of the LPM between patients with CLBP and healthy control (HC). Methods: Thirty participants (15 CLBP participants; 15 healthy controls) were enrolled in the study. Participants in the CLBP group were asked to complete the visual analog scale (VAS), Oswestry Disability Index (ODI), and Roland–Morris Disability Questionnaire (RDQ) to assess the pain intensity and disability in daily life. Independent sample t -tests were adopted to analyze the basic characteristics between the two groups. At 5, 50, 100, and 200 kHz current frequencies, the electrical properties were measured on each side of the LPM. The EIM parameters of resistance (R), reactance (X), phase angle (PA), and Z value were analyzed by one-way analysis of variance (ANOVA), with age as covariate. Spearman's rank correlation coefficient analysis was applied to explore the relationships between the questionnaires and the EIM parameters. Results: The R and Z values of bilateral LPM in the CLBP group were significantly larger than those in the HC group; the PA decreased and the X did not change at these four tested current frequencies. At 5 kHz, Z and R on the right side were non-significantly different between patients and HCs. Correlation analysis showed that at 50 kHz, ODI and RDQ scores correlated negatively with the R of the bilateral LPM (r = 0.523, r = 0.581, respectively; p < 0.05). RDQ scores correlated positively with the PA of the right LPM (r = 0.521, p < 0.05). Conclusion: The electrical properties of the bilateral LPM differed between CLBP participants and healthy individuals, regardless of the different frequencies used. These altered electrical properties of the LPM in the patients with CLBP correlated to some extent with disability in daily life. [ABSTRACT FROM AUTHOR]

Abstract Background Substantial investment has gone into research on the efficacy and effectiveness of pharmaceutical and nonpharmacologic interventions for chronic pain. However, synthesizing this extensive literature is challenging because of differences in the outcome measures used in studies of similar or competing interventions. The absence of a common metric makes it difficult to replicate findings, pool data from multiple studies, resolve conflicting conclusions, or reach consensus when interpreting findings. Methods This study has a seven-member Advisory Council of chronic pain experts. Preliminary analyses will be performed on data from several large existing datasets; intermediate analyses will be performed using primary data collected from Amazon’s Mechanical Turk (MTurk); and cross-validation will use primary data collected from a nationally-representative, probability-based panel. Target sample size for both primary datasets is 1500. The three study aims are as follows: Aim 1 will develop and evaluate links between the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS®-29) and legacy measures used for chronic pain such as the Roland-Morris Disability Questionnaire (RMDQ) and the Oswestry Disability Index (ODI). We will assess the best method of score linking and create crosswalk tables. Aim 2 will evaluate and refine the Impact Stratification Score (ISS) based on 9 PROMIS-29 items and proposed by the NIH Research Task Force on chronic low back pain. We will evaluate the ISS in terms of other indicators of condition severity and patient prognosis and outcomes and identify cut-points to stratify chronic pain patients into subgroups. Aim 3 will evaluate the strengths and limitations of MTurk as a data collection platform for estimating chronic pain by comparing its data to other data sources. Discussion The accomplishment of Aims 1 and 2 will allow direct comparison of results across past and future studies of chronic pain. These comparisons will help us to understand different results from seemingly similar studies, and to determine the relative effectiveness of all pharmaceutical and nonpharmacologic interventions for chronic pain across different trials. Aim 3 findings will provide valuable information to researchers about the pros and cons of using the MTurk platform for research-based data collection. Trial registration ClinicalTrials.gov: NCT04426812 ; June 10, 2020.

BackgroundLumbar paraspinal muscle (LPM) is important in spinal stabilization in patients with chronic low back pain (CLBP). However, the electrical properties of LPM in patients with CLBP remain unclear. Electrical impedance myography (EIM) is a novel and non-invasive technique that provides a simple quantitative evaluation of electrical properties of the LPM.PurposeThis study aimed to apply EIM to assess the electrical properties of the LPM between patients with CLBP and healthy control (HC).MethodsThirty participants (15 CLBP participants; 15 healthy controls) were enrolled in the study. Participants in the CLBP group were asked to complete the visual analog scale (VAS), Oswestry Disability Index (ODI), and Roland–Morris Disability Questionnaire (RDQ) to assess the pain intensity and disability in daily life. Independent sample t-tests were adopted to analyze the basic characteristics between the two groups. At 5, 50, 100, and 200 kHz current frequencies, the electrical properties were measured on each side of the LPM. The EIM parameters of resistance (R), reactance (X), phase angle (PA), and Z value were analyzed by one-way analysis of variance (ANOVA), with age as covariate. Spearman's rank correlation coefficient analysis was applied to explore the relationships between the questionnaires and the EIM parameters.ResultsThe R and Z values of bilateral LPM in the CLBP group were significantly larger than those in the HC group; the PA decreased and the X did not change at these four tested current frequencies. At 5 kHz, Z and R on the right side were non-significantly different between patients and HCs. Correlation analysis showed that at 50 kHz, ODI and RDQ scores correlated negatively with the R of the bilateral LPM (r = 0.523, r = 0.581, respectively; p < 0.05). RDQ scores correlated positively with the PA of the right LPM (r = 0.521, p < 0.05).ConclusionThe electrical properties of the bilateral LPM differed between CLBP participants and healthy individuals, regardless of the different frequencies used. These altered electrical properties of the LPM in the patients with CLBP correlated to some extent with disability in daily life.

Background and Objectives: The current options for acute pain control of vertebral compression fracture include hard brace, vertebroplasty, early surgery, and analgesic injection. We hypothesize that the gray ramus communicans nerve block (GRNB) controls the acute pain experienced during vertebral compression fractures. This study assessed the time course of pain control after injection and evaluated the risk factors affecting pain control failure. Materials and methods: Sixty-three patients (24 male, 66.19 ± 15.17 y) with a thoracolumbar vertebral fracture at the T10-L5 spine, who presented to our hospital from November 2018 to October 2019, were included in this retrospective cohort study. GRNB was performed within 1 week of the trauma. The patients were followed up on days 3, 14, 30, 90, and 180 and assessed with the serial visual analog scale (VAS, resting and motion), Oswestry Low Back Disability (ODI) questionnaire, and Roland-Morris Disability Questionnaire (RDQ). The failure group was defined by the need for an additional block or cement injection after a single GRNB. The failure group's risk factors, such as body mass index, initial thoracolumbar injury classification and severity score, Kummel's disease, age, bone marrow density (BMD), and underlying disease, were analyzed. Results: The motion VAS score improved from preoperative to three months post-procedure, but the resting VAS was affected by the procedure for only three days. The quality of life index improved at postoperative six months. A lower BMD was the only risk that affected treatment failure in the logistic regression analysis (p = 0.0038). Conclusion: The effect of GRNB was maintained even at three months after trauma based on motion VAS results. The only risk factor identified for GRNB failure was lower BMD. [ABSTRACT FROM AUTHOR]

Study Design: Cross-cultural adaptation and cross-sectional study.Objective: The aim of this study was to translate and cross-culturally adapt the Roland-Morris Disability Questionnaire (RMDQ) into Hausa language, and evaluate its psychometric properties in mixed rural and urban populations with low back pain (LBP).Summary Of Background Data: The RMDQ is one of the most commonly used and recommended condition-specific measures of disability related to LBP. However, no formal adapted and validated Hausa version exists at the time our study was initiated.Methods: The Hausa version of the RMDQ (Hausa-RMDQ) was developed according to established guidelines. Psychometric properties were evaluated in 125 patients with LBP recruited from rural and urban Nigerian clinics. Internal consistency (Cronbach's α), test-retest reliability using Intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and limits of agreement using Bland-Altman plots were calculated to evaluate reliability. Using Spearman's correlation for a priori hypotheses, the Hausa-RMDQ was correlated with Oswestry Disability Index (ODI) to evaluate concurrent validity, Numerical Pain Rating Scale (NPRS) to evaluate convergent validity, and age, educational level, and occupational status to evaluate divergent validity. Reliability and validity analyses were also conducted separately for rural and urban subgroups.Results: The Hausa-RMDQ had no major translation problems. The questionnaire had adequate internal consistency (α = 0.70), test-retest reliability (ICC = 0.79), minimal SEM (1.30) and MDC (3.60), and good agreement between test-retest values. The Hausa-RMDQ had a strong correlation with ODI (rho = 0.59), a moderate correlation with NPRS (rho = 0.46), and a null correlation with age, educational level, and occupational status (P > 0.05), thus confirming all the (5:5) a priori hypotheses constructed. These reliability and validity results were also replicated in the rural and urban subgroups.Conclusion: The Hausa-RMDQ was successfully developed and proved to be a reliable and valid measure of functional disability in Hausa culture. This questionnaire is recommended for future clinical and scientific research purposes.Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Background Data: Spondylolysis remains the commonest identifiable cause of low back pain in children and adolescents. Isthmic spondylolysis occurs most commonly at L5. Both repetitive trauma and inherent genetic weakness can make an individual more susceptible to spondylolysis. There are varieties of surgical treatments to spondylolysis whether surgical fusion or pars repair in patients with no evident slippage or disc degeneration. Purpose: To evaluate the efficacy of pars repair in patients with spondylolysis in regard to pain improvement and fusion. Study Design: Prospective case series study. Patients and Methods: Ten cases with isthmic spondylolysis were reported in this study. Between January 2016 and December 2018, three males and seven females were recruited. Inclusion criteria were as follows: age

The main objective of this study is to explore correlations between the severity of musculoskeletal disorders (MSDs) and aberrant driving behaviors among professional taxi drivers. Questionnaires were administered to 162 taxi drivers in a Chinese city. Drivers with more severe MSDs reported more general and dangerous error behaviors and negative moods. Interestingly, MSDs affect drivers' error behaviors through negative moods. The study also examined the effects of age, driving experience, traffic accidents, mood states, safety awareness and driving skills on aberrant driving behaviors. The results showed that age and driving experience were significant predictors of aberrant driving behaviors. Anger was a significant predictor of aggressive violations and dangerous errors. Additionally, drivers who reported higher levels of safety awareness also reported fewer aggressive violations, and drivers with higher levels of driving skills reported fewer dangerous error behaviors. [ABSTRACT FROM AUTHOR]

Study Design: Cohort study (level 3).Objective: The aim of this study was to identify independent risk factors for residual low back pain (LBP) following osteoporotic vertebral fracture (OVF).Summary Of Background Data: Nonunion has been proposed as the primary cause of residual LBP following OVF. However, LBP can occur even when union is maintained. Other reported causes of LBP after OVF include vertebral deformities and spinopelvic malalignment.Methods: Sixty-seven patients with single-level thoracolumbar OVF who had not received previous osteoporotic treatment were enrolled. Conservative treatment was conducted using a soft lumbosacral orthosis plus osteoporosis drugs, either weekly alendronate (bisphosphonate) or daily teriparatide. Pain scores, kyphosis angle of fractured vertebra (VKA), and spinopelvic alignment, including pelvic incidence minus lumbar lordosis (PI-LL), were assessed periodically during treatment. Radiographic union was evaluated independently by three specialists at 24 weeks post-admission. Patients were divided by pain scores >40% at 24 weeks into the LBP (n = 36) and non-LBP (n = 31) groups. Temporal changes and statistical associations were examined to identify risk factors for LBP at 24 weeks.Results: At 24 weeks, 25% of OVFs failed to achieve union. The LBP group consisted of 71% of nonunion and 48% of union cases. Stepwise multinomial regression analysis showed VKA at 24 weeks >25° was significant risk factor for the LBP group (odds ratio: 6.24, 95% confidence interval: 1.77-22.02, P = 0.004). Significant differences in VKA emerged during treatment in the LBP group, but PI-LL showed the tendency not to change throughout the treatment period. Non-union was correlated with VKA (area under the curve: 0.864).Conclusion: Although spinopelvic malalignment is considered as a preexisting factor for LBP, VKA exacerbated by nonunion predominantly led to LBP after a new OVF. Each incidence of OVF should be treated to limit further morphological changes to the fractured vertebra.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lower limb compensation for spinal sagittal malalignment and its impact on quality of life (QOL) and low back pain (LBP) have not been well studied. OBJECTIVE: To clarify postural compensation and the impact of spinal and lower limb sagittal alignment and muscle strength on QOL and LBP in persons > 50 years old. METHODS: In this cross-sectional study, 122 rural community-dwelling, healthy adults (56 males, 66 females; average age 71.1 years; age range, 52–88 years) underwent assessments of QOL (36-Item Short-Form Health Survey; SF-36), LBP (Roland-Morris Disability Questionnaire; RDQ), thoracic kyphosis (TK), lumbar lordosis (LL), sacral inclination (SI), grip strength, lower limb strength, and back extensor strength (BES). On univariate and multivariate analyses, variables that correlated with QOL and the RDQ were identified. RESULTS: LL was moderately correlated with SI and weakly correlated with the knee flexion angle (KFA). LL, KFA, C7-L5D, and BES were correlated with SF-36 subscales and the RDQ. KFA contributed to the physical component summary of the SF-36. Female sex and BES contributed to the RDQ. CONCLUSIONS: Knee flexion compensated for lumbar kyphosis, but affected physical QOL scores negatively; BES was the most reliable contributor to QOL and the RDQ. [ABSTRACT FROM AUTHOR]

Background Context: Spinal epidural lipomatosis (SEL) results from excess lumbar epidural fat (EF) accumulation that compresses the cauda equina or nerve roots. Guidelines for the therapeutic management of SEL are not currently available.Purpose: To elucidate the efficacy of lumbar decompression surgery in SEL.Study Design: Multicenter retrospective study.Patient Sample: A total of 288 consecutive patients who underwent posterior lumbar spinous-splitting decompression surgery for lumbar spinal canal stenosis and followed up greater than 2 years at participating institutions were retrospectively reviewed.Outcome Measures: Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Roland-Morris Disability Questionnaire (RDQ).Methods: Participants were divided into two groups according to the ratio of EF to anteroposterior diameter of the spinal canal (EF/SC-L) at the spinal level with maximum dural tube compression. Patients with EF/SC-L of ≥0.6 and <0.6 were defined as those with SEL and non-SEL, respectively. We assessed whether surgical treatment was "effective" or "not effective" using the JOABPEQ based on the following: an increase of ≥20 points in the postoperative score compared with the preoperative score, or a preoperative score <90 with a postoperative score ≥90 points. We constructed a multiple Poisson regression model by adjusting for confounding factors, and determined estimated relative risk (RR) for "not effective" with surgical treatment using the JOABPEQ. Additionally, we selected age-, sex-, BMI-, and decompression levels-matched patients with non-SEL and compared the frequency of "not effective" between SEL patients (n=60) and non-SEL patients (n=60).Results: Analysis using the RDQ and JOABPEQ showed that the 1- and 2-year postoperative scores were significantly better than the preoperative scores in the both groups. Multivariable Poisson regression analysis demonstrated that SEL was significantly associated with "not effective" for decompression surgery in the 1-year postoperative outcomes of walking ability ([RR] 1.5, 95% confidence interval [CI] 1.0-2.2) and social life (RR 1.3, 95% CI 1.0-1.8) and the 2-year postoperative outcomes of walking ability (RR 1.6, 95% CI 1.2-2.3). Matching analysis showed that SEL was significantly associated with "not effective" with lumbar decompression surgery in the 2-year postoperative outcomes of walking ability (p=.02).Conclusions: Patients with SEL exhibited significant improvements in surgical outcomes at 1 and 2 years postoperatively. However, compared with the non-SEL group, the efficacy of posterior lumbar spinous-splitting decompression surgery was worse in the SEL group, especially for walking ability. These results indicate that EF accumulation should be considered when planning treatment for patients with lumbar spinal canal stenosis and estimating the efficacy of lumbar decompression surgery. [ABSTRACT FROM AUTHOR]

Study DesignA prospective study in a hospital.PurposeTo investigate whether each disability based on the three sub-categories of the Roland-Morris disability questionnaire (RDQ) during hospitalization is associated with itself at 1 year postoperatively in patients with degenerative lumbar spinal stenosis (LSS).Overview of LiteratureAlthough the total score of the RDQ represents whole pain-related disabilities or health-related quality of life, it is a shortcoming that multi-dimensional changes in disabilities are difficult to understand when only using the RDQ.MethodsFifty-seven patients with LSS (men, 28; women, 29; 63.0±12.1 years) were included. Disabilities, pain intensity and depressive feelings were assessed at preoperation, discharge and 1 year postoperatively.ResultsThe range of "mental and physical activities (MPA)," "functional movements on/around a bed (FM)" and "walking function (WF)" scores were 0 to 13 (median, 8), 0 to 6 (median, 6) and 0 to 4 (median, 3) at preoperation; 0 to 12 (median, 0), 0 to 6 (median, 0), and 0 to 4 (median, 0) at discharge; and 0 to 8 (median, 0), 0 to 5 (median, 0), and 0 to 4 (median, 0) at 1 year postoperatively, respectively. The following significant multiple regression equations were obtained: MPA at 1 year postoperatively=0.56 (MPA at discharge)-0.10 (depression at discharge)+0.90 (adjusted r2=0.41), FM at 1 year postoperatively=0.35 (MPA at discharge)-0.06 (depression at discharge)+0.40 (adjusted r2=0.45) and WF at 1 year postoperatively=0.59 (WF at discharge)-0.08 (depression at discharge)+0.63 (adjusted r2=0.29).ConclusionsIn our LSS population, each disability based on MPA and WF at discharge is associated with itself in the future. Therefore, disabilities excluding functional movements are longitudinally independent.

Background Context: The majority of validation done on the Roland-Morris Disability Questionnaire (RMDQ) has been in patients with mild or moderate disability. There is paucity of research focusing on the psychometric quality of the RMDQ in patients with severe disability.Purpose: To evaluate the psychometric quality of the RMDQ in patients with severe disability.Study Design/setting: Observational clinical study.Sample: The sample consisted of 214 patients with painful vertebral compression fractures who underwent vertebroplasty or kyphoplasty.Outcome Measures: The 23-item version of the RMDQ was completed at two time points: baseline and 30-day postintervention follow-up.Methods: With the two-parameter logistic unidimensional item response theory (IRT) analyses, we derived the range of scores that produced reliable measurement and investigated the minimal clinically important difference (MCID).Results: Scores for 214 (100%) patients at baseline and 108 (50%) patients at follow-up did not meet the reliability criterion of 0.90 or higher, with the majority of patients having disability due to back pain that was too severe to be reliably measured by the RMDQ. Depending on methodology, MCID estimates ranged from 2 to 8 points and the proportion of patients classified as having experienced meaningful improvement ranged from 26% to 68%. A greater change in score was needed at the extreme ends of the score scale to be classified as having achieved MCID using IRT methods.Conclusions: Replacing items measuring moderate disability with items measuring severe disability could yield a version of the RMDQ that better targets patients with severe disability due to back pain. Improved precision in measuring disability would be valuable to clinicians who treat patients with greater functional impairments. Caution is needed when choosing criteria for interpreting meaningful change using the RMDQ. [ABSTRACT FROM AUTHOR]

Study Design: A translation, cross-cultural adaptation, and psychometric analysis.Objective: The aim of this study was to translate, cross-culturally adapt, and validate the Yoruba version of the RMDQ.Summary Of Background Data: The Roland-Morris Disability Questionnaire (RMDQ) is a valid outcome tool for low back pain (LBP) in clinical and research settings. There seems to be no valid and reliable version of the RMDQ in the Nigerian languages.Methods: Following the Guillemin criteria, the English version of the RMDQ was forward and back translated. Two Yoruba translated versions of the RMDQ were assessed for clarity, common language usage, and conceptual equivalence. Consequently, a harmonized Yoruba version was produced and was pilot-tested among 20 patients with nonspecific long-term LBP (NSLBP) for cognitive debriefing. The final version of the Yoruba RMDQ was tested for its construct validity and re-retest reliability among 120 and 87 patients with NSLBP, respectively.Results: Pearson product moment correlation coefficient (r) of 0.82 was obtained for reliability of the Yoruba version of the RMDQ. The test-retest reliability of the Yoruba RMDQ yielded Cronbach alpha 0.932, while the intraclass correlation (ICC) ranged between 0.896 and 0.956. The analysis of the global scores of both the English and Yoruba versions of the RMDQ yielded ICC value of between 0.995 (95% confidence interval 0.996-0.997), with the item-by-item Kappa agreement ranging between 0.824 and 1.000. The external validity of RMDQ using Quadruple Visual Analogue Scale was r = -0.596 (P = 0.001). The Yoruba version of the RMDQ had no floor/ceiling effects, as no patient achieved either of the maximum or the minimum possible scores.Conclusion: The Yoruba version of the RMDQ has excellent reliability and validity and may be an appropriate outcome tool for clinical and research purposes among Yoruba-speaking patients with LBP.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis study evaluated the effects of Pilates on pain and disability in patients with chronic low back pain., Methods: Six electronic databases were searched between January 2012 and December 2022. From these databases, only randomized controlled trials were selected. The criteria for assessing methodological quality using the PEDro scale were selected. The risk of bias was assessed using the Cochrane Risk of Bias Tool RoB 2.0. Additionally, the primary outcomes were pain and disability in this analysis., Results: The corresponding results confirmed that Pilates training led to a significant improvement in pain (Visual Analog Scale: weighted mean difference = -29.38, 95% confidence interval, -33.24 to -25.52, I² value = 56.70%; Pain Numerical Rating Scale: weighted mean difference = -2.12, 95% confidence interval, -2.54 to -1.69, I² value = 0.00%) and disability (Roland- Morris Disability Index: weighted mean difference = -4.73, 95% confidence interval, -5.45 to -4.01, I² value = 41.79%). Six months after completion of Pilates training, the improvement in pain (Pain Numerical Rating Scale: weighted mean difference = -1.67, 95% confidence interval, -2.03 to -1.32, I² value = 0.00%) and disability (Roland-Morris Disability Index: weighted mean difference = -4.24, 95% confidence interval, -5.39 to -3.09, I² value = 52.79%) was maintained., Conclusion: Pilates training may be an effective strategy to improve pain and disability in patients with chronic low back pain.

Purpose: Functional status measures are currently not widely used in South Africa to facilitate clinical decision-making or document treatment outcomes for patients with low back pain (LBP). This study investigated the internal consistency and clinical utility of a back-specific functional status measure, the Roland Morris Disability Questionnaire (RMDQ), and determined its ability to confirm the need for spinal fusion surgery. Method: Aretrospective, descriptive design was used with 42 patients with chronic mechanical low back pain who consulted a private Orthopaedic surgeon in Cape Town over a one year period. All patients completed the RMDQ prior to their consultation. On completion of the medical examination, a rating for surgery was determined for each patient. The completed questionnaires were analysed using Statistical Package for the Social Sciences (SPSS). Results: The mean RMDQ score was 8.6 (N=42; median=9.0; range=2-21). Cronbach’s alpha showed a high internal consistency between items (.92). A categorical principal component analysis (CATPCA) identified two distinct dimensions in the RMDQ. Item reduction improved the internal consistency and thus the construct validity of the RMDQ. There was a low correlation between the surgeon’s rating for surgery and RMDQ scores (r=.40; P

Study Design: A three-arm controlled trial with adaptive allocation.Objectives: The aim of this study was to compare short-term effects of a side-lying, thrust spinal manipulation (SM) procedure and a nonthrust, flexion-distraction SM procedure in adults with subacute or chronic low back pain (LBP) over 2 weeks.Summary Of Background Data: SM has been recommended in recently published clinical guidelines for LBP management. Previous studies suggest that thrust and nonthrust SM procedures, though distinctly different in joint loading characteristics, have similar effects on patients with LBP.Methods: Participants were eligible if they were 21 to 54 years old, had LBP for at least 4 weeks, scored 6 or above on the Roland-Morris disability questionnaire, and met the diagnostic classification of 1, 2, or 3 according to the Quebec Task Force Classification for Spinal Disorders. Participants were allocated in a 3:3:2 ratio to four sessions of thrust or nonthrust SM procedures directed at the lower lumbar and pelvic regions, or to a 2-week wait list control. The primary outcome was LBP-related disability using Roland-Morris Disability Questionnaire and the secondary outcomes were LBP intensity using visual analog scale, Fear-Avoidance Beliefs Questionnaire, and the 36-Item Short Form Health Survey. The study was conducted at the Palmer Center for Chiropractic Research with care provided by experienced doctors of chiropractic. Clinicians and patients were not blinded to treatment group.Results: Of 192 participants enrolled, the mean age was 40 years and 54% were male. Improvement in disability, LBP intensity, Fear-Avoidance Beliefs Questionnaire-work subscale, and 36-Item Short Form Health Survey-physical health summary measure for the two SM groups were significantly greater than the control group. No difference in any outcomes was observed between the two SM groups.Conclusion: Thrust and nonthrust SM procedures with distinctly different joint loading characteristics demonstrated similar effects in short-term LBP improvement and both were superior to a wait list control.Level Of Evidence: 2. [ABSTRACT FROM AUTHOR]

Study Design. Prospective cohort study. Objective. To determine whether there are distinct trajectories of back pain and function among older adults and to identify characteristics that distinguish among patients with substantially different prognoses. Summary of Background Data. Although the differential diagnosis and course of low back pain among older adults may differ from middle-aged adults, there is little evidence. Better understanding variability in recovery among older adults may help target patients for more intensive clinical interventions, plan resource use, and design clinical studies of more homogeneous patient groups. Methods. Patients aged 65 years or older with a new episode of care for back pain were recruited at 3 geographically diverse sites. Patients completed pain intensity and Roland-Morris Disability measures at baseline and 3, 6, and 12 months later. We used latent class analysis to identify distinct trajectories of pain and function and then logistic regression to identify predictors of membership in the improving trajectories. Results. There were 3929 participants who completed outcome measures at every follow-up interval. Latent class analysis identifi ed subgroups with low, intermediate, or high pain or disability scores who remained relatively stable over time. However, small subgroups showed dramatic improvement from baseline to 1 year (17% with major improvement in Roland score, pain intensity, or both). Shorter pain duration, higher patient confidence in improvement, and fewer comorbid conditions at baseline were each associated independently with favorable prognosis. Conclusion. Although most patients remained relatively stable over a year, latent class analysis identified small groups with major improvement in pain, function, or both. This technique may, therefore, be useful for studying back pain prognosis. Our results should help assemble more prognostically homogeneous groups for research, and the technique may help identify subgroups of patients with uniquely successful responses to investigational interventions. [ABSTRACT FROM AUTHOR]

Study Design. Cross-sectional design. Objective. To explore (1) the factor structure of the Roland-Morris Disability Questionnaire (RMDQ), (2) whether there is a dominant factor, and (3) whether the potential factors are unique predictors of other aspects related to back pain. Summary of Background Data. The RMDQ is one of the most recommended back-specific questionnaires assessing disability. The RMDQ is scored as a unidimensional scale summarizing answers to all 24 questions (Yes/No) regarding daily life functioning. However, there are indications that the scale is multidimensional. Methods. Patients (n = 457; age, 18-60 yr) with 8 to 12 weeks of back pain filled in questionnaires assessing subjective health complaints, emotional distress, instrumental and emotion-focused coping, and fear voidance behavior at baseline. A total of 371 patients (81.7%) filled in the RMDQ. Exploratory factor analysis was used to examine the factor structure of RMDQ items. Multiple regression analyses were used to assess whether the derived factors predicted relevant problems in back pain differently. Results. Exploratory factor analysis showed indices of model fit for a 3-factor solution after removing 2 items because of low prevalence (19 and 24). Two items were removed because of cross-loadings and low loadings (2 and 22). No support for a dominant factor was found as the 3 factors were only moderately correlated ( r = 0.34-0.40), and the ratio between the first and second eigenvalue was 2.6, not supporting essential unidimensionality. "Symptoms" were the factor that most strongly predicted subjective health complaints, whereas "avoidance of activity and participation" predicted fear avoidance behavior, instrumental and emotional coping. "Limitation in daily activities" did not predict any of these variables. Conclusion. The main findings of our study are that the RMDQ consists of 3 independent factors, and not 1 dominant factor as suggested previously. We think the time is now ripe to start treating and scoring the RMDQ as a multidimensional scale. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is the most common cause of time lost from work and has significant personal impacts and societal burdens. Caregivers for patients with disabilities have a high LBP prevalence that requires attention in the public health system. This study aimed to understand the LBP disability outcomes and determinants of care workers for people with intellectual, autistic and associated multiple disabilities. Study subjects included 678 care workers in 15 disability institutions who reported that they had experienced acute or chronic nonspecific LBP in the previous year. The effects of the LBP outcome were measured by the Roland–Morris Disability Questionnaire (RDQ), which is a self-rated assessment of pain-related disability used in this study. The mean score of the RDQ was 3.97 (range 0–24). Of the respondents, 14% expressed that they were free from pain disability (score = 0), 66.4% subjects expressed they had a little pain disability (score 1–6), 14.7% subjects reported that they were mildly affected by pain disability (score 7–12), 3.8% subjects reported that they were moderately affected by pain disability (score 13–18), and 1% reported they had severe pain disability (score 19–24). A multiple linear regression of the pain disability score revealed that those care workers who expressed that LBP affects their work and living ( p < 0.001), had ever sought pain care ( p = 0.008), with moderate ( p = 0.001) and severe ( p = 0.001) levels of LBP were significantly associated with a higher score of pain disability than their counterparts ( R 2 = 22.6%). This study suggests that a comprehensive assessment of pain disability and treatment strategies for LBP should be undertaken regarding the needs of care workers in disability sectors. [ABSTRACT FROM AUTHOR]

Study Design: A prospective study in a hospital. Purpose: To investigate whether each disability based on the three sub-categories of the Roland-Morris disability questionnaire (RDQ) during hospitalization is associated with itself at 1 year postoperatively in patients with degenerative lumbar spinal stenosis (LSS). Overview of Literature: Although the total score of the RDQ represents whole pain-related disabilities or health-related quality of life, it is a shortcoming that multi-dimensional changes in disabilities are difficult to understand when only using the RDQ. Methods: Fifty-seven patients with LSS (men, 28; women, 29; 63.0±12.1 years) were included. Disabilities, pain intensity and depressive feelings were assessed at preoperation, discharge and 1 year postoperatively. Results: The range of "mental and physical activities (MPA)," "functional movements on/around a bed (FM)" and "walking function (WF)" scores were 0 to 13 (median, 8), 0 to 6 (median, 6) and 0 to 4 (median, 3) at preoperation; 0 to 12 (median, 0), 0 to 6 (median, 0), and 0 to 4 (median, 0) at discharge; and 0 to 8 (median, 0), 0 to 5 (median, 0), and 0 to 4 (median, 0) at 1 year postoperatively, respectively. The following significant multiple regression equations were obtained: MPA at 1 year postoperatively=0.56 (MPA at discharge)- 0.10 (depression at discharge)+0.90 (adjusted r2=0.41), FM at 1 year postoperatively=0.35 (MPA at discharge)-0.06 (depression at discharge)+0.40 (adjusted r2=0.45) and WF at 1 year postoperatively=0.59 (WF at discharge)-0.08 (depression at discharge)+0.63 (adjusted r2=0.29). Conclusions: In our LSS population, each disability based on MPA and WF at discharge is associated with itself in the future. Therefore, disabilities excluding functional movements are longitudinally independent. [ABSTRACT FROM AUTHOR]

Study Design. This was a cross-sectional study. Objective. We sought to test the psychometric properties of the modified lower extremity functional scale (LEFS) for tow back pain (LBP). Summary of Background Data. Low back and lower extremities are anatomically and functionally related, and radiating leg pain is common among patients with LBP. The LEFS is a reliabIe and valid questionnaire for patients with lower extremity conditions caused by musculoskeletal disorders, although its utility in LBP with or without radiating leg pain has not been tested. Methods. We recruited subjects with LBP from physical medicine and rehabilitation outpatient clinics whose age was at least 18 years. The evaluation included demographic data, back pain history, pain intensity by the visual analogue scale, the Roland-Morris Disability Questionnaire, and the modified LEFS, in which "lower limb problem" was substituted with "low back/lower limb problem" in the introductory sentence of the questionnaire. Data from 242 patients were analyzed for the psychometric properties of the modified LEFS, including floor and ceiling effects, internal consistency, test-retest reliability, dimensionality, and construct validity. Results. The modified LEFS had no floor or ceiling effects, high internal consistency (Cronbach α: 0.94), and good test-retest reliability (intraciass correlation coefficient[2,1]: 0.86). Principal component analysis identified one major factor that had an eigenvalue of 9.9 and explained 49.6% of the total variance. The correlations between the modified LEFS and Roland-Morris Disability Questionnaire was high (Pearson correlation coefficient: -0.71). The modified LEFS also discriminated well between the subgroups of LBP with unilateral leg pain and those with bilateral leg pain. Conclusion. The modified LEFS had satisfactory psychometric properties in patients with LBP and could serve as a supplementary outcome measure to assess their activity limitations. [ABSTRACT FROM AUTHOR]

The article discusses a study aimed at translating the Roland-Morris Disablity Questionnare (RMDQ) in to simplified Chinese and validating the version in mainland Chnese people with low back pain (LBP). The study was performed in 3 stages namely translation and cross-cultural adaption, a pilot study and a validation study. It indicates the successful and cross-culturally translation of RMDQ into simplified Chinese characters without losing any properties of the original version.

We evaluated the reliability and validity of an adapted Korean version of the Roland-Morris Disability Questionnaire (RMDQ). Translation/retranslation of the English version of RMDQ was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the Visual Analog Scale (VAS) measure of pain, RMDQ, and the previously validated Oswestry Disability Index (ODI) were mailed to 100 consecutive patients with chronic lower back pain (LBP) of at least 3 months. Eighty-one patients responded to the first mailing of questionnaires and 63 of the first-time responder returned their second survey. The average age of the 63 patients (45 female, 18 male) was 47.8 years. Reliability assessment was determined by estimating kappa statistics of agreement for each item, the intraclass correlation coefficient (ICC), and Cronbach's α. Concurrent validity was evaluated by comparing the responses of RMDQ with the results of VAS and responses of ODI by using Pearson's correlation coefficient. The constructed Bland-Altman plot showed a good reliability. All items had a kappa statistics of agreement greater than 0.6. The RMDQ showed excellent test/re-test reliability as evidenced by the high ICC for 2 test occasions (ICC = 0.932, P < 0.001). Internal consistency was found to be very good at both assessments with Cronbach's α (0.942 and 0.951 at first and second assessments, respectively). The RMDQ was correlated with the VAS ( r = 0.692; P = 0.000 and r = 0.668; P = 0.000 at first and second assessments, respectively), and with the ODI ( r = 0.789; P = 0.000 and r = 0.802; P = 0.000, respectively). The adapted Korean version of the RMDQ was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for outcome assessments in the Korean speaking patients with LBP. [ABSTRACT FROM AUTHOR]

Lumbago is one of the most prevalent symptoms in patients with osteoporotic vertebral fracture. Roland-Morris Disability Questionnaire (RDQ) is a quality of life (QOL) questionnaire targeted for evaluating lumbago. Although total score is the usual way of analysis, we have tried to make more use of it by subscale analysis. Forty-four osteoporotic patients were evaluated for their QOL using RDQ and SF-8; a widely accepted generic (non disease-specific) QOL questionnaire. Subscales and summary scores of SF-8 were significantly lower than Japanese norm. Patients with fracture had significantly lower scores including RDQ. Multiple regression analysis has shown that total score of RDQ was significantly contributed by bodily pain as well as other subscales of SF-8. Principal component analysis has revealed that RDQ consists of two components representing general, and mental or social aspect of lumbago. Defining the component structure and determining the procedure to obtain the subscales would make the most use of RDQ, and contribute to the better evaluation of patients with lumbago. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine fit of the original 24-item Roland-Morris Disability Questionnaire and three short-form versions to a Rasch model with particular attention to targeting of item difficulty and to differential item functioning. Cross-sectional survey of 140 people with low back pain seeking physiotherapy treatment. Data were analysed using a dichotomous Rasch model. All versions showed adequate overall data fit to the Rasch model, with few misfitting items. Person separation was around 0.85 for all versions. Item 5 (use a handrail to get upstairs) showed differential item functioning by age. Targeting of persons of high ability was poor and short-form versions also had poor targeting of persons of low ability. Items of similar difficulty clustered in the centre of the logit scale. Although the Roland data fit the Rasch model, there were insufficient items of higher difficulty to sufficiently evaluate disability in persons with mild disability. Short-form versions also lacked items of lower difficulty. [ABSTRACT FROM AUTHOR]

The article presents a survey concerning the low back pain patients in Brazil. It aims to perform the translation and cross-cultural adaptation of the Patient-Specific Functional Scale (PSES) and compare the clinimetric properties of PSPS, Ronald-Morris Disability Questionnaire (RMDQ), and Functional Rating Index (FRI). The study shows that the Brazilian-Portuguese versions of the RMDQ, FRI, and PSFS have similar clinimetric properties.

The article reports on the psychometric testing of a translated, culturally adapted questionnaire for use on patients with lumbar pain in Argentina. The Roland-Morris Disability Questionnaire (RMDQ) is one of the most widely used and validated instruments for measuring disability in low back pain. The results of the study show that the Argentinean version of the RMDQ is reliable and valid as a lumbar disability measurement tool.

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 atest. External construct validity was assessed by association with pain, the Schober test and the General Function Score. Sensitivity to change was determined using at-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 a 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. [ABSTRACT FROM AUTHOR]