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Roland Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale: Which has Superior Measurement Properties in Older Adults with Low Back Pain?

OBJECTIVE
To examine validity, reliability and responsiveness of three commonly used questionnaires for assessing physical function (i.e. Oswestry Disability Questionnaire (ODI), Quebec Back Pain Disability Scale (QBPDS) and Roland-Morris Disability Questionnaire (RMDQ)) in older patients undergoing chiropractic care for low back pain (LBP).


DESIGN
Head-to-head clinimetric comparison.


METHODS
Patients completed the ODI, QBPDS and RMDQ at baseline and after 2 weeks of treatment. Reliability was evaluated for internal consistency (Cronbach's α), test-retest reliability (interclass correlation coefficient [ICC]), measurement error (standard error of measurement (SEM), and smallest detectable change (SDC). Structural validity was evaluated through unidimensional confirmatory factor analysis, and construct validity was investigated by a priori hypotheses with other measures. Responsiveness was evaluated testing a priori hypotheses using data at baseline and 2-week follow-up.


RESULTS
214 patients (53 % males and 47% females) with a mean age 66.2 (SD 7.8 years) were included, of which 193 patients completed the 2-week follow-up for our responsiveness analysis. The RMDQ, ODI and QBPDS showed sufficient internal consistency (Cronbach's α = 0.89; 0.86; 0.94 respectively) and test-retest reliability (ICC(2,1) was 0.85; 0.89; 0.84 respectively). The SDC for RMDQ was 6.9, ODI 19.1 and QBPDS 23.6, which are values larger than the Minimal Important Change (MIC). None of the measures met all criteria for sufficient structural validity, but RMDQ and ODI exhibited a partial unidimensional fit. The questionnaires had sufficient construct validity and responsiveness.


CONCLUSION
The ODI, QBPDS and RMDQ have similar measurement properties in older adults with LBP. J Orthop Sports Phys Ther, Epub 18 May 2022. doi:10.2519/jospt.2022.10802.