DISABILITY RATING SCALE FOR LOW BACK PAIN

US English version of the Roland-Morris disability questionnaire from MAPI 2005

The cultural adaptation process described in section 1.2 at the end of the questionnaire.

When your back hurts, you may find it difficult to do some of the things you normally do.

This list contains some sentences that people have used to describe themselves when they have back
pain. When you read them, you may find that some stand out because they describe you today. As you
read the list, think of yourself today. When you read a sentence that describes you today, mark the box
next to it. If the sentence does not describe you, then leave the space blank and go on to the next one.
Remember, only mark the sentence if you are sure that it describes you today.

1. I stay at home most of the time because of the pain in my back.

2. I change position frequently to try and make my back comfortable.
3. I walk more slowly than usual because of the pain in my back.
4. Because of the pain in my back, I am not doing any of the jobs that I usually do around the house.
5. Because of the pain in my back, I use a handrail to get upstairs.
6. Because of the pain in my back, I lie down to rest more often.
7. Because of the pain in my back, I have to hold on to something to get out of a reclining chair.
8. Because of the pain in my back, I ask other people to do things for me.
9. I get dressed more slowly than usual because of the pain in my back.
10. I only stand up for short periods of time because of the pain in my back.
11. Because of the pain in my back, I try not to bend or kneel down.
12. I find it difficult to get out of a chair because of the pain in my back.
13. My back hurts most of the time.
14. I find it difficult to turn over in bed because of the pain in my back.
15. My appetite is not very good because of the pain in my back.
16. I have trouble putting on my socks (or stockings) because of the pain in my back.
17. I only walk short distances because of the pain in my back.
18. I sleep less because of the pain in my back.
19. Because of the pain in my back, I get dressed with help from someone else.
20. I sit down for most of the day because of the pain in my back.
21. I avoid heavy jobs around the house because of the pain in my back.
22. Because of the pain in my back, I am more irritable and bad tempered with people.
23. Because of the pain in my back, I go upstairs more slowly than usual.
24. I stay in bed most of the time because of the pain in my back.

F:\INSTITUT\CULTADAP\PROJECT\GSK2387\Etude2387\Final-versions\RMDQ\RMDQusaq.doc-31/01/2005
Summary of translation method used by MAPI Research Institute, 27 rue de la Villette,
69003 Lyon, France.

Web : www.mapi-research-inst.com.
E-mail institut@mapi.fr

The aim of a linguistic validation process is to obtain a translation of an original instrument in a

target language that is both conceptually equivalent to the original and easily understood by
the people to whom the translated questionnaire is administered.

This is achieved using an internationally accepted translation methodology recommended by

Mapi Research Institute which is outlined below. This describes the general approach taken by
Mapi to translations. For local reasons, the translation process may differ in minor respects for
some languages. This translation of the RMDQ was carried out in collaboration with Professor
Martin Roland, Director of the National Primary Care Research and Development Centre, at
the University of Manchester.

1.1. Standard linguistic validation process

The standard linguistic validation process recommended by Mapi Research Institute comprises
the following steps:

Conceptual analysis of the original instrument in collaboration

with the developer to define the notions investigated through each item.

The developer is also involved throughout the linguistic validation

process whenever further clarification is needed.

1.1.2. Recruitment and briefing of a consultant in each target country as

project manager and supervisor of the translation process.

1.1.3. Forward translation step

a. Production of two independent forward translations of the original

questionnaire by two professional translators, native speakers of the
target language and fluent in the source language.

b. Production of a reconciled language version on the basis of the two

forward translations and of a report in English explaining translation
decisions.

c. Review of the report by Mapi Research Institute and discussion with

the consultant.

1.1.4. Backward translation step

a. Production of a backward translation of the reconciled language

version into the source language by one professional translator, native
speaker of the source language and fluent in the target language.

b. Comparison of the backward translation and the original, analysis of

the discrepancies encountered, resulting, if necessary, in changes in the
reconciled translation in the target language, and subsequent production
of a second language version.

F:\INSTITUT\CULTADAP\PROJECT\GSK2387\Etude2387\Final-versions\RMDQ\RMDQusaq.doc-31/01/2005
 c. Production of a report in English explaining translation decisions.

d. Review of the backward translation and report by Mapi Research

Institute and discussion with the consultant.

1.1.5. Pilot testing

1.1.5.1. Clinician's review

a. Review of the second language version by a clinician appointed by the sponsor in the
target country to get feedback from experts in the relevant medical field.

1.1.5.2. Cognitive Debriefing

a. Test of the second language version on a small sample of individuals representative of the
target population and native target language speakers, in order to assess the clarity,
appropriateness of wording and acceptability of the translated questionnaire.

b. Production of the third language version based on the results of the clinician's review and
respondents' feedback, followed by a report in English explaining translation decisions made.

c. Review of the report by Mapi Research Institute and discussion with the consultant,
resulting in the third language version.

1.1.6. International harmonisation

a.. When more than one language is involved, comparison of all translations with one another
and with the original, during a meeting with translators representing each target language in
order to ensure conceptual equivalence in all versions.

b. Discussion of suggestions made during international harmonization with the consultant,

resulting in the fourth language version.

1.1.7. Proof-reading

a. Proof-reading of the fourth language version by the consultant and by one translator,
native speaker of the target language.

b. Discussion of proof-reading results with the consultant, resulting in the final language
version.

1.2. Adjusted linguistic validation process

For some languages that are close to one another (e.g. British English and American English),
the complete standard linguistic validation process with forward and backward translation
steps may not be appropriate. For such cases, an adjusted linguistic validation process has
been established.

The forward and backward translation steps are replaced by an adaptation step, where the
work is based on a version considered as the "mother language" version.

The subsequent steps are identical to those used in the standard linguistic validation process.

This adjusted process is as follows:

F:\INSTITUT\CULTADAP\PROJECT\GSK2387\Etude2387\Final-versions\RMDQ\RMDQusaq.doc-31/01/2005
1.2.1. Conceptual analysis
See 1.1.1.

1.2.2. Recruitment and briefing of a consultant in each target country as

project manager and supervisor of the translation process.

1.2.3. Adaptation step

a.. Review of the "mother language" version by the consultant to check its suitability for the
linguistic and cultural context of the target country, leading to the establishment of a first
country-specific version.

b.. Production of a report in English explaining the decisions made.

c.. Review of the report by Mapi Research Institute and discussion with the consultant.

1.2.4. Pilot testing

1.2.4.1. Clinician's review

See 1.1.5.1.

1.2.4.2. Cognitive Debriefing

See 1.1.5.2..

1.2.5. International harmonisation

See 1.1.6.

1.2.6. Proof-reading
See 1.1.7.

Roland-Morris Low Back Pain

Dan Disability Questionnaire (RMQ)
Sumber: Stratford PW, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Mendefinisikan tingkat
minimum
perubahan yang dapat dideteksi untuk kuesioner Roland-Morris. Ther Phys . 1996 April; 76 (4): 359-65;
diskusi 66-8.
The Roland-Morris Questionnaire (RMQ) adalah ukuran kecacatan yang dikelola sendiri di mana tingkat
yang lebih tinggi
kecacatan tercermin dari angka yang lebih tinggi pada skala 24 poin. RMQ telah terbukti menghasilkan
handal
pengukuran, yang valid untuk menyimpulkan tingkat kecacatan, dan menjadi sensitif terhadap
perubahan dari waktu ke waktu
kelompok pasien dengan nyeri punggung bawah.
Petunjuk pemberian skor
Pasien diinstruksikan untuk memberi tanda di samping setiap pernyataan yang tepat. Tambahkan jumlah
total
pernyataan yang ditandai untuk mendapatkan skor pasien.
Interpretasi skor
Roland dan Morris tidak memberikan deskripsi tentang berbagai tingkat kecacatan (misalnya, 40% -60%
parah
cacat). Peningkatan klinis dari waktu ke waktu dapat dinilai berdasarkan analisis kuesioner serial
skor. Jika, misalnya, pada awal pengobatan, skor pasien adalah 12 dan, pada akhir
pengobatan, skor mereka adalah 2 (10 poin peningkatan), kami akan menghitung 83% (10/12 x 100)
perbaikan.

Roland Morris Low Back Pain dan Disability Questionnaire (RMQ)

F:\INSTITUT\CULTADAP\PROJECT\GSK2387\Etude2387\Final-versions\RMDQ\RMDQusaq.doc-31/01/2005
Halaman 2
Roland-Morris Low Back Pain dan Disability Questionnaire
(RMQ)
Instruksi
Nama pasien:
File #:
Tanggal:
Silakan baca instruksi: Ketika punggung Anda sakit, Anda mungkin merasa sulit untuk melakukan
beberapa hal yang Anda lakukan
biasanya. Tandai hanya kalimat yang menggambarkan Anda hari ini.

1. Saya tinggal di rumah sebagian besar waktu karena punggung saya.

2. Saya sering berganti posisi untuk berusaha agar punggung saya nyaman.
3. Saya berjalan lebih lambat dari biasanya karena punggung saya.
4. Karena punggung saya, saya tidak melakukan pekerjaan apa pun yang biasanya saya lakukan di
rumah.
5. Karena punggungku, aku menggunakan pegangan untuk naik ke atas.
6. Karena punggungku, aku berbaring untuk beristirahat lebih sering.
7. Karena punggungku, aku harus berpegang pada sesuatu agar bisa keluar dari kursi malas.
8. Karena punggungku, aku berusaha membuat orang lain melakukan sesuatu untukku.
9. Saya berpakaian lebih lambat dari biasanya karena punggung saya.
10. Saya hanya berdiri untuk waktu yang singkat karena punggung saya.
11. Karena punggung saya, saya mencoba untuk tidak membungkuk atau berlutut.
12. Saya merasa sulit untuk keluar dari kursi karena punggung saya.
13. Punggungku sakit hampir sepanjang waktu.
14. Saya merasa sulit untuk membalikkan badan di tempat tidur karena punggung saya.
15. Nafsu makanku tidak begitu baik karena punggungku.
16. Saya kesulitan memakai kaos kaki (atau stoking) karena rasa sakit di punggung saya.
17. Saya hanya bisa berjalan jarak pendek karena sakit punggung saya.
18. Saya tidur kurang nyenyak karena punggung saya.
19. Karena sakit punggung saya, saya berpakaian dengan bantuan orang lain.
20. Saya duduk untuk sebagian besar hari karena punggung saya.
21. Saya menghindari pekerjaan berat di sekitar rumah karena punggung saya.
22. Karena sakit punggung, saya lebih mudah tersinggung dan pemarah dengan orang-orang dari
biasanya.
23. Karena punggungku, aku naik ke atas lebih lambat dari biasanya.
24. Saya sering tidur di tempat tidur karena punggung saya.

https://translate.google.co.id/translate?
hl=id&sl=en&u=https://www.worksafe.qld.gov.au/__data/assets/pdf_file/0009/76851/roland-morris-low-
back-pain-and-disability-questionnaire-rmq1.pdf&prev=search

F:\INSTITUT\CULTADAP\PROJECT\GSK2387\Etude2387\Final-versions\RMDQ\RMDQusaq.doc-31/01/2005