Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain

Study Design. Cross-cultural adaptation and cross-sectional psychometric te sting. Objectives. To develop and validate a cross-cultural Version of the Roland- Morris Questionnaire for use in German-speaking patients with low back pain . Summary of the Background Data. Clinical research related to the management of back pain would be facilitated enormously if a small number of patient- oriented questionnaires became widely used. If the transposition of a quest ionnaire from its original cultural context is done by simple translation, it is unlikely to be successful because of language and cultural difference s. Therefore, a simple direct translation of a questionnaire from one langu age to another does not permit its use in clinical trials. Methods. The instrument was translated and back-translated, pretested, and reviewed by a committee. The German version of the Roland-Morris Questionna ire was tested in 125 patients with low back pain. The study was conducted at the spa resort at Senftenberg, Austria, which is visited by patients fro m all countries of German-speaking Europe. Reliability and concurrent const ruct Validity were assessed with Pearson's correlation coefficient on the R oland-Morris Questionnaire scores compared with the scales of the Medical O utcome Study Short Form-36 questionnaire. Results. Pearson's correlation coefficient for test-retest reliability of t he German version was r = 0.82 (P = 0.0001), and Cronbach's alpha was 0.81. The concurrent validity was r = 0.81 (Roland-Morris Questionnaire/pain rat ing; P = 0.0001), r = 0.48 (Roland-Morris Questionnaire/forward bending; P = 0.0001), and r = -0.47 (Roland-Morris Questionnaire/lateral bending; P = 0.0001). Correlation between the functional scales of the Medical Outcome S tudy Short Form-36 questionnaire and the Roland-Morris Questionnaire sum sc ores ranged from r = -0.29 (emotional limitations; P= 0.0011) to r = -0.71 (physical limitations; P= 0.0001). Conclusion. Because the German version of the Roland-Morris Questionnaire s eems to be reliable and valid for the assessment of the functional status i n German-speaking patients with low back pain, the use of this translated i nstrument can be recommended in future clinical trials.