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Patient-reported outcome measure

RMDQ Calculator

Roland-Morris Disability Questionnaire

The Roland-Morris Disability Questionnaire measures physical disability from low back pain by counting how many of 24 statements a patient agrees with, giving a score from 0 (no disability) to 24 (maximum disability).

Free to use24 items~5 min0–24, lower is better

Disability statements

When your back hurts, you may find it difficult to do some of the things you normally do. Mark Yes for each statement that describes you today. If the statement does not describe you today, mark No.

1I stay at home most of the time because of my back.
2I change position frequently to try and get my back comfortable.
3I walk more slowly than usual because of my back.
4Because of my back, I am not doing any of the jobs that I usually do around the house.
5Because of my back, I use a handrail to get upstairs.
6Because of my back, I lie down to rest more often.
7Because of my back, I have to hold on to something to get out of an easy chair.
8Because of my back, I try to get other people to do things for me.
9I get dressed more slowly than usual because of my back.
10I only stand up for short periods of time because of my back.
11Because of my back, I try not to bend or kneel down.
12I find it difficult to get out of a chair because of my back.
13My back is painful almost all the time.
14I find it difficult to turn over in bed because of my back.
15My appetite is not very good because of my back pain.
16I have trouble putting on my socks (or stockings) because of the pain in my back.
17I only walk short distances because of my back pain.
18I sleep less well because of my back.
19Because of my back pain, I get dressed with help from someone else.
20I sit down for most of the day because of my back.
21I avoid heavy jobs around the house because of my back.
22Because of my back pain, I am more irritable and bad tempered with people than usual.
23Because of my back, I go upstairs more slowly than usual.
24I stay in bed most of the time because of my back.

What the RMDQ score means

RMDQ scores run from 0 to 24, where a lower score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.

  • Minimal disability0–3
  • Mild disability4–8
  • Moderate disability9–14
  • Severe disability15–19
  • Maximum disability20–24

Clinically important thresholds

A change in score only matters if it exceeds the smallest difference patients actually notice. Every threshold below is reported with the population it was derived in — a threshold quoted without its population is not usable.

TypeValueSubscalePopulationFollow-upSource
MCID2–3 points—Acute low back pain—Jordan K 2006
MCID5 points—Chronic low back pain—Jordan K 2006
MCID30% change from baseline—Low back pain, recommended by the IMMPACT consensus—Ostelo RW 2008
MDC4–5 points—Chronic low back pain—Stratford PW 1996

MCID is the smallest change a patient perceives as meaningful. PASS is the score above which patients consider their state acceptable. SCB is a substantial rather than minimal benefit. MDC is the smallest change exceeding measurement error.

How the score is calculated

Stated in full so the calculation can be independently checked, and reproduced by hand if needed.

Each statement the patient agrees with scores 1 and each statement they do not agree with scores 0. The RMDQ score is the total number of statements agreed with, giving a range from 0 to 24. A higher score means greater disability, which is the opposite direction to most function scales.

Missing data

Because an unendorsed statement legitimately scores zero, the instrument has no missing-data problem in the usual sense. If a patient genuinely skips items, the developers recommend reporting the score as incomplete rather than prorating.

Instrument profile

Developer
Martin Roland and Richard Morris
Institution
University of Manchester, United Kingdom
First published
1983
Items
24
Response format
Yes/No statements, scored 0 or 1
Score range
0 to 24
Direction
Lower score = better
Recall period
Today
Completion time
About 5 minutes
Age range
Adults
Regions
Spine
Conditions
Low back pain, Acute low back pain, Chronic low back pain, Lumbar disc herniation
Procedures
Lumbar discectomy, Spinal fusion, Conservative back rehabilitation
Languages
English, Spanish, German, Dutch, French, Turkish, Japanese, 30+ validated translations
Test–retest (ICC)
0.83–0.91
Internal consistency
Cronbach's alpha 0.84–0.93
Validity
Correlates strongly with the Oswestry Disability Index (r ≈ 0.8) and with pain intensity ratings.
Responsiveness
More responsive than the Oswestry at the milder end of the disability range, which is why it is preferred in primary care and acute back pain trials.
Ceiling effect
Ceiling effect in severely disabled patients, where the Oswestry discriminates better above roughly 18 points.
Floor effect
Floor effect is uncommon but the instrument discriminates poorly among patients scoring 0–2.

Normative values

Reference values from published cohorts, for comparison against the score you calculated.

PopulationAgeMeanSD
Primary care low back pain at presentation—9–12—
Chronic low back pain referred to secondary care—13–16—

When to use the RMDQ

Well suited to

  • Acute or primary care low back pain, where it is more responsive than the Oswestry.
  • Trials and audits needing a short, freely available and widely comparable back-specific measure.
  • Serial tracking during a course of conservative rehabilitation.

Limitations and poor fits

  • Severe or surgical low back pain populations, where its ceiling effect limits discrimination — use the Oswestry instead.
  • Neck or thoracic pain, for which it was never designed or validated.
  • When a percentage score is required for comparison with ODI-based literature.

RMDQ compared with other instruments

Instruments measuring a related construct, with the practical difference between them.

InstrumentItemsRangeWhat it adds
ODI100–100The Oswestry Disability Index measures how far low back pain restricts ten everyday activities, scoring each section from 0 to 5 and expressing the total as a percentage from 0% (no disability) to 100% (maximum disability).

Copyright and permitted use

Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.

Free to use

The RMDQ was published in full in Spine in 1983 and is distributed freely for clinical and research use. Its authors have historically made it available without fee, and it is reproduced widely in guidelines and trials.

References

  1. Roland M, Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine. 1983.PMID 6222486
  2. Stratford PW, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Defining the minimum level of detectable change for the Roland-Morris questionnaire. Physical Therapy. 1996.PMID 8710962
  3. Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine. 2000.PMID 11124727
  4. Jordan K, Dunn KM, Lewis M, Croft P. A minimal clinically important difference was derived for the Roland-Morris Disability Questionnaire for low back pain. Journal of Clinical Epidemiology. 2006.PMID 16360555
  5. Ostelo RW, Deyo RA, Stratford P, et al.. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008.PMID 18165753

Editorial status

Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.