Translation, cross-cultural adaptation, validity and reliability of the inaugural Albanian Roland-Morris Disability Questionnaire in Albanian population with low back pain

Background context: To precisely evaluate the disability resulting from low back pain and the efficacy of interventions, it is essential to utilize a standardized instrument capable of measuring the patient’s condition changes over time. One of the most frequently utilized self-administered standardized questionnaires is the Roland Morris Disability Questionnaire (RMDQ). Purpose: To culturally adapt the RMDQ into Albanian and assess its psychometric properties within an Albanian population. Study design: Observational: Patient sample: The total sample consisted of 200 individuals diagnosed with various conditions including persistent low back pain, coxofemoral luxation, back trauma, lumbar fracture, and arthritis. Outcome measures: The RMQ consists of 24 individual items each presented as a single sentence. The maximum achievable score is 24, while the minimum is 0. Methods: The research procedure involved two phases: initially, the translation and cultural adaptation, and subsequently, the assessment of quality within a clinical investigation. Test-retest reliability at 7 days was evaluated in 200 participants. Results: Kappa statistics showed that Alb-RMDQ had acceptable item-by-item agreement for 11 items (k = 0.603–0.755) and the remaining 13 were moderate agreement (k = 0.464–0.595). The exploratory factor analysis (EFA) of Albanian version was used to determine this dimensionality. An initial EFA analysis with a principal component analysis using Varimax with Kaiser Normalization rotation method resulted in a 10-factor structure with a KMO = 0.465 and a Chi-square = 461.791, p = 0.000. The Interclass Correlation Coefficient (ICC) between the first and the second evaluation for each item performed with two mixed effect model was between 0.621–0.938 using an absolute agreement definition. Conclusions: The AlbRMDQ version of RMDQ has a good validity and reliability and may be an important outcome tool for the clinical and research purpose for the Albanian speaking population.