Translation, Cross-Cultural Adaptation, and Validation of the Malay Version of the Roland-Morris Disability Questionnaire for Low Back Pain

Objective: To translate, culturally adapt, and validate the Roland-Morris Disability Questionnaire (RMDQ) for Malay-speaking individuals with low back pain (LBP) in Malaysia. Methods: A methodological study was conducted following established international guidelines for cross-cultural adaptation and psychometric validation. The process included forward-backward translation, expert review, content validation, face validation, and psychometric testing among individuals with LBP. Content and face validity indices were evaluated by rehabilitation professionals (n=8) and individuals with LBP (n=9). Psychometric testing was conducted with 102 participants to assess internal consistency, test-retest reliability (n=31), concurrent validity using the Malay Oswestry Disability Index, and known-groups validity. Results: All items demonstrated excellent content and face validity (I-CVI, I-FVI, S-CVI/Ave, and S-FVI/Ave=1.00). The Malay RMDQ showed high internal consistency (Cronbach's α=0.932) and excellent test-retest reliability (ICC=0.996). Concurrent validity with the Malay Oswestry Disability Index was moderate (r=0.742, p<0.001). A preliminary known-groups comparison showed a statistically significant difference in the Malay RMDQ scores between participants with LBP and those without LBP (p=0.03). Conclusion: The Malay RMDQ demonstrated preliminary psychometric support, including evidence of reliability, validity, and cultural appropriateness, for assessing disability in individuals with LBP. Future research should explore its responsiveness and utility in broader populations.