The Fidelity of Commonly Used Low Back Pain Disability Tools in Indian Context

A bstract Objective: This study evaluated the suitability of three commonly used low back pain (LBP) questionnaires in addressing the activities and participation limitations of Indian patients. In addition, given the cultural diversity in daily activities, the International Classification of Functioning (ICF) was employed as a universal framework for comparison. Materials and Methods: The observational study employed an exploratory approach and involved 110 participants with LBP. Data collection was conducted in three steps: first, identifying widely used LBP questionnaires; second, interviewing patients to document their disabilities, affected activities, and recovery goals; and third, aligning questionnaire items with patients’ problems and goals using ICF categories. Patient responses were classified as either a problem, not a problem, or irrelevant. Descriptive statistics were used for analysis. Results: The results highlighted that the activity “running” was irrelevant for over 80% of participants. Similarly, activities such as “putting on footwear,” “attending ceremonies,” and “socializing” were not problematic for over 70% of participants but were still included in the questionnaires. Conversely, tasks such as changing positions from squatting, household chores (notably for women), maintaining employment, driving (specifically for men), and spirituality were reported as problematic by over 50% of participants but were absent from the questionnaires. Conclusion: Among the tools analyzed, the Rolland-Morris Disability Questionnaire was found to be more relevant in the Indian context than the other two measures. However, it did not adequately address several critical concerns of Indian patients with LBP. This highlights the necessity for developing a culturally tailored functional outcome measure that incorporates the unique challenges faced by Indian patients.