Martin J. Nuhr ^A1, Richard Crevenna ^A1, Michael Quittan ^A1, Alexandra Auterith ^A2, Günther F. Wiesinger ^A1, Thomas Brockow ^A3, Peter Nuhr ^A4, Veronika Fialka-Moser ^A1, Andrew Haig ^A5, Gerold Ebenbichler ^A1
A1 Department of Physical Medicine and Rehabilitation University of Vienna, Vienna General Hospital Vienna
^A2 Department of Medical Statistic University of Vienna Vienna Austria
^A3 Spa Medicine Research Institute Bad Elster Germany
^A4 Nuhr-Zentrum, Spa Medicine Resort Senftenberg Austria
^A5 Department of Physical Medicine and Rehabilitation University of Michigan Ann Arbor Michigan USA

DOI: 10.1080/16501970410031101

Objective: To develop and validate a cross-cultural version of the Manniche Low Back Pain Rating Scale (MRS) for use in German-speaking low back pain patients. Background: Clinical intervention research in back pain would be enormously facilitated if a small number of relevant, patient-centred questionnaires became internationally used. MRS seems to be particularly suitable for cross-cultural adaptation due to its coverage of multidimensional back pain-specific health domains. Methods: MRS was translated and back-translated, pre-tested and reviewed by a committee. The German version was tested in 126 patients with low back pain from all countries of German-speaking Europe. Reliability (subsample n =20), dimensionality and construct validity was assessed. Single-dimensionality, higher correlations of MRS with the physical scales compared with the mental scales of the MOS SF-36, a moderate to good correlation with the Roland Morris Questionnaire and a low correlation with the Finger Floor Distance were hypothesized. Results: Spearman's Rho for test-retest reliability was 0. 98 (p <0. 001); Cronbach's alpha 0. 95. Factor analysis revealed only 1 factor with an Eigenvalue >1 [3. 25]. MRS was strongly correlated with the Roland Morris Questionnaire (r =0. 91), and slightly correlated with the Finger Floor Distance (r =0. 23). Correlations of MRS with domains of the SF-36 "Physical Functioning", "Role Physical" and "Bodily Pain" were higher (r -0. 66 to -0. 72) than with "Role Emotional", "Mental Health" and "Social Functioning" (r -0. 34 to -0. 61). Conclusion: The German version of the MRS seems to be reliable, uni-dimensional and construct valid for the assessment of functional status in German-speaking low back pain patients.