The psychometric properties of the Evaluation of Daily Activity Questionnaire in seven musculoskeletal conditions

Purpose: The purpose of this study is to psychometrically test the Evaluation of Daily Activity Questionnaire in seven musculoskeletal conditions.

Materials and methods: One thousand and two hundred people with ankylosing spondylitis; osteoarthritis; systemic lupus erythematosus; systemic sclerosis; chronic pain; chronic upper limb disorders; or Primary Sjögren’s syndrome completed the Evaluation of Daily Activity Questionnaire, Health Assessment Questionnaire and Short-Form Health Survey v2. We examined internal construct validity using Rasch analysis, internal consistency, concurrent validity with the Health Assessment Questionnaire and Short-Form Health Survey v2. Participants repeated the Evaluation of Daily Activity Questionnaire to assess test–retest reliability.

Results: The 12 domains satisfied Rasch model expectations for fit, local dependency, unidimensionality and invariance by age and gender, in each musculoskeletal condition. Internal consistency was consistent with individual use (Cronbach’s α?>?0.90); concurrent validity was strong (Health Assessment Questionnaire:?r_s?=?0.60–0.92; Short-Form Health Survey v2 Physical Function:?r_s?=??0.61 to ?0.91) and test–retest reliability excellent (Intra-Class Correlation Coefficient(2,1)?=?0.77–0.96).

Conclusion: The Evaluation of Daily Activity Questionnaire satisfied Rasch model requirements for construct validity and has good reliability and validity in each MSC. The Evaluation of Daily Activity Questionnaire can be used as a measure of everyday activity in practice and research with people with musculoskeletal conditions.

• Implications for rehabilitation

• The Evaluation of Daily Activity Questionnaire evaluates users’ ability to perform common daily activities (in 12 domains) that were identified as problematic by people with seven musculoskeletal conditions (i.e., osteoarthritis, systemic lupus, ankylosing spondylitis, chronic pain, chronic upper limb conditions, systemic sclerosis, Sjogren’s syndrome).

• Most patients considered the Evaluation of Daily Activity Questionnaire was the right length and would be helpful for discussing everyday problems with an occupational therapist.

• The 12 domains have good reliability and validity and can be combined into two components: Self-Care and Mobility.

• The Evaluation of Daily Activity Questionnaire is suitable for use both in clinical practice and research and a User Manual is available for therapists and researchers.

     

Cross-cultural adaptation,reliability, and validity of the Japanese version of the Cumberland ankle instability tool

Purpose To study validity and reliability of a Japanese version of the Cumberland Ankle Instability Tool and to determine the optimal cutoff score. Methods In this study, the questionnaire was cross-culturally adapted into Japanese. The psychometric properties tested in the Japanese version of the CAIT were measured for criteria validity, internal consistency and test–retest reliability in 111 collegiate soccer athletes. We also established the questionnaire cutoff score for discriminating between individuals with and without CAI. Results There was a significant correlation between the Japanese version of the CAIT and the Karlsson score (r?=?0.604, p?α?=?0.833) and reliability [intraclass correlation coefficient (ICC)?=?0.826, 95% confidence interval (CI): 0.732–0.888]. The optimal cutoff score was?≤25, which was consistent with previous reports. Conclusions The Japanese version of the CAIT has been shown to be a valid and reliable questionnaire for determining the presence of CAI. We expect that researchers and clinicians will use the Japanese version of the CAIT in Japan.

• Implications for Rehabilitation

• Chronic Ankle Instability (CAI), which not only increases recurrence rate of ankle sprain but also decreases athletic performance, is a residual symptom after ankle sprain.

• Cumberland Ankle Instability Tool, which has the reliability and validity to assess CAI, will be critically useful in assessment procedure for CAI.

• It is preferable for clinicians and researchers to use the native language version of the CAIT.

     

Chinese cross-cultural adaptation and validation of the Foot Function Index as tool to measure patients with foot and ankle functional limitations

Purpose: To perform a cross-cultural adaptation and validation of the Foot Function Index (FFI) questionnaire to develop the Chinese version.

Materials and methods: Three hundred and six patients with foot and ankle neuromusculoskeletal diseases participated in this observational study. Construct validity, internal consistency and criterion validity were calculated for the FFI Chinese version after the translation and transcultural adaptation process.

Results: Internal consistency ranged from 0.996 to 0.998. Test–retest analysis ranged from 0.985 to 0.994; minimal detectable change 90: 2.270; standard error of measurement: 0.973. Load distribution of the three factors had an eigenvalue greater than 1. Chi-square value was 9738.14 (p?r?=??0.634 (Factor 2) and r?=??0.191 (Factor 1). Foot Function Index (Taiwan Version), Short-Form 12 (Version 2) and EuroQol-5D were used for criterion validity. Factors 1 and 2 showed significant correlation with 15/16 and 14/16 scales and subscales, respectively.

Conclusions: Foot Function Index Chinese version psychometric characteristics were good to excellent. Chinese researchers and clinicians may use this tool for foot and ankle assessment and monitoring.

• Implications for rehabilitation

• A cross-cultural adaptation of the FFI has been done from original version to Chinese.

• Consistent results and satisfactory psychometric properties of the Foot Function Index Chinese version have been reported.

• For Chinese speaking researcher and clinician FFI-Ch could be used as a tool to assess patients with foot disease.

     

Measurement properties of the Wheelchair Skills Test – Questionnaire for powered wheelchair users*

Purpose: To evaluate the test–retest reliability, concurrent validity and responsiveness of the Wheelchair Skills Test – Questionnaire (WST-Q) Version 4.1 for powered wheelchair users. Methods: A volunteer sample of 72 community-dwelling, experienced powered wheelchair users, ranging in age from 50 to 77 years, participated in this study. Participants completed measures at baseline and 1 month later. Results: Mean?±?standard deviation total percentage WST-Q scores at baseline and 1 month were 83.7%?±?10.9 and 86.3%?±?10.0 respectively. Cronbach’s alpha was 0.90 and the 1 month test–retest intraclass correlation coefficient (ICC_1,1) was 0.78 (confidence interval: 0.68–0.86). There were no floor or ceiling effects. Percentages of agreement between baseline and 1 month for individual skills ranged from 72.2% to 100%. The correlations between the WST-Q and the objective Wheelchair Skills Test (WST), WheelCon and Life Space Assessment were r?=?0.65, r?=?0.47 and r?=?0.47 respectively. The standard error of measurement (SEM) and smallest real difference (SRD) were 5.0 and 6.2 respectively. Conclusion: The WST-Q 4.1 has high internal consistency, strong test–retest reliability and strong support for concurrent validity and responsiveness.

• Implications for Rehabilitation:

• There is evidence of reliability, validity and responsiveness of the Wheelchair Skills Test – Questionnaire (WST-Q) among experienced older adult powered wheelchair users.

• The WST-Q can be used to measure powered wheelchair skills, guide intervention and measure change over time.

     

The Nordic Musculoskeletal Questionnaire: cross-cultural adaptation into Turkish assessing its psychometric properties

Purpose: The purpose of this study was to linguistically and culturally adapt the Nordic Musculoskeletal Questionnaire (NMQ) for use in Turkey, and to examine the psychometric properties of this adapted version.

Method: The cross-cultural adaptation was achieved by translating the items from the original version, with back-translation performed by independent mother-tongue translators, followed by committee review. Reliability (internal consistency and test–retest) was examined for 198 participants who completed the NMQ twice (with a 1 week interval). Construct validity was examined with data from 126 participants from the same population, who completed further four questionnaires related to the body regions described in the NMQ.

Results: The internal consistency was excellent (Cronbach’s alpha?=?0.896). The test–retest reliability was examined with the prevalence-adjusted bias-adjusted kappa (PABAK) and all items showed moderate to almost perfect reliability (PABAK?=?0.57–0.90). Participants with a musculoskeletal problem in a related region had significantly more disability/pain, as assessed by the relevant questionnaires (p?Conclusions: This study provided considerable evidence that the Turkish version of the NMQ has appropriate psychometric properties, including good test–retest reliability, internal consistency and construct validity. It can be used for screening and epidemiological investigations of musculoskeletal symptoms.

• Implications for Rehabilitation

• The Nordic Musculoskeletal Questionnaire (NMQ) can be used for the screening of musculoskeletal problems.

• The NMQ allows comparison of musculoskeletal problems in different body regions in epidemiological studies with large numbers of participants.

• The Turkish version of the NMQ can be used for rehabilitation due to its appropriate psychometric properties, including good test–retest reliability, internal consistency and construct validity.

     

Adaptation of the Activity Measure Post-Acute Care (AM-PAC) from English to Mandarin using the dual-panel translation approach

Purpose: The aims of this study were to translate and adapt the Activity Measure Post-Acute Care (AM-PAC) from US English to Mandarin using the dual-panel method, and to assess its psychometric properties in an outpatient rehabilitation setting.

Methods: The AM-PAC outpatient short forms were translated using the dual-panel method. The translated AM-PAC was tested in 550 Chinese-speaking rehabilitation outpatients. Floor and ceiling effects were evaluated and internal consistency was assessed using Cronbach’s alpha. Spearman correlation was used to assess the concurrent validity of the AM-PAC with the Barthel Index and the Mini-Mental State Examination. Test–retest reliability was determined by administering the AM-PAC twice to 57 participants within a 2–7?day interval.

Results: Some ceiling effects (>20%) were observed in the Applied Cognition subscale. All subscales exhibited good internal consistency (α?>?0.70). Supportive evidence for concurrent validity was found in strong correlations between Basic Mobility subscale and Barthel Index (r?=?0.68), and Daily Activity subscale and Barthel Index (r?=?0.70); and moderate correlations between Applied Cognition subscale and Mini-Mental State Examination (r?=?0.50). Test–retest reliability for all subscales was high (intraclass correlation coefficient?=0.89–0.98).

Conclusions: The dual-panel approach was successfully used to translate the AM-PAC from English to Mandarin. Adequate reliability and validity in rehabilitation outpatients in Taiwan were established.

• Implications for Rehabilitation

• The dual-panel method is a modern translation technique, which was successfully used to adapt the Activity Measure Post-Acute Care from English to Mandarin.

• The Mandarin version of Activity Measure Post-Acute Care demonstrates adequate internal consistency, concurrent validity, and test–retest reliability in rehabilitation outpatients.

• The Activity Measure Post-Acute Care is superior to existing functional measures used to monitor activity performance for rehabilitation patients in Taiwan.

     

The validity and reliability of the Thai version of the Kujala score for patients with patellofemoral pain syndrome

Purpose: To develop a Thai version of the Kujala score and show the evaluation of the validity and reliability of the score.

Method: The Thai version of the Kujala score was developed using the forward–backward translation protocol. The 49 PFPS patients answered the Thai version of questionnaires including the Kujala score, Short Form-36 (SF-36) and International Knee Documentation Committee (IKDC) Subjective Knee Form. The validity between the scores has been tested. The reliability was assessed using test–retest reliability and internal consistency.

Results: The Thai version of the Kujala score showed a good correlation with Thai IKDC Subjective Knee Form (Pearson’s correlation coefficient; r?=?0.74: p?r?=?0.586, 0.571 and 0.524, respectively: p?p?p?Conclusion: The Thai version of the Kujala score has shown good validity and reliability. This score can be effectively used for evaluating Thai patients with patellofemoral pain syndrome.

• Implications for Rehabilitation

• The Kujala score is a self-administered questionnaire for patients with patellofemoral pain syndrome (PFPS).

• The validity and reliability of the Thai version of Kujala are compatible with other versions (Turkish, Chinese and Persian version).

• The Thai version of Kujala has been shown to have validity and reliability in Thai PFPS patients and can be used for clinical evaluation and also in the research work.

     

The Swedish Exercise Self-Efficacy Scale (ESES-S): reliability and validity in a rheumatoid arthritis population

Abstract

Purpose: The aim of the present study was to investigate aspects of reliability and validity of the Exercise Self-Efficacy Scale (ESES-S) in a rheumatoid arthritis (RA) population. Methods: A total of 244 people with RA participating in a physical activity stkudy were included. The six-item ESES-S, exploring confidence in performing exercise, was assessed for test–retest reliability over 4–6 months, and for internal consistency. Construct validity investigated correlation with similar and other constructs. Results: An intraclass correlation coefficient (ICC) of 0.59 (95% CI 0.37–0.73) was found for 84 participants with stable health perceptions between measurement occasions. Cronbach’s alpha coefficients of 0.87 and 0.89 were found at the first and second measurements. Corrected item-total correlation single ESES-S items ranged between 0.53 and 0.73. Construct convergent validity for the ESES-S was partly confirmed by correlations with health-enhancing physical activity and outcome expectations respectively (Pearson’s r?=?0.18, p?<?0.01). Construct divergent validity was confirmed by the absence of correlations with age or gender. No floor or ceiling effects were found for ESES-S. Conclusions: The results indicate that the ESES-S has moderate test–retest reliability and respectable internal consistency in people with RA. Construct validity was partially supported in the present sample. Further research on construct validity of the ESES-S is recommended.

• Implications for Rehabilitation

• Physical exercise is crucial for management of symptoms and co-morbidity in rheumatoid arthritis.

• Self-efficacy for exercise is important to address in rehabilitation as it regulates exercise motivation and behavior.

• Measurement properties of self-efficacy scales need to be assessed in specific populations and different languages.

     

Greek cultural adaption and validation of the Kujala anterior knee pain scale in patients with patellofemoral pain syndrome

Purpose: To cross-culturally adapt and validate the Greek version of the Kujala anterior knee pain scale (KAKPS). Methods: The Greek KAKPS was translated from the original English version following standard forward and backward translation procedures. The survey was then conducted in clinical settings by a questionnaire comprising the Greek KAKPS and patellofemoral pain syndrome (PFPS) severity scale. A total of 130 (62 women and 68 men) Greek-reading patients between 18 and 45 years old with anterior knee pain (AKP) for at least four weeks were recruited from physical therapy clinics. To establish test–retest reliability, the patients were asked to complete the KAKPS at initial visit and 2–3 days after the initial visit. The Greek version of the PFPS severity scale was also administered once at initial visit. Internal consistency of the translated instrument was measured using Cronbach’s α. An intraclass correlation coefficient was used to assess the test–retest reliability of the KAKPS. Concurrent validity was measured by correlating the KAKPS with the PFPS severity scale using Pearson’s correlation coefficient. Results: The results showed that the Greek KAKPS has good internal consistency (Cronbach’s α?=?0.942), test–retest reliability (ICC?=?0.921) and concurrent validity (r?>?0.7). Conclusions: This study has shown that the Greek KAKPS has good internal consistency, test–retest reliability and concurrent validity when correlated with the PFPS severity scale in adult patients with AKP for at least four weeks.

• Implications for rehabilitation

• The Greek version of the KAKPS has been found to be reliable and valid when used in adult patients with AKP for at least four weeks.

• The results of the psychometric characteristics were compatible with those of the original English version.

• The KAKPS could be applied in a Greek-speaking population to assess functional limitations and symptoms in patients aged 18–45 years old with AKP for at least four weeks.

     

Cross-cultural adaptation,reliability, and validation of the Korean version of the identification functional ankle instability (IdFAI)

Abstract

Purpose: To cross-culturally adapt the Identification Functional Ankle Instability for use with Korean-speaking participants.

Methods: The English version of the IdFAI was cross-culturally adapted into Korean based on the guidelines. The psychometric properties in the Korean version of the IdFAI were measured for test-retest reliability, internal consistency, criterion-related validity, discriminative validity, and measurement error 181 native Korean-speakers.

Results: Intra-class correlation coefficients (ICC_2,1) between the English and Korean versions of the IdFAI for test–retest reliability was 0.98 (standard error of measurement?=?1.41). The Cronbach’s alpha coefficient was 0.89 for the Korean versions of IdFAI. The Korean versions of the IdFAI had a strong correlation with the SF-36 (r_s?=??0.69, p?<?.001) and the Korean version of the Cumberland Ankle Instability Tool (r_s?=??0.65, p?<?.001). The cutoff score of >10 was the optimal cutoff score to distinguish between the group memberships. The minimally detectable change of the Korean versions of the IdFAI score was 3.91.

Conclusion: The Korean versions of the IdFAI have shown to be an excellent, reliable, and valid instrument. The Korean versions of the IdFAI can be utilized to assess the presence of Chronic Ankle Instability by researchers and clinicians working among Korean-speaking populations.

• Implications for rehabilitation

• The high recurrence rate of sprains may result into Chronic Ankle Instability (CAI).

• The Identification of Functional Ankle Instability Tool (IdFAI) has been validated and recommended to identify patients with Chronic Ankle Instability (CAI).

• The Korean version of the Identification of Functional Ankle Instability Tool (IdFAI) may be also recommend to researchers and clinicians for assessing the presence of Chronic Ankle Instability (CAI) in Korean-speaking population.

     

The Wheelchair Use Confidence Scale: Italian translation,adaptation, and validation of the short form

Objective: We developed an Italian version of the Wheelchair Use Confidence Scale for Manual Users-Short Form (WheelCon-M-I-short form) and examined its reliability and validity.

Methods: The original scale was translated from English to Italian using the “Translation and Cultural Adaptation of Patient Reported Outcomes Measures–Principles of Good Practice” guidelines. The WheelCon-M-I-short form was administered to experienced manual wheelchair users who had a variety of diagnoses. Its internal consistency and test–retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Italian version of the Wheelchair Outcome Measure (WhOM-I) and the Italian version of the Barthel index (BI).

Results: The WheelCon-M-I-short form was administered to 31 subjects. The mean?±?SD of the WheelCon-M-I-short form score was 7.5?±?1.9. All WheelCon-M-I-short form items were either identical or similar in meaning to the WheelCon-M-short form items. Cronbach’s α for the WheelCon-M-I-short form was 0.95 (p?p?p?p?Conclusions: The WheelCon-M-I-short form was found to be reliable and a valid outcome measure for assessing manual wheelchair confidence in the Italian population.

• Implication for Rehabilitation

• The WheelCon-M-I-short form is a valid outcome measure available for assessing wheelchair confidence, according to Bandura’s social cognitive theory, self-efficacy is a better predictor of future behavior than skill itself.

• Translation of the WheelCon-M-short form into the WheelCon-M-I-short form provides a new tool for Italian professionals.

• Clinicians now have a method to measure this invisible barrier to wheelchair use, and they will be able to make informed decisions when prescribing the use of manual wheelchairs and when training clients in their use.

• The WheelCon-M-I-short form also provides researchers with a tool in an important and relevant area of study for future research.

     

Validity and reliability of the multidimensional assessment of fatigue scale in Iranian patients with relapsing-remitting subtype of multiple sclerosis

Purpose: The purpose of this study is to investigate the validity and reliability of the Persian version of the Multidimensional Assessment of Fatigue Scale (MAFS) in an Iranian population with multiple sclerosis.

Method: A self-reported survey on fatigue including the MAFS, Fatigue Impact Scale and demographic measures was completed by 130 patients with multiple sclerosis and 60 healthy persons sampled with a convenience method. Test–retest reliability and validity were evaluated 3 days apart. Construct validity of the MAFS was assessed with the Fatigue Impact Scale.

Results: The MAFS had high internal consistency (Cronbach’s alpha >0.9) and 3-d test–retest reliability (intraclass correlation coefficient?=?0.99). Correlation between the Fatigue Impact Scale and MAFS was high (r?=?0.99). Correlation between MAFS scores and the Expanded Disability Status Scale was also strong (r?=?0.85). Questionnaire items showed acceptable item-scale correlation (0.968–0.993).

Conclusions: The Persian version of the MAFS appears to be a valid and reliable questionnaire. It is an appropriate short multidimensional instrument to assess fatigue in patients with multiple sclerosis in clinical practice and research.

• Implications for Rehabilitation

• The Persian version of Multidimensional Assessment of Fatigue is a valid and reliable instrument for the assessment and monitoring the fatigue in Persian-language patients with multiple sclerosis.

• It is very easy to administer and a time efficient scale in comparison to other instruments evaluating fatigue in patients with multiple sclerosis.

     

Construct validity of the Eating Assessment Tool (EAT-10)

Abstract

Purpose: We aimed to evaluate the construct validity of the Eating Assessment Tool (EAT-10) by determining its dimensionality, rating scale integrity, item-person match, precision and relationship with the degree of airway invasion and functional oral intake.

Methods: We conducted a retrospective analysis of patients’ EAT-10 scores. We used the Rasch rating scale model. We investigated correlations between the EAT-10 and scores on the Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS).

Results: The median score of the EAT-10 from 127 patients was 16 of 40 (range 0–40). Confirmatory factor analysis supported unidimensionality. The 5-point rating scale categories met published criteria. Two items misfit the Rasch model and two other items displayed differential item functioning. Rasch person reliability was 0.79. Our patient cohort was divided into three person-strata. Correlations between the EAT-10 and the PAS and FOIS were weak to moderate in strength (respectively: r?=?0.26, p?=?0.0036; r?=??0.27, p?=?0.0027).

Conclusions: Our analyses identified deficits in the construct validity of the EAT-10 suggestive of a need to improve the EAT-10 to support its frequent use in clinical practice and research.

• Implications for Rehabilitation

• Swallowing disorders are associated with severe complications, such as pneumonia and malnutrition, and impose both social and psychological burdens on patients.

• The Eating Assessment Tool is a self-report instrument developed to estimate initial dysphagia severity and monitor change in patient-reported dysphagia symptoms as a response to treatment.

• This study shows that the Eating Assessment Tool has deficits in its construct validity and a need to improve the instrument to support its frequent use in clinical practice and research.

     

Measurement properties of the WheelCon for powered wheelchair users

Purpose: To evaluate the measurement properties of the Wheelchair Use Confidence Scale for power wheelchair users (WheelCon-P).

Design: One-month test–retest design, using data from a longitudinal study of power wheelchair use.

Participants: Volunteer sample of 73 community dwelling, older adult experienced power wheelchair users who had a mean age of 60.5?±?7.1 years.

Methods: Participants completed the WheelCon-P twice to assess retest reliability. Concurrent validity was assessed by evaluating hypothesized relationships between the WheelCon-P and relevant variables.

Results: The baseline mean (standard deviation) WheelCon-P score was 78.8?±?14.5. Cronbach’s α was 0.92. The one-month test–retest intraclass correlation coefficient was 0.85 (CI 0.77–0.90). Correlations ranging from r?=?0.26 (social support) to r?=?0.49 (wheelchair skills) were found between the WheelCon-P and the validation outcome measures.

Conclusion: The WheelCon-P has high internal consistency, strong retest reliability and evidence supporting its validity. Although further work is needed, the WheelCon-P may serve as a useful clinical and research tool for measuring power wheelchair confidence.

• Implications for rehabilitation

• The WheelCon-P is a reliable and valid outcome measure for assessing wheelchair confidence.

• This tool can be used to identify individuals with low power wheelchair confidence who require a confidence-enhancing intervention.

     

Brazilian Portuguese version of the Revised Fibromyalgia Impact Questionnaire (FIQR-Br): cross-cultural validation,reliability, and construct and structural validation

Purpose: This study aimed to culturally adapt and validate the Revised Fibromyalgia Impact Questionnaire (FIQR) to Brazilian Portuguese, by the use of analysis of internal consistency, reliability, and construct and structural validity.

Method: A total of 100 female patients with fibromyalgia participated in the validation process of the Brazilian Portuguese version of the FIQR (FIQR-Br).The intraclass correlation coefficient (ICC) was used for statistical analysis of reliability (test–retest), Cronbach’s alpha for internal consistency, Pearson’s rank correlation for construct validity, and confirmatory factor analysis (CFA) for structural validity.

Results: It was verified excellent levels of reliability, with ICC greater than 0.75 for all questions and domains of the FIQR-Br. For internal consistency, alpha values greater than 0.70 for the items and domains of the questionnaire were observed. Moderate (0.40?r?r?>?0.70) correlations were observed for the scores of domains and total score between the FIQR-Br and FIQ-Br. The structure of the three domains of the FIQR-Br was confirmed by CFA.

Conclusions: The results of this study suggest that that the FIQR-Br is a reliable and valid instrument for assessing fibromyalgia-related impact, and supports its use in clinical settings and research. The structure of the three domains of the FIQR-Br was also confirmed.

• Implications for Rehabilitation

• Fibromyalgia is a chronic musculoskeletal disorder characterized by widespread and diffuse pain, fatigue, sleep disturbances, and depression. The disease significantly impairs patients’ quality of life and can be highly disabling.

• To be used in multicenter research efforts, the Revised Fibromyalgia Impact Questionnaire (FIQR) must be cross-culturally validated and psychometrically tested. This paper will make available a new version of the FIQR-Br since another version already exists, but there are concerns about its measurement properties.

• The availability of an instrument adapted to and validated for Brazilian Portuguese may make it possible to reliably verify the effects of rehabilitation programs on disability from fibromyalgia.

• The FIQR-Br showed results comparable with other versions of the FIQR in other languages, thereby enabling comparison of effects of rehabilitation interventions on disability from fibromyalgia conducted in Brazil with results of studies carried out in other parts of the world.

     

The Trunk Impairment Scale – modified to ordinal scales in the Norwegian version

Purpose: To translate the Trunk Impairment Scale (TIS), a measure of trunk control in patients after stroke, into Norwegian (TIS-NV), and to explore its construct validity, internal consistency, intertester and test–retest reliability. Method: TIS was translated according to international guidelines. The validity study was performed on data from 201 patients with acute stroke. Fifty patients with stroke and acquired brain injury were recruited to examine intertester and test–retest reliability. Construct validity was analyzed with exploratory and confirmatory factor analysis and item response theory, internal consistency with Cronbach’s alpha test, and intertester and test–retest reliability with kappa and intraclass correlation coefficient tests.Results: The back-translated version of TIS-NV was validated by the original developer. The subscale Static sitting balance was removed. By combining items from the subscales Dynamic sitting balance and Coordination, six ordinal superitems (testlets) were constructed. The TIS-NV was renamed the modified TIS-NV (TIS-modNV). After modifications the TIS-modNV fitted well to a locally dependent unidimensional item response theory model. It demonstrated good construct validity, excellent internal consistency, and high intertester and test–retest reliability for the total score.Conclusions: This study supports that the TIS-modNV is a valid and reliable scale for use in clinical practice and research.

Implications for Rehabilitation

• Trunk control is an essential part of balance and postural control, thereby an important prerequisite for daily activities and function

• Impairments of trunk control is a common problem in stroke

• The TIS-modNV is a valid and reliable measure to evaluate impairments in trunk control

• The TIS-modNV containing ordinal superitems is recommended for use in clinical practice and research

     

Psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool

Abstract

Purpose: To estimate the psychometric properties of the Spanish version of the Cumberland Ankle Instability Tool (CAIT-Sv). Method: One hundred and seventy-one subjects participated. The psychometric properties tested for CAIT-Sv were internal consistency with Cronbach’s α (n?=?171) in the first measurement; test–retest reliability using the intraclass correlation coefficient (ICC_2,1) (n?=?171) in two measurements separated by one week; criterion validity by ICC_2,1 between the original CAIT and CAIT-Sv in two measurements separated by two weeks for a subgroup of 54 bilingual subjects; ceiling and floor effects (n?=?78 subjects with a history of at least one ankle sprain), and responsiveness using Cohen’s d in a subgroup of 25 subjects with a history of at least one ankle sprain and a score ≤24 points on the CAIT-Sv and treated with a rehabilitation program during four weeks. Results: Internal consistency was excellent (Cronbach’s α: 0.8–0.84). Test–retest reliability was high (ICC_2,1: 0.95). Criterion validity was high (ICC_2,1: 0.91; 95% CI: 0.84–0.94; p?<?0.001 for dominant ankle). There were no ceiling (9%) and floor (0%) effects. Responsiveness was moderate (Cohen’s d: 0.6995; CI: 0.11–1.27). Conclusions: CAIT-Sv is a reliable instrument with high criterion validity to measure the presence and severity of chronic ankle instability (CAI) in the Spanish population.

• Implications for Rehabilitation

• Chronic ankle instability is the most prevalent complication after ankle injuries.

• CAIT is a widely used tool for clinical detection of subjects with chronic ankle instability (CAI).

• In this study, CAIT-Sv has shown good phsychometric properties for using with Spanish speaking individuals.

     

Validity and reliability of the French translation of the VISA-A questionnaire for Achilles tendinopathy

Purpose: The Victorian Institute of Sport Assessment – Achilles tendinopathy questionnaire (VISA-A) evaluates the clinical severity of Achilles tendinopathy. The aim of this study was to translate the VISA-A into French and to study the reliability and validity of this French version, the VISA-AF.

Method: The VISA-A was translated into French to produce the VISA-AF using a validated methodology in six steps. Thereafter, several psychometric properties of this French version such as test–retest reliability, internal consistency, construct validity and floor and ceiling effects were evaluated. Therefore, we recruited 116 subjects, distributed into 3 groups: pathological patients (n?=?31), at-risk athletes (n?=?63) and healthy people (n?=?22).

Results: The final version of the VISA-AF was approved by an expert committee. On a scale ranging from 0 to 100, the average scores of the VISA-AF obtained were 59 (±?18) for the pathological group, 99 (±?1) for the healthy group and 94 (±?7) for the at-risk group. The VISA-AF shows excellent reliability, low correlations with the discriminant subscales of the SF-36 and moderate correlations with the convergent subscales of the SF-36.

Conclusions: The French version of the VISA-A is equivalent to its original version and is a reliable and valid questionnaire for French-speaking patients with Achilles tendinopathy.

• Implication for Rehabilitation

• The VISA-AF questionnaire is a reliable translation of the original VISA-A, from English into French, which is one of the most widespread languages in the world.

• The VISA-AF questionnaire is now a valid instrument that can be used by clinicians and researchers to assess the severity of pain and disability of French-speaking subjects with Achilles tendinopathy.

• The VISA-AF is a questionnaire to assess the severity of Achilles tendinopathy symptoms but is not a diagnostic tool.

     

An exploration of the relationship between two measures of children’s participation

Purpose: To investigate the relationship between the Children Participation Questionnaire and the Children’s Assessment of Participation with Hands.

Materials and methods: Two researchers classified the item contents independently using the International Classification of Functioning, Disability and Health-Child and Youth version as a guide. Parents of 51 children with intellectual and developmental disabilities completed both measures within one month.

Results: The linking results indicated that the two participation measures covered a broad range of life domains, which corresponded well to the conceptually matched Activities and Participation categories/chapters of the International Classification of Functioning, Disability and Health-Child and Youth version. A significant moderate link (Spearman’s ρ coefficient?=?0.68, p?ρ?=?0.47–0.71, p?Conclusion: This study provides evidence for the content and construct validity of the two children’s participation measures. The findings also offer important insights about the similarities and differences between the two measures. This knowledge will assist clinicians in selecting outcome measures.

• Implications for rehabilitation

• The Children Participation Questionnaire and Children’s Assessment of Participation with Hands demonstrate good content and convergent validity.

• The two measures capture distinctive aspects and/or degrees of children’s participation.

• Clinicians and researchers need to be aware of the similarities and differences between the two measures before selecting outcome measure.

     

Transcultural adaptation and validation of Hindi version of Quebec Back Pain Disability Scale

Abstract

Purpose: To transculturally adapt the Quebec Back Pain Disability Scale for Hindi-speaking population and examine its psychometric properties in patients with low back pain.

Materials and methods: The Quebec Back Pain Disability Scale was translated and cross-culturally adapted into Hindi following international guidelines. Hindi version of the scale was completed by 120 patients with low back pain and 60 healthy controls. Patients with low back pain were also administered the Hindi-Roland Morris Disability Questionnaire and Visual Analog Scale. Psychometric evaluation included test–retest reliability, convergent and discriminative validity. Exploratory factor analysis was carried out to determine the factor structure.

Results: The factorial analysis revealed a four-factor solution (bending/carrying, ambulation/reach, prolonged postures and rest). Convergent validity was confirmed by high correlation of Hindi Quebec Back Pain Disability Scale to the Hindi version of Roland Morris Disability Questionnaire (r?=?0.77 and p?<?0.001) as well as Visual Analog Scale (r?=?0.682 and p?<?0.001) scores. Discriminative validity was established by significantly different scores for patients with low back pain and the healthy controls (35.36?±?18.6 vs. 9.13?±?6.08 and p?<?0.001). The translated version of the scale showed remarkable internal consistency (Cronbach α?=?0.98) and the intraclass correlation coefficient of test–retest reliability was excellent (ICC_2,1=0.96). MDC₉₅ and SEM scores obtained were 10.28 and 3.71, respectively.

Conclusion: The Hindi version of Quebec Back Pain Disability Scale has good test–retest reliability, discriminative and convergent validity and is appropriate for clinical and research use in Hindi-speaking low back pain patients.

• Implications for rehabilitation

• Linguistically and culturally adapted questionnaires help researchers make adequate inferences about instruments measuring health and quality of life.

• The translated version would serve as a valid research tool allowing comparability of data across cultures thus, providing opportunities for large multicenter, multicountry trials.

• A Hindi Quebec Back Pain Disability Scale version will help to improve the quality and efficacy of assessment of low back pain by developing in patients, a better understanding of the items which can be easily correlated with the activities of daily living.