Cross-cultural adaptation,validity and reliability of the Arabic version of the Lower Extremity Functional Scale

Purpose: The aim was to translate and cross-culturally adapt the Lower Extremity Functional Scale (LEFS) into Arabic language and to examine its measurement properties in patients with musculoskeletal disorders of the lower extremity. Methods: Standard forward and backward translation followed by expert committee review, then preliminary testing was carried out to produce the final Arabic version of LEFS (LEFS-Ar). The test–retest reliability, measurement error, internal consistency and construct validity of the LEFS-Ar were examined in patients with musculoskeletal disorders of the lower extremity (N?=?116). Results: The LEFS-Ar had excellent test–retest reliability (ICC_2,1?=?0.96). LEFS-Ar standard error of measurement was 3.5 points while the minimal detectable change MDC₉₅ was 9.8 points. LEFS-Ar showed excellent internal consistency with Cronbach’s alpha of 0.95. Parallel analysis and factor analysis showed that LEFS-Ar measures one underlying factor with all items loading heavily on this single factor. LEFS-Ar showed significant positive correlation with patient’s global assessment of function (r?=?0.59) and that patients recovering from surgery reported lower LEFS-Ar score compared to patients with no surgery further supporting the construct validity of the LEFS-Ar. Conclusion: LEFS-Ar has excellent internal consistency, test–retest reliability with relatively small measurement error and is a valid measure of activity limitation due to lower extremity musculoskeletal disorders. All these measurement properties of the LEFS-Ar suggest the clinical usefulness of this measure.

• Implications for Rehabilitation

• The Arabic Lower Extremity Functional Scale (LEFS-Ar) is a reliable and valid measure of activity limitation due to lower extremity musculoskeletal disorders with relatively small measurement error.

• LEFS-Ar can be used in daily clinical practice and for research purposes to quantify activity limitation in Arabic-speaking individuals with lower extremity musculoskeletal disorders.

     

Reliability and validity of the Finnish version of the Lower Extremity Functional Scale (LEFS)

Purpose: The present study aimed to assess the psychometric properties of the Finnish version of the Lower Extremity Functional Scale (LEFS) among foot and ankle patients.

Methods: The LEFS was translated and cross-culturally adapted to Finnish. We assessed the test–retest reliability, internal consistency, floor-ceiling effect, construct validity and criterion validity in patients who underwent surgery due to musculoskeletal pathology of the foot and ankle (N?=?166).

Results: The test–retest reliability was high (ICC = 0.93, 95% CI: 0.91–0.95). The standard error of measurement was 4.1 points. The Finnish LEFS showed high internal consistency (Cronbach’s α?=?0.96). A slight ceiling effect occurred as 17% achieved the maximum score. The LEFS correlation was strong with the 15D Mobility dimension (r?=?0.74) and overall HRQoL (r?=?0.66), pain during foot and ankle activity (r=??0.69) and stiffness (r=??0.62). LEFS correlated moderately with foot and ankle pain at rest (r=??0.50) and with physical activity (r?=?0.46).

Conclusions: The Finnish version of the LEFS showed reliability and validity comparable to those of the original version. This study indicates that the Finnish version of the LEFS serves both clinical and scientific purposes in assessing lower-limb function.

• Implications for Rehabilitation

• The Finnish version of the Lower Extremity Functional Scale (LEFS) is a reliable and valid tool for assessing lower-extremity musculoskeletal disability in Finnish-speaking population.

• Investigation of the psychometric properties of the Finnish version of the LEFS showed validity and reliability comparable to those of the original English version.

• The Finnish LEFS is easy to complete and suitable for clinical, rehabilitation and research purposes.

     

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.

     

Cross-cultural adaptation,reliability and validity of the Persian version of the modified falls efficacy scale

Purpose.?To translate the Swedish version of the Falls Efficacy Scale (FES), the FES(S), into Persian, and to determine reliability and validity of the scale to be used for Persian speaking elderly people.

Method.?The ‘forward-backward’ procedure was applied to translate the FES(S) into Persian. A methodological study was then carried out to determine the psychometric properties of the Persian version of the scale. Eighty-one community-dwelling elderly persons (≥65 years) were included.

Results.?Both reliability and validity of the Persian FES(S) were found to be acceptable (Cronbach's α == 0.75, interclass correlation coefficients == 0.99, p < 0.001 and standard errors of measurements == 1.82). Low to moderate negative correlations of the total score of the scale with the age of the participants and number of falls in the past year were shown. There were also low to moderate correlations between the Persian FES(S) score and the Mini-Mental State Examination score, duration of walks and physical fitness. The participants who took a daily walk, felt healthy, reported no general tiredness and who had had no fall during the past year rated their self-efficacy higher than did their peers.

Conclusions.?The present study verified that the Persian FES(S) is a culturally relevant, valid and reliable tool for measuring self-perceived confidence in Iranian older adults.     

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 validity and reliability of the Turkish version of the MacNew Heart Disease Questionnaire in patients with angina

Aims and objectives Health‐related quality of life (HRQL) is an important patient‐reported outcome when identifying the effects of the angina and evaluating the efficacy of treatment. The aim of this study was to determine the reliability and validity of the Turkish version of the MacNew Heart Disease HRQL Questionnaire (MacNew) in patients with angina. Method The Short Form SF‐36, the MacNew, and the Hospital Anxiety and Depression Scale were completed by the 125 patients in first 2–3 days after admission to the coronary care unit. Internal consistency reliability (Cronbach’s α) and reproducibility (intraclass correlation coefficients, ICC) of the MacNew were assessed, and test–retest reproducibility was evaluated over a 2‐month period in 25 clinically stable patients. Results The original three‐factor structure for the Turkish MacNew was confirmed, with construct validity only partially confirmed; reliability statistics show that Cronbach’s α exceeded 0.80 and the ICC exceeded 0.60 for all MacNew scales. Discriminative validity of the MacNew was confirmed. Conclusion The MacNew appears to be reliable and valid in Turkish patients with angina.     

Study of the reliability and validity of the Community Health Intensity Rating Scale (CHIRS) in the Turkish community

The purpose of this study was to examine the reliability and validity of the Community Health Intensity Rating Scale (CHIRS) that was translated into the Turkish language and applied in the Turkish community. The CHIRS is a tool that assesses the intensity of need for care of persons/families in the community. The original version of the tool was translated into Turkish, examined for face validity and language appropriateness by the Turkish experts, and then applied to 372 families living in Odemis, Turkey. Significant correlations were found between total scale score (TSS) and total number of household members, and between the TSS and the total number of visits to any health institution within the previous month. In addition, the self-health care needs evaluation scores supported predictive validity. For reliability, min-max values, standard errors and deviations, skewness, and kurtosis coefficients of parameter scores, domain scores, and TSS were examined. The mean TSS was 26.7 (+/- 5.32) and the mean age of the participants was 35.0 years. For internal consistency, Cronbach's alpha (.525) and Guttman split-half coefficient (.629) values were established for the TSS. In conclusion, the reliability and validity of the Turkish version of CHIRS have been established.     

中文版Barthel指数的信度与效度研究

目的 研究脑卒中患者中文版Barthel指数(Barthel Index,BI)的信度和效度.方法 147例急性脑卒中患者分别由不同评定者对同一脑卒中患者于入院当天、入院第15天、发病后第90天进行BI的评定.用Kappa值表示重测信度与评定者间信度,用Cronbach α值表示分半信度、内部一致性信度.采用Spearman相关分析预测效度,采用因子分析方法评定结构效度.结果 所有重测信度、评定者间信度的Kappa值差异均有统计学意义(P＜0.01);分半信度:BI奇偶项两部分的Cronbach α值分别为0.837、0.824,两部分的rs为0.903;内部一致信度:Cronbach α值为0.916;效度研究中患者的KMO统计量为0.854,Bartlett球形检验拒绝相关阵是单位阵(P＜0.01);入院时、发病15天的BI评分结果与发病90天后BI呈正相关(rs=0.614,0.583,均P＜0.01);与斯堪的那维亚卒中量表(Scandinavian Stroke Scale,SSS)结果呈正相关(rs=0.619,0.704,0.882,均P＜0.01),与美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)呈负相关(rs=-0.587,-0.705,-0.790,均P＜0.01).结论 中文版的BI重测信度和评定者间信度佳,内部一致性好;具有结构效度、预测效度;使用方便,易于掌握,可广泛应用于脑卒中的评定中.     

Translation,cultural adaptation,reliability, and validity of the Turkish version of the Penn Shoulder Score

Purpose: The purpose of this study is to translate the Penn Shoulder Score into Turkish and to establish its cultural adaptation, reliability, and validity in patients with shoulder dysfunctions.

Methods: The Penn Shoulder Score was translated and culturally adapted from English into Turkish. Subsequently, the Penn Shoulder Score, the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index were completed by 97 patients with shoulder dysfunctions. To determine the test–retest reliability, 30 patients completed the Penn Shoulder Score again on day 3. Intraclass correlation coefficient and Cronbach alpha were calculated to assess reliability. The validity of the questionnaire was assessed in terms of convergent validity with Pearson Correlation Coefficient using the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index.

Results: Internal consistency was good, with a Cronbach alpha of 0.81. The Intraclass correlation coefficient was 0.90 (95% confidence interval: 0.78, 0.90), demonstrating good test–retest reliability. Pearson correlation coefficients of the Penn Shoulder Score in relation with the Constant Score, the American Shoulder and Elbow Score, and the Western Ontario Rotator Cuff Index were 0.65, 0.78, and ?0.77, respectively.

Conclusion: The Turkish version of the Penn Shoulder Score is a reliable and valid measure for assessing patients with shoulder dysfunctions.

• Implications for Rehabilitation

• The Turkish version of the Penn shoulder score is valid and reliable outcome measure for assessing patients with shoulder dysfunctions.

• The Turkish version of the Penn shoulder score could be easily performed by patients and it is easy to score by clinicians. It is recommended to use in clinical settings and in research.

     

简体版改良Barthel指数在脑卒中恢复期中的信度与效度研究

目的:观察简体版改良Barthel指数量表(MBI)在评定脑卒中患者恢复期基础性日常生活活动(BADL)的信度和效度。方法:由2名研究员对100名符合入选标准的脑卒中恢复期患者进行BADL评定。在患者入院的次日,上午由评定员A、B使用MBI分别对每位患者的BADL进行评定,下午由评定员A使用MBI、评定员B使用BI分别对每位患者的BADL进行再次评定,收集整理数据并加以分析。采用相关系数(ICC)值描述评价者的重测信度、评价者间信度,采用Cronbach’sα系数进行计算量表的内部一致性;邀请6名高级职称康复专家对简体版MBI的内容效度(CVI)进行评估,采用Spearman相关性检验分析简体版MBI的校标效度(以BI为金标准),采用KMO检验、Bartlett球形检验和因子分析方法来分析构想效度。结果:6名专家对简体版MBI的条目水平CVI为0.83~1,量表水平CVI均值为0.95;简体版MBI各个条目、总分的重测信度为ICC=0.909~0.991;简体版MBI各个条目、总分的评定者间信度为ICC=0.880~0.992;简体版MBI内部一致性Cronbach’α系数为0.929;以BI为金标准,简体版MBI的校标效度(Spearman相关系数)依次为:进食(0.562)、个人卫生(0.701)、洗澡(0.715)、如厕(0.785)、穿衣(0.684)、大便控制(0.690)、小便控制(0.630)、床椅转移(0.925)、步行/轮椅(0.864)、上下楼梯(0.877)、总分(0.941),均P<0.001;简体版MBI构想效度结果显示,KMO统计量为0.877,Bartlett球形检验拒绝相关阵是单位阵(P<0.05),80.28%的总方差可由2个公因子解释,旋转后因子1有:洗澡、穿衣、如厕、床椅转移、步行/轮椅、上下楼;旋转后因子2有:进食、个人卫生、大便控制、小便控制。结论:简体版MBI量表不仅具有良好内容效度、重测信度、评定者间信度、内部一致性、校标效度和构想效度,而且易于掌握、使用方便。     

Cross-cultural adaptation,reliability and validity of the Arabic version of the reduced Western Ontario and McMaster Universities Osteoarthritis index in patients with knee osteoarthritis

Purpose: We adapted the reduced Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index for the Arabic language and tested its metric properties in patients with knee osteoarthritis (OA). Methods: One hundred and twenty-one consecutive patients who were referred for physiotherapy to the outpatient department were asked to answer the Arabic version of the reduced WOMAC index (ArWOMAC). After the completion of the ArWOMAC, the intensity of knee pain and general health status were assessed using the visual analog scale (VAS) and the 12-item short form health survey (SF-12), respectively. A second assessment was performed at least 48?h after the first session to assess test–retest reliability. The test–retest reliability was quantified using the intra-class correlation coefficient (ICC), and Cronbach’s alpha was calculated to assess the internal consistency of the Arabic questionnaire. The construct validity was assessed using Spearman rank correlation coefficients. Results: The total ArWOMAC scale and pain and function subscales were internally consistent with Cronbach’s coefficient alpha of 0.91, 0.89 and 0.90, respectively. Test–retest reliability was good to excellent with ICC of 0.91, 0.89 and 0.90, respectively. SF-12 and VAS score significantly correlated with ArWOMAC index (p?Conclusions: The ArWOMAC index is a reliable and valid instrument for evaluating the severity of knee OA, with metric properties in agreement with the original version.

• Implications for Rehabilitation

• Although, the reduced WOMAC index has been clinically utilized within the Saudi population, the Arabic version of this instrument is not validated for an Arab population to measure lower limb functional disability caused by OA.

• The Arabic version of reduced WOMAC (ArWOMAC) index is a reliable and valid scale to measure lower limb functional disability in patients with knee OA.

• The ArWOMAC index could be suitable in Saudi Arabia and other Arab countries where the language, culture and the life style are similar.

     

Cross-cultural validation of the Persian version of the Functional Independence Measure for patients with stroke

Purpose: To translate and cross-culturally adapt the Functional Independence Measure (FIM) into the Persian language and to test the reliability and validity of the Persian FIM (PFIM) in patients with stroke. Method: In this cross-sectional study carried out in an outpatient stroke rehabilitation center, 40 patients with stroke (mean age 60 years) were participated. A standard forward–backward translation method and expert panel validation was followed to develop the PFIM. Two experienced occupational therapists (OTs) assessed the patients independently in all items of the PFIM in a single session for inter-rater reliability. One of the OTs reassessed the patients after 1 week for intra-rater reliability. Results: There were no floor or ceiling effects for the PFIM. Excellent inter-rater and intra-rater reliability was noted for the PFIM total score, motor and cognitive subscales (ICC_agreement 0.88–0.98). According to the Bland–Altman agreement analysis, there was no systematic bias between raters and within raters. The internal consistency of the PFIM was with Cronbach's alpha from 0.70 to 0.96. The principal component analysis with varimax rotation indicated a three-factor structure: (1) self-care and mobility; (2) sphincter control and (3) cognitive that jointly accounted for 74.8% of the total variance. Construct validity was supported by a significant Pearson correlation between the PFIM and the Persian Barthel Index (r?=?0.95; p?Conclusions: The PFIM is a highly reliable and valid instrument for measuring functional status of Persian patients with stroke.

• Implications for Rehabilitation

• The Functional Independence Measure (FIM) is an outcome measure for disability based on the International Classification of Functioning, Disability and Health (ICF).

• The FIM was cross-culturally adapted and validated into Persian language.

• The Persian version of the FIM (PFIM) is reliable and valid for assessing functional status of patients with stroke.

• The PFIM can be used in Persian speaking countries to assess the limitations in activities of daily living of patients with stroke.

     

The validity and reliability of the Turkish version of short‐form McGill Pain Questionnaire in patients with leukemia

Aims and objectives. To assess reliability and validity of the Turkish version of the Short‐form McGill Pain Questionnaire. Background. Pain is one of the most frequent and significant problems encountered by nurses practice across the world. The Short‐form McGill Pain Questionnaire was widely translated and used to assess the pain experience of several types of patients because it combines the properties of the standard McGill Pain Questionnaire but takes substantially less time to administer. Design. The study used psychometric testing to establish reliability and validity of the Turkish version of Short‐form McGill Pain Questionnaire. Methods. A convenience sample of 160 patients with leukaemia in Turkey was used to collect data regarding pain evaluation. The original version of the Short‐form McGill Pain Questionnaire, adapted into Turkish, was tested for internal consistency, content validity, construct validity and concurrent validity. Results. Internal consistency was found adequate at both assessments with Cronbach’s α 0·88 for test and 0·91 for retest. For reliability of the total, sensory, affective and evaluative total pain intensity, high intraclass correlations were demonstrated (0·85, 0·84, 0·82 and 0·70, respectively). Correlation of total, sensory and affective score with the numerical rating scale was tested for construct validity demonstrating r = 0·61 (p < 0·01) for test and r = 0·68 (p < 0·01) for retest. Correlation with blood pressure values for concurrent validity was found to be r = 0·78 (p < 0·001) for test and r = 0·73 (p < 0·001) for retest. Conclusion. Turkish version of the Short‐form McGill Pain Questionnaire has shown statistically acceptable levels of reliability and validity for pain evaluation in patients with leukaemia. Relevance to clinical practice. This study provided evidence that the Turkish version of the Short‐form McGill Pain Questionnaire is a reliable and valid instrument for assessing pain. This scale can be used to assess nursing interventions aimed at decreasing pain and efficacy of the treatment.     

中文版家庭坚韧性量表的信度和效度研究

目的测评中文版家庭坚韧性量表的信度和效度。方法取得原作者对量表的翻译和使用的授权,组成翻译小组对量表进行翻译,选取30名入院患儿的父母进行预调查,对语言表述调适,采用中文版家庭坚韧性量表对330名住院患儿父母进行调查,评价其内部一致性、重测信度、内容效度、结构效度。结果中文版家庭坚韧性量表的Cronbach'sα系数为0.803,折半信度系数为0.738,各条目内容效度和量表总体内容效度指数均为1,结构效度3个公因子的累积贡献率为61.25%。结论中文版家庭坚韧性量表的信度和效度高,有可操作性,可作为家庭坚韧性的测量工具。     

Upper extremity movement reliability and validity of the Kinect version 2

Purpose: Studies have shown that marker-less motion detection systems, such as the first generation Kinect (Kinect 1), have good reliability and potential for clinical application. Studies of the second generation Kinect (Kinect 2) have shown a large range of accuracy relative to balance and joint localization; however, few studies have investigated the validity and reliability of the Kinect 2 for upper extremity motion. This investigation compared reliability and validity among the Kinect 1, Kinect 2 and a video motion capture (VMC) system for upper extremity movements.

Design: One healthy, adult male performed six upper extremity movements during two separate sessions. All movements were recorded on the Kinect 1, Kinect 2 and VMC simultaneously. Data were analyzed using MATLAB (Natick, MA), Microsoft Excel (Redmond, WA), and SPSS (Armonk, NY).

Results: Results indicated good reliability for both Kinects within a day; results between days were inconclusive for both devices due to the inability to exactly repeat the desired movements. Range of motion (ROM) magnitudes for both Kinects were different from the VMC, yet patterns of motion were very highly correlated for both devices.

Conclusion: Simple transformations of Kinect data could bring magnitudes in line with those of the VMC, allowing the Kinects to be used in a clinical setting.

• Implications for Rehabilitation

• The clinical implications of the investigation support the notion that the Kinects could be used in the clinical setting if an understanding of their limitations exists.

• Using the Kinects to make assessments with a given data collection session is acceptable. Using the Kinects to make comparisons across different days such as before or after an intervention should be approached with caution.

• The Kinect 2 provides a more cost effective option compared to the VMC. Additionally, the Kinect is more portable, requires less time to set-up, and takes up less space, thus increasing its overall usability compared to the VMC.