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Study Design. Cross-sectional study. Objective. The aim of this study was to assess the structural validity of the Brazilian version of the Neck Disability Index (NDI) in patients with chronic neck pain. Summary of Background Data. NDI is widely used in clinical and scientific contexts, although its structure has not been evaluated in the Brazilian version. Methods. Native Brazilian Portuguese speakers, aged ≥18 years, with neck pain complaint of at least 3 months, and minimal pain rating of 3 points at rest or during neck movements were included. Exploratory factorial analysis (EFA) and confirmatory factorial analysis (CFA) were used. In EFA, the adequacy of the model was assessed using Bartlett test of sphericity and Kaiser-Meyer-Olkin test. In CFA, the goodness-of-fit was assessed by the indices: root mean square error of approximation with 90% of confidence interval, comparative fit index, Tucker-Lewis Index, standardized root mean square residual, and χ2/degree of freedom. Akaike information criterion (AIC) and Bayesian information criterion (BIC) were considered to compare the models. Results. Two hundred fifty-four participants with chronic neck pain were included. The NDI model with one domain and five items presented the most adequate goodness-of-fit indexes and the lowest values of AIC and BIC, when compared with models with one domain and 10, eight, or seven items, and with the model with two domains and 10 items. Conclusion. In the Brazilian context, the NDI version with one domain and five items (personal care, concentration, work, driving, and recreation) presents the best structure according to the factorial analysis. Level of Evidence: 5

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INTRODUCTION Cross-cultural adaptations of questionnaires in developing countries, such as Brazil, have fostered a major debate involving the fields of economics, health, politics and culture. 1 Today, with the development and dissemination of the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures 2 and of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN), 3 standardization of cross-cultural adaptation relating to culture, language and country is providing positive outcomes within scientific and clinical contexts. Within healthcare sciences, especially in the field of prevention and rehabilitation of musculoskeletal injuries, it is common to use questionnaires to measure self-reported outcomes, mainly in relation to pain and functional disability. 4-6 Among the questionnaires for screening of musculoskeletal injuries, in addition to instruments that were created by researchers for specific evaluations, 7,8 the Nordic Musculoskeletal Questionnaire (NMQ) stands out through its widespread use for locating musculoskeletal pain in diverse populations. 9-12 However, the NMQ does not have a severity score, and it is not possible to use it to make inferences about functional disability. Therefore, as a way to fill this gap, the Self-Estimated Functional Inability because of Pain (SEFIP) questionnaire was developed and published in 1999. This is an instrument created based