Arabic translation, cultural adaptation, and validation study of Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS)

Abstract

Knee complaints and their accompanying functional impairments are frequent problems encountered by healthcare practitioners worldwide. Plenty of functional scoring systems were developed and validated to give a relative estimation about the knee function. Despite the wide geographic distribution of Arabic language in the Middle East and North Africa, it is rare to find a validated knee function scale in Arabic. The present study is aimed to translate, validate, and culturally adjust the Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS) into Arabic language for future use among Arabic-speaking patients. Permission for translation was obtained from the copyrights holder. Two different teams of high-level clinical and linguistic expertise conducted translation process blindly. Forward-backward translation technique was implemented to ensure preservation of the main conceptual content. Main study consisted of 280 subjects. Reliability was examined by test-retest pilot study. Visual Analogue Scale (VAS), Get Up and Go (GUG) Test, Ascending/Descending Stairs (A/D Stairs), and Subjective Assessment of Function (SAF) were conducted concurrently to show the validity of Arabic KOS-ADLS statistically in relation to these scales. Final translated version showed no significant discrepancies. Minor adaptive adjustment was required to fit Arabian cultural background. Internal consistency was favourable (Cronbach's alpha 0.90). Patients' scoring on Arabic KOS-ADLS appeared relatively consistent with their scoring on VAS, GUG, A/D Stairs, and SAF. A significant linear relationship was demonstrated between SAF and total KOS-ADLS scores on regression analysis (adj. R = 0.548). Arabic KOS-ADLS, as its English counterpart, was found to be a simple, valid, and useful instrument for knee function evaluation. Arabic version of KOS-ADLS represents a promising candidate for unconditional use among Arabic-speaking patients with knee complaints.

A Systematic Review of Psychometric Properties of Knee-Related Outcome Measures Translated, Cross-Culturally Adapted, and Validated in Arabic Language

“…A total of 20 articles were selected for this review; out of which 12 articles were from Saudi Arabia [ 1 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], two each from Morocco [ 36 , 37 ], Egypt [ 38 , 39 ], and Jordan [ 40 , 41 ], and one each from Tunisia [ 14 ], and Kuwait [ 42 ]. A total of 10 knee-related outcome measures were cross-culturally adapted, and their psychometric measurement properties were evaluated in the Arabic language.…”

Measures of Adult Knee Function

“…The KOS‐ADLS instrument has been validated after translation to Arabic , Chinese , French , German , Portuguese , Polish , Turkish , and Greek .…”

“…Possible scores range from 0 to 100, in which 100 = no symptoms or disability. Scores are categorized as excellent , good , fair , and poor (less than 64) .…”

Patient-Rated Outcome Measure Using Disease-specific Koos-PS Short Form Arabic Questionnaire in Knee Osteoarthritis

“…Functional difficulties can be better perceived by affected persons, and the subjective information is well valid as the patient comes across their quality of activities of daily life than an objective evaluation and is better possible to document their level of knee difficulties from disease to disability. Several studies have evaluated and reported the occurrence of knee osteoarthritis [1][2][3][4] and its effects on the population using various health-related questionnaires in their original form [5], but very few have reported about knee osteoarthritis in Saudi Arabian population using Arabic versions [6]. This study used the disease-specific Knee injury and osteoarthritis outcome score physical function short form (KOOS-PS) Arabic questionnaire and hence, this study is intended to fill the gap.…”

“…The Arabic language is being used by twenty-two countries in the middle east to African countries [7]. One recent validation study in the Arabic language stated that there are many self-administered questionnaires available today to evaluate the knee functional status in western versions but very few of them are available in the Arabic language [6]. A disease-specific knee questionnaire does provide a clinician a definitive disease data to consider for further evaluation and also serve as a better prognostic tool.…”