Cross-Cultural Adaptation and Psychometric Properties of the Lithuanian Version of the Majeed Pelvic Score

Abstract

Background and Objectives: There are no valid patient-based pelvic ring function assessment tools in Lithuania. The most widely used instrument is the Majeed Pelvic Score (MPS), which is proven to be an effective tool for assessing pelvic function after pelvic injuries. The aims of our study were: (1) the translation and cross-cultural adaptation of the MPS for the Lithuanian-speaking population, (2) to test the psychometric properties of the Lithuanian version of the MPS (MPS-LT) at follow-up two-time points after pelvic fractures. Materials and Methods: The MPS was translated and culturally adapted. Psychometric properties of the MPS-LT were determined in one patient group (n = 40) at two time-points during follow-up examination from 1.5 to 3 months (mean 2 months) and from 11 to 20 months (mean 12 months). Results: At the mean time of 2 months after trauma, Cronbach’s α of the MPS-LT was 0.65. Correlation of the MPS-LT with the Iowa Pelvic Score (IPS) was r = 0.84 (p < 0.001), and with the Lithuanian SF-36, PCS was r = 0.53 (p < 0.001). At the mean time follow-up of 12 months, Cronbach’s α was 0.86, correlation with the IPS was r = 0.92 (p < 0.001), and with the Lithuanian SF-36, PCS – r = 0.82 (p < 0.001). At the 2-month follow-up, neither floor nor ceiling effects were reached, but at 12 months, 27.5% of patients reached the ceiling effect, while none reached the floor effect. The effect size of the MPS-LT was 1.66. Conclusions: The MPS-LT has limited ability to measure functional outcomes at 2 months after pelvic fracture. In contrast, at the 12-month follow-up examination, the MPS-LT had a good ability to assess pelvic function, and it was sensitive to health changes. The MPS-LT can be used as a pelvic function assessment tool after pelvic fractures for the Lithuanian-speaking population.

The Italian Version of the Majeed Pelvic Score: Translation, Cross-Cultural Adaptation and Validation

“…We found a signi cant ceiling effect (over 15%) in all domains of the translated MPS, in accordance with the existing literature [21,23,27,29]. This ceiling effect has been shown by Brouwers et al [31] to be present already 3 months after injury.…”

“…Busso et al [27] reported a ceiling effect of the overall questionnaire at a minimum of 5 years of follow-up. Petryla et al [23] observed that ceiling effect wasn't present 2 months after injury, while it appeared in a second evaluation at 12 months. This may be explained by muscle repair and bone healing and their in uence on pain, physical activity and walking performance.…”

“…In both reviews the Majeed Pelvic Score (MPS) was the most used pelvis-speci c instrument. Indeed, limited testing of its psychometric properties has been done in the past, and only a few number of studies evaluating construct validity, content validity and reliability of this score [21][22][23][24][25][26]. However, its widespread use make it the best way to compare outcomes of different studies and data sets [17].…”

“…We think brevity, coupled with simple wording, allowed for a high completion rate, with no missing data to report. Among the studies evaluating the MPS' psychometric properties there are two instances of translation, cross-cultural adaptation and measurement of the psychometric properties of the translated MPS: one in the Lithuanian language by Petryla et al [23] and one in the Italian language by Busso et al [27] In both cases the brevity of the MPS and its intuitive formulation allowed translation without any reported issue. At the beginning of our work no translation and validation of the MPS into the Italian language had been previously published.…”

“…In Busso et al's [27] work construct validity was tested by correlation with the Italian Owestry disability index (ODI) [28] a validated pathology-speci c score for lower back pain that showed acceptable correlation with the MPS in analyzing sacroiliac joint pain [29]. A strong correlation between the Physical Component Summary (PCS) of the SF-36 and the MPS has been well documented in literature [21,[23][24][25][26], indicating that the questionnaire has good properties of assessing the physical outcomes of the injury. In our study a strong correlation was con rmed with the PCS of the SF-12.…”