Cross‐cultural adaptation and validation of the Arabic version of the foot function index in patients with chronic lateral ankle instability

Abstract

Background The English version of the Foot Function Index (FFI) is a reliable and valid tool for measuring pain and functional instability due to chronic lateral ankle instability (CLAI). However, its use among Arabic speakers with CLAI is limited because of the unavailability of the Arabic version of the FFI (FFI-Arb). This study aimed to translate, cross-culturally adapt and validate the FFI from the original English version into Arabic. Methods The FFI questionnaire was translated using the Beaton guidelines. Two-hundred-and-thirty native Arabic-speaking participants with CLAI were recruited from different physiotherapy clinics in Saudi Arabia. The convergent validity of the FFI-Arb was tested using the Spearman correlation with the Arabic version Cumberland ankle instability tool (CAIT-Arab). Test-retest reliability was tested among 92 participants who completed the form again after seven days. Results Two-hundred-and-thirty participants were enrolled (mean age = 32.09, Standard deviation (SD) = 8.64 years old). There was excellent internal consistency for the three subscales of FFI: pain (0.95), disability (0.97), and activity limitation (0.86), as for the total score (0.98). Convergent validity was analyzed by Spearman rank correlation between the new translated versions of FFI-Arb and CAIT-Arab. The total FFI-Arb and CAIT-Arab scores were moderately correlated (rho = − 0.569; p < 0.001). Subscales of FFI-Arb, such as pain, disability, and activity limitation, were also moderately correlated with CAIT-Arab (rho = − 0.565, rho = − 0.561, rho = − 0.512; p < 0.001). The construct validity was confirmed by principal component analysis (factor analysis) showing a three-factor structure (eigenvalue 1) of FFI-Arb with a total variance of 77.3%. Test-retest reliability was excellent for the total score of the FFI-Arb and all its subscales (interclass correlation coefficient = 0.984–0.999). Conclusions The FFI-Arb is a reliable and valid tool for Arabic-speaking patients with CLAI. The FFI-Arb can be utilized in hospitals and clinics in Arabic speaking countries.

Cross‐cultural adaptation and validation of the Chinese version of the ankle joint functional assessment tool (AJFAT) questionnaire

“…The high overall internal consistency of the AJFAT-C was similar to the Chinese FAAM [36] and the Chinese CAIT [21], and this result is also consistent with other CAI questionnaires in different languages [18,20,32]. The first question of the AJFAT-C showed the weakest correlation with the total score, possibly because it assessed "pain," while the other items evaluated ankle function.…”

“…All participants completed the CAIT-C at the initial measurement time point. The total CAIT-C score ranges from 0 to 30, with scores ≤ 27 identifying CAI [ 13 , 32 ]. The Spearman's correlation coefficient was used to assess the relationship between CAIT-C and AJFAT-C, with correlation coefficients being judged as poor when < 0.30, moderate when between 0.30 and 0.50 and strong when > 0.50.…”

Arthroscopic all‐inside ligament repair has similar or superior clinical outcomes compared to open repair for chronic ankle instability without concomitant intra‐articular pathology at 5 years follow‐up

“…However, regarding the FFI scores the arthroscopic repair reported significantly better results at final follow‐up than the open group ( p < 0.05). It is important to note that according to the literature the FFI has been reported as reliable when evaluating CAI [2], whilst the AOFAS score is not a validated outcome scale to evaluate ankle instability [28].…”

Systematic review of the methodological quality of patient-reported outcome measure for patients with chronic ankle instability

“…On the other hand, the patient-reported outcome measures vary widely in the number of cross-cultural adaptations made, which range from none for the Chronic Ankle Instability Scale, to 3 for the Ankle Instability Instrument (French, Persian and Hebrew), 12,16,17 15 for the Identification of Functional Ankle Instability (Arabic, Brazilian-Portuguese, Chinese, Simplified Chinese, French, Greek, Japanese, Korean, Malay, Persian, Spanish (in two papers), Thai, Turkish and Hebrew) [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] and 16 for the Cumberland Ankle Instability Tool (Arab, Brazilian-Portuguese, Chinese, Digital Version, Dutch, French, Greek, Japanese, Korean, Persian, Spanish (in two papers), Taiwan-Chinese, Urdu, Hebrew and Thai). 17,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] Table 2 presents the data from these 36 studies to which the COSMIN criteria were applied.…”