Cross-cultural adaptation, validity, and reliability of the Persian version of the Upper Limb Functional Index

Mokhtarinia, Hamid Reza; Zareiyan, Armin; Gabel, Charles Philip

doi:10.1177/1758998320986832

Cited by 9 publications

(28 citation statements)

References 54 publications

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“…The internal consistency (α = 0.94) is slightly higher than the original and Spanish versions (α = 0.91) [ 14 , 15 ] and notably higher consistency than the Turkish version (α = 0.82) [ 16 ]. This is most likely due to the culturally distinct response attitudes of populations in the Turkish region, as similar findings are also found for Persian responses to questionnaires [ 25 , 26 ].…”

Section: Discussionsupporting

confidence: 67%

Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints

Bejer

Bieś

Kyc

et al. 2021

IJERPH

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This study aimed to perform linguistic and cross-cultural adaptation to establish a Polish version of the Lower Limb Functional Index (LLFI) as well as an evaluation of the psychometric properties. This was a two-stage, cross-sectional study. The first stage—linguistic and cultural adaptation, complied with the International Society for Pharmacoeconomics and Outcomes Research guidelines to produce the Lower Limb Functional Index, Polish version (LLFI-PL). The subjects were recruited to the second stage of the study from a sample of convenience (n = 125, age x- = 52.86 ± 19.53 years, 56% female, symptoms duration x- = 17.69 ± 18.39 weeks). Baseline reliability was performed on the LLFI-PL with retest period at 3–7 days. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC), EuroQol Health Questionnaire 5-Dimensions 5-Level (EQ-5D-5L), and an 11-point Pain Numerical Rating Scale (P-NRS) were completed to assess the validity of the LLFI-PL. Statistical analysis showed high internal consistency (α = 0.94), and excellent test–retest reliability (ICC2.1 = 0.96). The measurement error was SEM = 1.69% with MDC90 = 3.93%. Construct validity demonstrated strong correlations between the LLFI-PL and WOMAC (r = 0.81) and moderate correlations with the EQ-5D-5L (r = −0.63) and P-NRS (r = −0.39). Exploratory factor analysis confirmed a single-factor structure. The LLFI-PL is a psychometrically sound questionnaire for Polish-speaking patients with lower limb musculoskeletal conditions. The results support findings from the previous original English, Spanish, and Turkish versions.

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Section: Discussionsupporting

confidence: 67%

Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints

Bejer

Bieś

Kyc

et al. 2021

IJERPH

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“…The internal consistency of ULFI-U was found excellent as the value of Cronbach’s alpha obtained was 0.94( α = 0.94). The item to total correlation has been measured using spearman rank correlation that depicts the strength of association between each item and overall ULFI-U minus the score of the item that is being investigated [ 21 ]. When the value is larger than 0.7, it indicates a strong association between two variables.…”

Section: Resultsmentioning

confidence: 99%

“…The upper limb functional index has already been translated into different languages i.e. Brazilian Portugese [ 23 ], Italian [ 25 ], Korean [ 24 ], Persian [ 21 ], Spanish [ 13 ], French Canadian [ 22 ], and Turkish [ 16 ]. There were no missing responses as comparable findings with original English, Spanish and Turkish versions [ 3 , 13 , 32 ] which indicates that ULFI is an easy-to-understand outcome measure.…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion criteria were 18–40 years of age [ 22 ]. Both male and female gender patients were included; enrolled in a physiotherapy program for shoulder, arm/wrist, or hand musculoskeletal injury with the symptoms duration of ≤12 weeks and diagnosed by a medical practitioner [ 7 , 21 , 22 ]. Sub-acute or chronic upper limb musculoskeletal disorders such as tendonitis or tenosynovitis, carpal tunnel syndrome (CTS), the cramp of the hand or forearm from prolonged periods of repetitive movement, osteoarthritis or hand-arm vibration syndrome (HAVS) were included.…”

Section: Methodsmentioning

confidence: 99%

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Translation, cross-cultural adaptation and psychometric properties of Urdu version of upper limb functional index; a validity and reliability study

Arooj

Amjad

Tanveer

et al. 2022

BMC Musculoskelet Disord

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Background The upper limb functional index is broadly used outcome measure for musculoskeletal disorders of the upper limb. The main objective of the study was to translate and validate the upper limb functional index (ULFI) outcome measure in the Urdu language. Methods Upper limb functional index was translated into Urdu language using Beaton et al. guidelines through forward and backward translation along with the expert committee reviews. Two fifty (n = 250) Urdu-speaking patients with sub-acute or chronic conditions of upper limb musculoskeletal disorders were included in the study. The mean age was 32.33 ± 4.67 years. The data were collected from the physical therapy department of The University of Lahore Teaching hospital. All participants completed the upper limb functional index-Urdu (ULFI-U), Numeric pain rating scale (NPRS), Quick Disability of arm, shoulder, and hand (QuickDash), and (health survey) SF-12 at baseline while only ULFI-U at day three. Reliability was assessed through internal consistency by Cronbach’s alpha and test-retest reliability by intra-class correlation (ICC). Content validity was measured by Lynn and Lawshee method. Spearman’s correlation has been used to measure criterion validity. The construct validity was measured through hypothesis testing. The structural validity has been explained through factor analysis by exploratory factor analysis (EFA) using Maximum likelihood extraction (MLE) with Promax rotation. Results The English version of ULFI was translated into the Urdu language with minor alterations. The Urdu version ULFI has demonstrated high levels of reliability with intra-class correlation (ICC2,1= 0.91) and Cronbach’s alpha (α = 0.94). The content validity index found as 0.808, the criterion validity for ULFI-U correlating with quick Dash was found excellent (r = 0.845) and ULFI-U established strong correlation with 6 domains of SF-12(r = 0.697 to 0.767) and weak correlation with its 2 domains and NPRS(r = 0.520). A two-factor structure was obtained using EFA. Conclusions The ULFI-U is a valid and reliable patient-reported outcome (PRO) that can be used to assess upper limb musculoskeletal disorders in Urdu-speaking patients. Trial registration This study was registered in the U. S National Library on clinicaltrial.gov under registration no. NCT05088096. (Date: 21/10/2021).

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“…The same expert panel used in the face validity process evaluated the content validity using a 4-point Likert scale for each item relevance to the construct of upper extremity functional deficit (1=not relevant, 2=somewhat relevant, 3=quite relevant, and 4=highly relevant). Subsequently, the Content Validity Index (CVI) was determined at two levels of the item (I-CVIs) and scale (S-CVI) [24,25]. The accepted values for the I-CVI and S-CVI values are considered above 0.78 and 0.90, respectively, which represents evidence of high content validity value for the scale [24].…”

Section: Content Validitymentioning

confidence: 99%

Translation, Validity, and Reliability of the Upper Extremity Fugl-Meyer Assessment (FMA-UE) in Persian Speaking Stroke Patients

Hassani

Mokhtarinia

Kahlaee

et al. 2021

IRJ

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Objectives: Fugl-Meyer Assessment (FMA) is the common scale for clinical and functional evaluation of sensorimotor conditions and related Upper Extremity (UE) dysfunction after stroke. This study was done to translate and cross-culturally adjust the original upper extremity FMA (FMA-UE) into Persian and to evaluate the psychometric properties of the translated version. Methods: A procedure of forward/backward translation based on the published guidelines was adopted and two independent bilingual translators performed the translations in each stage. The conceptual and semantic equivalence was obtained through a consensus between experts. Consecutive stroke patients (n=47, male=63%) with a mean age of 61.54±10.9 years were recruited. Content, face, and concurrent validity was calculated using the content validity index, a cognitive interview, and correlation with the Wolf Motor Function Test (WMFT). Internal consistency and intra-rater reliability were determined by calculating Cronbach’s alpha and the Intra-Class Correlation coefficient (ICC2.1). Results: During the forward translation and cultural adjustment, some wording changes were performed. In the forward translation, the most challenging clarifications are related to anatomical terms and positions. The total FMA-Persian score demonstrated acceptable internal consistency (α=0.86) and intra-rater reliability (ICC2.1=0.96). Joint passive motion showed the lowest reliability among all domains. The FMA motor subscales showed a floor effect, while sensation, joint passive motion, and pain domains showed ceiling effects. The correlation between the FMA-UE score and the WMFT was 0.78 (P<0.001). Discussion: The FMA-UE translation and adjustment were performed successfully into the Persian language. The results of the current study found FMA-UE as an acceptable, reliable, and valid instrument for evaluating the upper limb function after stroke in Persian-speaking patients. However, it should be noted that floor and ceiling effects are respectively present in the domains of the motor subscales and for sensation, passive motion, and pain.

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Cross-cultural adaptation, validity, and reliability of the Persian version of the Upper Limb Functional Index

Cited by 9 publications

References 54 publications

Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints

Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints

Translation, cross-cultural adaptation and psychometric properties of Urdu version of upper limb functional index; a validity and reliability study

Translation, Validity, and Reliability of the Upper Extremity Fugl-Meyer Assessment (FMA-UE) in Persian Speaking Stroke Patients

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