Patients With Lower Limb Deformity Report Worse Quality of Life Than Control Subjects Regardless of Degree of Deformity

Heath, Madison R.; Shin, Tom Jonggu; Mehta, Rena; Principe, Peter; Mackie, Alexandra T.; Fragomen, Austin T.; Rozbruch, S. Robert; Fabricant, Peter D.

doi:10.5435/jaaosglobal-d-21-00182

Cited by 15 publications

(13 citation statements)

References 19 publications

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“…[ 24 , 29 , 30 ]. The value of PROMs is highlighted by the fact that PROMs do not necessarily correlate well with radiological or other objectively assessed outcomes [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…By adjusting the existing Scoliosis Research Society (SRS) questionnaire for spinal deformities to encompass limb deformities, Fabricant et al, created the LD-SRS [ 34 ]. This PROM has since been validated and used for adults with lower limb deformities [ 30 , 31 , 32 ]. It contains similar scales to LIMB-Q Kids (namely “functioning/activity”, “pain”, or “mental health”) but is not specific to a certain patient age or diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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LIMB-Q Kids—German Translation and Cultural Adaptation

et al. 2022

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(1) Purpose: Lower limb deformities can have a severe impact on health-related quality of life (HRQL). LIMB-Q Kids is a new patient-reported outcome measure (PROM) aiming to elucidate the experience of 8–18-year-old patients before, during and after treatment, and to measure the different aspects of HRQL. The aim of this study was to translate and culturally adapt LIMB-Q Kids to German. (2) Methods: The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were followed. Three forward translations, a backward translation, an expert panel meeting with eight participants, and twenty cognitive debriefing interviews led to the final German version of LIMB-Q Kids. (3) Results: In the forward translations, 4/159 items were difficult to translate, and 2/159 items in the backward translation differed from the original English version. Cognitive debriefing interviews with 20 patients identified 7/159 items that were difficult to comprehend/answer, and 2 of these items were changed. (4) Conclusions: Lower limb deformities can have a great impact on children, and it is important to measure and consider the impact on HRQL. In order to be able to use PROMs in different countries, conceptually equivalent translations and cultural adaptations should be performed in order to ensure comprehensibility. The final German version of LIMB-Q Kids is ready for use in an international field test.

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“…[ 24 , 29 , 30 ]. The value of PROMs is highlighted by the fact that PROMs do not necessarily correlate well with radiological or other objectively assessed outcomes [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

LIMB-Q Kids—German Translation and Cultural Adaptation

et al. 2022

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“…Limb deformities (LD) include the shortening or angular/rotational malalignment of the upper or lower extremities. LD are often associated with functional impairment of the affected extremity [ 1 ]. LD can arise from a variety of medical conditions (congenital or acquired due to trauma, tumor, infection as well as iatrogenic and idiopathic origin) [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Most PROMs focus on patients’ health status without including objective factors such as imaging, laboratory values, or clinician assessments [ 9 ]. A recent study showed that the perception of mental health, pain, or perceived function does not necessarily correlate with the severity of the deformity and is therefore not readily assessable by radiographic or objective clinical findings [ 1 ]. Furthermore, the self-perception of deformity, e.g., scoliosis, may not be correlated with the extent of the objectively measured deformity [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

German Translation and Cross-Cultural Adaptation of the Limb Deformity-Scoliosis Research Society (LD-SRS) Questionnaire

et al. 2022

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Background: Patient-reported outcome measures are gaining increasing importance in clinical research and quality control. Clinical impairment through limb deformities can appear in various forms. This study aimed at translating and culturally adaptating the Limb Deformity-Scoliosis Research Society (LD-SRS) patient-reported outcome measure (PROM) into German by following the scientific rigor of the cross-cultural adaptation process as well as ensuring the reliability of the translated version. The LD-SRS is applicable in children and adults. Methods: The translation was performed in accordance with the creators of the LD-SRS following the Professional Society for Health Economics and Outcomes Research (ISPOR) guidelines for translation and cultural adaptation. Two forward translations were performed, and after a consensus meeting, a professional translator translated the PROM back to English. The creators reviewed the back translation of the preliminary German version. Thirty patients with upper and lower limb deformities participated in cognitive debriefing interviews. The version was proofread and, finally, the test-retest reliability was estimated. Results: The mean age was 19 years (range 6–61). Twenty-six patients (87%) completed the retest after 6 days (range 3–26). The internal consistency was estimated with a Cronbach’s alpha of 0.96 (range 0.94–0.97), and the intraclass correlation was 0.92 (range 0.89–0.94), indicating an excellent reliability. The scores were normally distributed. Thereafter, the German version was proofread and finalized. Conclusions: The German translation and cross-cultural adaptation of the LD-SRS score resulted in a high reliability and internal consistency. The German LD-SRS score is readily usable and may be applied in future studies of German-speaking limb deformity patients.

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“…9,10 One important factor to consider regarding indications for femoral derotational osteotomy is patient quality of life. Heath et al 11 described the importance of patients' perceived quality of life as a necessary factor when planning for lower limb deformity surgery. Indeed, capturing the patient-centered experience through patient-reported outcome measure (PROM) surveys can help surgeons provide more patientfocused and higher-quality care.…”

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confidence: 99%

Signficant Femoral Version Abnormalities and Patient-Reported Quality of Life

Greenstein,

Ellsworth,

Sheridan

et al. 2023

JAAOS Glob Res Rev

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Introduction: The purpose of this study was to determine how the Limb Deformity–Modified Scoliosis Research Society (LD-SRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire scores differ between patients with femoral version abnormalities and healthy control subjects. Methods: A retrospective database review identified patients with femoral version abnormalities between December 2018 and September 2022. A total of 21 adult patients scheduled for femoral derotational osteotomy and 33 control subjects were included. All individuals completed the LD-SRS and PROMIS questionnaires. Results: Patients with femoral version abnormalities reported significantly worse scores than control subjects on all LD-SRS and PROMIS domains: LD-SRS (Total [3.46 ± 0.66 vs. 4.58 ± 0.37, P < 0.001]; Function/Activity [3.48 ± 0.83 vs. 4.44 ± 0.4, P < 0.001]; Mental Health [3.41 ± 0.96 vs. 4.3 ± 0.73, P < 0.001]; Pain [3.55 ± 0.9 vs. 4.81 ± 0.31, P < 0.001]; and Self-Image/Appearance [3.37 ± 0.79 vs. 4.75 ± 0.43, P < 0.001]) and PROMIS (Function [41.6 ± 7.58 vs. 60.0 ± 7.28, P < 0.001]; Pain Intensity [45.85 ± 8.04 vs. 33.7 ± 4.89, P < 0.001]; Pain Interference [56.78 ± 9.63 vs. 42.8 ± 6.6, P < 0.001]; Global Mental Health [47.97 ± 9.68 vs. 55.3 ± 7.81, P = 0.004]; and Global Physical Health [45.23 ± 7.49 vs. 58.2 ± 7.07, P < 0.001]). Discussion: Patients with femoral version abnormalities reported markedly worse quality of life as measured on the LD-SRS and PROMIS scores compared with healthy control subjects. The combination of these two surveys effectively captures the multifaceted quality-of-life–deficit individuals with excessive femoral version may experience.

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Patients With Lower Limb Deformity Report Worse Quality of Life Than Control Subjects Regardless of Degree of Deformity

Cited by 15 publications

References 19 publications

LIMB-Q Kids—German Translation and Cultural Adaptation

LIMB-Q Kids—German Translation and Cultural Adaptation

German Translation and Cross-Cultural Adaptation of the Limb Deformity-Scoliosis Research Society (LD-SRS) Questionnaire

Signficant Femoral Version Abnormalities and Patient-Reported Quality of Life

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