Cross-cultural adaptation and validation of the Arabic version of the Pain Self-Efficacy Questionnaire in Arab people with chronic low back pain

Arabic-Translated Versions of Patient-Reported Outcome Measures Utilized in Spine Research: A Review of Validated Studies

Patient-reported outcome measures (PROMs) are standardized tools commonly applied in research and healthcare appraisal. Most were developed in English and the cross-cultural adaptation (CCA) and validation of their translated versions remain topics of contemporary research appeal. This review aimed to identify the Arabic-translated PROMs that were utilized in spine research and to assess the methodological qualities of their studies. The PubMed database was searched, and all relevant publications were identified. The CCA and measurement properties were assessed using the guidelines described by Oliveria and Terwee respectively. Thirty studies that validated the Arabic versions of 26 PROMs were found suitable. The tools that had the highest total citation numbers were Neck Disability Index, Ronald-Morris Disability Questionnaire, Oswestry Disability Index, Fear Avoidance Beliefs Questionnaire, Scoliosis Research Society-22, Back Beliefs Questionnaire, Quebec Back Pain Disability Scale, and McGill Pain Questionnaire-Short Form. The Arabic versions of Short Form-36 (SF-36), Visual Analogue Scale (VAS), and EuroQol-5D (EQ-5D) were not included due to lack of validation in spine research. All the articles were published from 2007 to 2023 (median 2019) and their journal's impact factor and citation numbers were relatively modest (mean 2 and 6.5 respectively). Most patients had low back pain (19 articles), were recruited from physiotherapy and rehabilitation departments (18 articles) and came from the Kingdom of Saudi Arabia (12 articles). The quality of the CCA of the Arabic versions was rated good in forward translation, synthesis, back translation, and expert committee review but less so in pretesting and submission. The measurement properties of the studies were considered good quality in internal consistency, reliability, structural validity and cross-cultural validity but less so in content validity, error measurement, responsiveness and floor/ceiling effect. In conclusion, with a few exceptions, most of the widely utilized PROMs in spine research have validated Arabic versions. The methodological quality of the studies was good apart from a few shortages that could be improved upon by further research. Work should be done to address the validation of Arabic versions of SF-36, VAS and EQ-5D in spine research. PROMs are valuable in systematizing subjective outcomes. Their usage in research and clinical settings in any validated language should be highly encouraged.

Psychometric properties of the translated Spanish version of the Pain Self-Efficacy Questionnaire

Introduction

Some patients with rotator cuff injuries do not report significant changes in pain-related outcomes. Pain self-efficacy, which is commonly assessed using the Pain Self-Efficacy Questionnaire, may contribute toward this outcome. However, a Spanish adaptation of this questionnaire is currently lacking. Therefore, this study's purpose was developing the Spanish version of this questionnaire, and assess its psychometric properties.

Methods

The Spanish version of the Pain Self-Efficacy Questionnaire was translated and culturally adapted, and a sample of 107 patients with rotator cuff injuries completed the questionnaire to examine its convergent validity (analyzing its correlation with the Tampa Scale of Kinesiophobia), its test-retest reliability, for which a subset of 40 participants completed again the questionnaire, and its internal consistency.

Results

Translation was conducted without any problems, and 107 participants completed the study. Mean scores for the Pain Self-Efficacy Questionnaire were 45.2 points (standard deviation, 11.4). The Pain Self-Efficacy Questionnaire showed a moderate negative correlation with the Tampa Scale of Kinesiophobia (Pearson's correlation index r = -0.48) supporting its convergent validity. High test-retest reliability (Intraclass Correlation Coefficient of 0.90) and excellent internal consistency (Cronbach's α value of 0.92) were also found.

Discussion

The Spanish version of the Pain Self-Efficacy Questionnaire presents high validity, test-retest reliability, and internal consistency to assess pain self-efficacy in patients suffering rotator cuff injuries in Spanish-speaking settings.

Does Telerehabilitation Help in Reducing Disability among People with Musculoskeletal Conditions? A Preliminary Study

Introduction: During the coronavirus pandemic, an initiative was launched in Saudi Arabia to provide telerehabilitation for people with musculoskeletal conditions who were unable to access in-person physiotherapy due to the associated lockdown. The purpose of this study was to explore the therapeutic impact and acceptability of telerehabilitation among the Saudi population. Methods: Ninety-five participants were recruited through an online advertisement and received a physiotherapy consultation and interventions via an online video conference platform (Google Meet). Following screening for red flags, participants received tailored education and conditioning exercises 2–3 times a week for 6 weeks. Outcome measures were recorded at baseline and 6 weeks and comprised the Pain Self-Efficacy Questionnaire, Patient-Specific Functional Scale, Musculoskeletal Health Questionnaire and a satisfaction survey. Results: The most frequent musculoskeletal conditions reported were lower back (37%), knee (14%) and neck (10%) pain and post-operative conditions (15%). Participants showed significant improvements in outcomes at the end of the program (p < 0.001) with effect sizes ranging from 0.6 to −1.9 and reported a high level of satisfaction with the telerehabilitation intervention. Conclusion: This study showed that telerehabilitation was an acceptable method of providing physiotherapy interventions for patients with musculoskeletal conditions in Saudi Arabia.