Measurement properties of the 15-item Arabic lower extremity functional scale

Responsiveness and Minimal Important Change of the Arabic Disabilities of the Arm, Shoulder and Hand (DASH) in Patients with Upper Extremity Musculoskeletal Disorders

The aim of this study was to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand (DASH) and to quantify its minimal important change (MIC) for improvement. People with upper extremity musculoskeletal problems who were receiving physical therapy were evaluated at baseline and again during a follow-up appointment, with a median time frame of 7 days between the two testing sessions (range of 6 to 72 days). The participants completed the Arabic DASH, Global Assessment of Function (GAF), Numeric Pain Rating Scale (NPRS) and Global Rating of Change Scale (GRC). The responsiveness of the Arabic DASH was assessed by examining the pre-specified hypotheses. The MIC for improvement was determined using the receiver operating characteristic method (MICROC) and the predictive modeling method (MICpred). As hypothesized, a change in the Arabic DASH demonstrated a significant positive correlation with changes in the GAF (r = 0.69), NPRS (r = 0.68) and GRC (r = 0.73). Consistent with our hypotheses, the DASH change scores could be used to differentiate between participants who improved and those who did not improve (area under the receiver operating characteristic curve = 0.87), and they showed a large magnitude of change (effect size = 1.53, standardized response mean = 1.42) in patients who improved. All the hypotheses specified a priori were supported by the results. The Arabic DASH MICROC and MICpred were estimated to be 14.22 and 14.85. The interaction between the DASH change and baseline score was not a significant predictor of status (improved vs. not improved) (p = 0.75), indicating that the DASH MIC was not baseline-dependent. The Arabic DASH demonstrated sufficient responsiveness, supporting the idea that the Arabic DASH is capable of detecting changes in upper extremity function over time. The value of the Arabic DASH MIC was similar when estimated using the predictive modeling and ROC methods, and the MIC was not dependent on baseline status.

Responsiveness of the Arabic Quick Disabilities of the Arm, Shoulder and Hand in Patients with Upper Extremity Musculoskeletal Disorders

This study aimed to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand short version (Quick-DASH) in patients with upper extremity musculoskeletal disorders. Participants with upper extremity musculoskeletal disorders (N = 88) under physical therapy care were assessed at initial visit and later at a follow-up visit, and they completed the Arabic Quick-DASH, DASH, Numeric Pain Rating Scale (NPRS), Global Assessment of Function (GAF), and the Global Rating of Change Scale (GRC). Responsiveness of the Arabic Quick-DASH was assessed by examining six pre-defined hypotheses. Consistent with the pre-defined hypotheses, the Arabic Quick-DASH changes scores exhibited significant positive correlation with the change in DASH (r = 0.98), GAF (r = 0.67), NPRS (r = 0.72), and the GRC (r = 0.78). As hypothesized, the Arabic Quick-DASH showed a large effect size above the pre-determined level (ES = 1.61, SRM = 1.49) in patients who reported improved upper extremity function. The Arabic Quick-DASH change score discriminated between patients who reported improvement versus no improvement in upper extremity function (area under the receiver operating characteristic curve = 0.90). The results supported 100% (six out of six) of the pre-defined hypotheses. The Arabic Quick-DASH demonstrated sufficient responsiveness where all the pre-defined hypotheses were supported, leading to the established validity of the Arabic Quick-DASH change score as a measure of change in upper extremity function and symptoms. The minimal importance change in the Arabic Quick-DASH needs to be determined in future studies.

Cross-cultural validation of the Lower Extremity Functional Scale in Serbian postmenopausal women with knee osteoarthritis

OBJECTIVE

Translation and cross-cultural validation of the Serbian version of the Lower Extremity Functional Scale (Srb-LEFS).

METHODS

This prospective cross-sectional study initially included 186 postmenopausal women aged 60 to 75 years who underwent an x-ray examination of both knees, along with body mass, body height, waist circumference, knee range of motion, and blood pressure measurements. The laboratory analyses included the evaluation of fasting glucose levels and lipid profile. All participants completed the LEFS, Lequesne index, and 36-Item Short-Form Survey-RAND.

RESULTS

The analyses revealed good internal consistency (α = 0.95), good test-retest reliability, and a two-factor structure of the Srb-LEFS. Concurrent validity analysis confirmed a significant positive correlation between Srb-LEFS scores and the 36-Item Short-Form Survey-RAND Physical Functioning subscale ( r = 0.889, P < 0.0001), the Lequesne index ( r = -0.976, P < 0.0001), and the Numeric Rating Scale for pain ( r = -0.762, P < 0.0001). Convergent validity analyses revealed a statistically significant negative correlation between the Srb-LEFS scores and age ( r = -0.25, P = 0.006), body mass index ( r = -0.31, P < 0.01), and waist circumference ( r = -0.37, P < 0.0001). The Srb-LEFS scores were statistically significantly higher among participants that reported moderate physical activity levels, as well as those that had fewer comorbidities, minor structural knee damage, greater knee range of motion, and greater quadriceps femoris muscle strength.

CONCLUSIONS

The Serbian version of the LEFS is feasible, valid, and reliable for use in both clinical practice and clinical studies to assess self-reported physical functioning in older individuals with knee osteoarthritis.

Responsiveness of the Arabic Upper Extremity Functional Index in Patients with Upper Extremity Musculoskeletal Disorders

The aim of this study was to examine the ability of the Arabic Upper Extremity Functional Index (UEFI) to detect change over time in upper extremity function (responsiveness) in patients with upper extremity musculoskeletal disorders. Patients receiving physical therapy care for their upper extremity musculoskeletal disorders completed the Arabic UEFI; Disabilities of the Arm, Shoulder and Hand (DASH); Numeric Pain Rating Scale (NPRS); Global Assessment of Function (GAF); and the Global Rating of Change Scale (GRC) at the initial visit and later at a follow-up assessment. Responsiveness was examined by testing predefined hypotheses regarding the correlations between the change scores in the Arabic UEFI and the other measures. The Arabic UEFI change scores demonstrated a significant positive correlation with the change in the DASH (r = 0.94), GAF (r = 0.65), NPRS (r = 0.63), and GRC (r = 0.73), which was in line with the predefined hypotheses. The Arabic UEFI change scores demonstrated a pattern of correlation with changes in other outcome measures that are consistent with the argument that the Arabic UEFI change scores represent a change in upper extremity function. The responsiveness of the Arabic UEFI was supported, and its use to monitor changes in upper extremity function in patients with upper extremity musculoskeletal disorders was supported.

Cross-cultural adaptation and validation of the Arabic version of the upper extremity functional index

PURPOSE

The purpose of this study was to translate and cross-culturally adapt the UEFI into Modern Standard Arabic language and to examine its psychometric properties among patients with upper extremity musculoskeletal disorders.

MATERIALS AND METHODS

Translation and cross-cultural adaptation were done following Beaton's guidelines. Internal consistency, test-retest reliability, measurement error and floor and ceiling effects for the Arabic UEFI were tested among 109 patients with upper extremity musculoskeletal disorders. Construct validity of the Arabic UEFI was also examined.

RESULTS

Translation and cross-cultural adaptation processes were generally smooth with no major issues. The Arabic UEFI was considered appropriate and comprehensible by the participants. Internal consistency for Arabic UEFI was adequate (Cronbach's alpha = 0.96). Test-retest reliability for Arabic UEFI was excellent with ICC_2,1=0.92. Measurement error was acceptable with a standard error of measurement of 5.5 and minimal detectable change of 12.8 points. Arabic UEFI shows no floor or ceiling effects. The results supported the majority of the construct validity predefined hypotheses (78%) supporting the construct validity of Arabic UEFI as a measure of upper extremity function.

CONCLUSION

The Arabic UEFI is an appropriate, valid and reliable outcome measure for Arabic-speaking patients with upper extremity musculoskeletal disorders.Implication for Rehabilitation:The Arabic UEFI is an acceptable, clear and comprehensible outcome measure.The Arabic UEFI has excellent internal consistency, test-retest reliability, and acceptable measurement error with no floor and ceiling effects.The Arabic UEFI is a valid measure of upper extremity activity limitation.

Validity and reliability of the Arabic quick disabilities of the arm, Shoulder and Hand (QuickDASH-Arabic)

BACKGROUND

The QuickDASH is a commonly used upper extremity region-specific outcome measure assessing activity limitation and symptoms. The Arabic version of QuickDASH is available in the official outcome measure website, but no prior studies have examined its psychometric properties.

OBJECTIVE

To examine the psychometric properties of the Arabic QuickDASH in patients with upper extremity musculoskeletal disorders.

METHODS

Participants with upper extremity musculoskeletal disorders were recruited (N = 109) using convenience sampling and completed the Arabic QuickDASH, Numeric Pain Rating Scale, Global Assessment of Function, and RAND 36-item Health Survey in two testing sessions (2-7 days apart). The Arabic QuickDASH structural validity, internal consistency, floor and ceiling effect, test-retest reliability, measurement error, and construct validity were examined.

RESULTS

Exploratory factor analysis indicated a one factor underlying the Arabic QuickDASH. The Arabic QuickDASH had Cronbach's alpha of 0.90 and ICC_2.1 of 0.91 indicating excellent internal consistency and test-retest reliability. None of the participant reached the minimum or the maximum score. The scale's standard error of measurement and minimal detectable change were 7.0 and 16.3. Five out of the six construct validity predefined hypotheses were supported by the results.

CONCLUSION

The Arabic QuickDASH is a unidimensional scale with excellent internal consistency, test-retest reliability and acceptable measurement error. The Arabic Quick DASH is a valid and reliable outcome measure that can be used in Arabic speaking countries with Arabic patients suffering from various upper extremity activity limitations and symptoms.

Cross-cultural adaptation and measurement properties of the Arabic version of the Patient-Specific Functional Scale in patients with lower extremity musculoskeletal disorders

PURPOSE

To cross-culturally adapt the Patient-Specific Functional Scale (PSFS) into Arabic language and to examine its measurement properties in patients with lower extremity musculoskeletal disorders.

MATERIALS AND METHODS

The original English version of the PSFS was cross-culturally adapted into modern standard Arabic language following Beaton's guidelines. Patients with lower extremity musculoskeletal disorders (N = 116) were recruited to examine the test-retest reliability, measurement error, floor and ceiling effects, and construct validity of the Arabic PSFS. Construct validity was tested by examining eight predefined correlational hypotheses.

RESULTS

Participants in the current study indicated that the Arabic PSFS was clear and understandable. The Arabic PSFS had very good test-retest reliability (ICC = 0.86) with no floor or ceiling issues. The standard error of measurement and the minimal detectable change of the Arabic PSFS were 0.64 and 1.49 points respectively indicating acceptable measurement error. The majority of the predefined construct validity hypotheses (75%) were supported by the results justifying the construct validity of the Arabic PSFS.

CONCLUSIONS

The Arabic PSFS is a comprehensible and easy to use measure. The Arabic PSFS has very good test-retest reliability, acceptable measurement error, and evidence supporting its construct validity as measure of activity limitation in patients with lower extremity musculoskeletal disorders.Implications for rehabilitationRehabilitation specialist can confidently interpret patient's score in the Arabic PSFS to represent the extent of activity limitation.Patients with unchanged clinical status will have similar scores in the Arabic PSFS with repeated administrations of the scale over time.The Arabic PSFS can be used in daily clinical practice and in research studies to measure activity limitation in Arabic-speakers with lower extremity musculoskeletal disorders.The Arabic PSFS enables rehabilitation specialist to quantify activity limitation in a way that is relevant to the culture and life style of Arabic-speakers.