Central Sensitisation Inventory-Thai version: translation, cross-cultural adaptation, and psychometric evaluation in chronic non-specific neck pain

PURPOSE

To translate and cross-culturally adapt the English version of the Central Sensitisation Inventory (CSI) into Thai (CSI-Thai) and to evaluate its psychometric properties in individuals with chronic non-specific neck pain.

MATERIALS AND METHODS

Cross-cultural translation and adaptation of the CSI were performed according to standard guidelines. A total of 340 participants were invited to complete the CSI-Thai, Visual Analogue Scale (pain intensity), Neck Disability Index, Fear-Avoidance Beliefs Questionnaire, Pain Catastrophising Scale (PCS), and Short Form-36. Psychometric evaluation included confirmatory factor analysis, internal consistency, test-retest reliability, agreement, and construct validity.

RESULTS

Dimensionality analyses indicated that a bifactor model, comprising one general factor plus four orthogonal factors, fit the CSI structure better than unidimensional and the four-factor models. The general factor showed substantial reliability (Cronbach α = 0.91, Omega ω = 0.94, and omega hierarchical ω-h = 0.91). The intraclass correlation coefficient was 0.90, representing excellent stability over a 48 h interval. Moderate-to-strong correlations and acceptable-to-excellent discriminations were found between the CSI-Thai and all questionnaires. The exception was the PCS (no correlation and discrimination). The standard error of measurement and minimal detectable change of the CSI-Thai were 2.33 and 6.47, respectively.

CONCLUSIONS

The translation and cross-cultural adaptation of the CSI-Thai were successful, with satisfactory reliability and construct validity.Implications for rehabilitationCentral Sensitisation Inventory-Thai version (CSI-Thai) is successfully adapted and demonstrated satisfactory reliability and construct validity.The CSI-Thai can be applicable to assess central sensitisation-related signs and symptoms in Thai-speaking patients with chronic non-specific neck pain (CNSNP) both clinical and research purposes.The CSI-Thai correlated to pain, disability and quality of life among patients with CNSNP.

Translation, cross-cultural adaptation and psychometric validation of the Thai version of the STarT Back Screening Tool in patients with non-specific low back pain

BACKGROUND

Low back pain (LBP) is a top musculoskeletal problem and a substantial cause of socioeconomic burden internationally. The STarT Back Screening Tool (SBST) is a useful screening tool to manage patients with LBP but it is unavailable in Thai. Therefore, the aims of this study were to translate and cross-culturally adapt the SBST into a Thai version (SBST-TH) and validate its psychometric properties (e.g., factor analysis, internal consistency, test-retest reliability, agreement, convergent validity and discriminative validity).

METHODS

Translation and cross-cultural adaptation of the SBST into Thai version were conducted according to standard guidelines. A total of 200 participants with non-specific LBP were invited to complete the SBST, visual analogue scale for pain intensity, Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire, pain catastrophising scale, hospital anxiety and depression scale and the EuroQol five-dimensional questionnaire. Thirty participants completed the SBST-TH twice with an interval of 48 h to evaluate test-retest reliability.

RESULTS

Factor analysis demonstrated two (physical and psychological) components for the SBST-TH (39.38% of the total variance). The Cronbach's alpha (0.86 for total score and 0.76 for psychosocial subscore) represent satisfactory internal consistency. The acceptability of intraclass correlation coefficient was found in the total (0.73) and subscore (0.79). The areas under the curve (AUC) for the total score ranged 0.67-0.85 and 0.66-0.75 for subscore. The excellent discriminative validity was observed (AUC = 0.85, 95% confidence interval = 0.72, 0.97) between the total score of the SBST-TH and disability (RMDQ). Spearman's correlation coefficients represented moderate to strong correlation (0.32-0.56) between the SBST-TH and all questionnaires. The findings suggest a good relationship between the SBST-TH and disability and quality of life. Owing to the results from the convergent and discriminative validity, construct validity of the SBST-TH can be supported. The minimal detectable changes of the total score and subscore were 2.04 and 1.60, respectively. Significant floor and ceiling effects were not found in the SBST-TH.

CONCLUSION

The SBST-TH was successfully translated and adapted. It is a valid and reliable tool to classify Thai patients with non-specific LBP into low, moderate and high risks for chronicity.

TRIAL REGISTRATION

TCTR20191009005 #.

Translation, cross-cultural adaptation and psychometric evaluation of the Thai version of the fear-avoidance beliefs questionnaire in patients with non-specific neck pain

OBJECTIVES

Fear-avoidance beliefs questionnaire (FABQ) is a self-report, valid and reliable questionnaire to quantify fear and avoidance beliefs related to physical activity and work. Furthermore, it can be used to predict prolong disability in patients with non-specific neck pain. Although it was originally developed to manage patients with low back pain, it has also been studied in individuals with neck pain. This questionnaire was translated into several languages following reports of potential benefits in patients with neck pain. Recently, Thai neck clinical trials, international multi-centre trials and data sharing are growing throughout the world but no validated Thai version of the FABQ is available for clinical and research uses. Our objectives were to translate and cross-culturally adapt the FABQ into Thai version and evaluate its psychometric properties in Thai patients with non-specific neck pain.

METHODS

Cross-cultural translation and adaptation of the FABQ were conducted according to standard guidelines. A total of 129 participants with non-specific neck pain were invited to complete the Thai versions of the FABQ (FABQ-TH), neck disability index and visual analogue scale for pain intensity. Psychometric evaluation included exploratory factor analysis, internal consistency, test-retest reliability, agreement, and convergent validity. Thirty participants completed the FABQ-TH twice with a 48-h interval between tests to assess the test-retest reliability.

RESULTS

Factor analysis identified four components for the FABQ-TH (66.69% of the total variance). The intraclass correlation coefficient of test-retest reliability was excellent for the total score (0.986), work attitudes (0.995), physical activity attitudes (0.958), physical activity experiences (0.927), and expected recovery (0.984). Cronbach's alpha for internal consistency was excellent (range 0.87-0.88) for all items. The minimal detectable change of the FABQ-TH was 5.85. The FABQ-TH correlated to its subscales (range 0.470-0.936), indicating the strongest association with work attitude. The weakest correlation was observed between the FABQ-TH and disability (r _s =0.206, p=0.01). Missing data and significant floor or ceiling effects were not found.

CONCLUSIONS

The Thai version of the FABQ for non-specific neck pain was successfully adapted. It is a valid and reliable instrument to quantify fear and avoidance beliefs among patients with non-specific neck pain who speak and read Thai.