Translation, adaptation and validation of the Moroccan version of the Quebec Back Pain Disability Scale

Department of Physical Medicine and Rehabilitation, El Ayachi Hospital, University Hospital of Rabat-Sale, Sale, Morocco.
Clinical Rheumatology (Impact Factor: 1.77). 02/2012; 31(6):943-9. DOI: 10.1007/s10067-012-1961-0
Source: PubMed


This study aims to translate and cross-culturally adapt the Moroccan version of the Quebec Back Pain Disability Scale (QDS) and to investigate its reliability and validity in Moroccan patients with low back pain (LBP). The translation and cross-cultural adaptation of the QDS were developed in agreement with published guidelines. The QDS was translated by use of the forward and backward translation procedure. After pretest, it was validated in 64 Moroccan patients with LBP. The QDS was recorded twice, at baseline visit and 72 h later. Reproducibility was evaluated using intraclass correlation coefficient (ICC) and Bland and Altman method. Internal consistency was measured by Cronbach α coefficient. Ceiling and floor effects were assessed. Validity was measured by correlating the scores of the Moroccan QDS with visual analogue scale (VAS) for Pain, Disability VAS, Schober test, fingertip-floor measurement and the Moroccan version of the Roland Morris Disability Questionnaire (RMDQ) by means of the Spearman rank correlation coefficient. Association with gender and education level was also studied. Reliability was excellent with an ICC (type 2.1) of 0.959 (CI 95%: 0.934-0.975). The internal consistency was high with a Cronbach α of 0.979. The Bland and Altman method showed homogenous distribution of the differences, with no systematic trend. There were no floor or ceiling effects. The correlation between QDS and RMDQ was very good (r = 0.664; p ≤ 0.001). There was no correlation between QDS and the other variables. Accordingly, the Moroccan version of QDS has good reproducibility, internal consistency and validity for the assessment of disability in Moroccan-speaking patients with LBP.

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    ABSTRACT: Purpose Patient-reported outcome measurements (PROMs) are widely used in spine care. The development of reliable and valid National versions of spine-related disability questionnaires is strongly recommended from both the clinical and scientific points-of-view. The aims of this study were to adapt and validate the Oswestry Disability Index (ODI) and the Quebec Back Pain Disability Scale (QDS) for use with the Hungarian language. Methods After translating and culturally adapting the ODI and QDS, 133 patients with lumbar degenerative spinal disorder filled in the questionnaire booklet twice within 2 weeks. Subjects completed the Hungarian versions of the two PROMs as well as the WHOQoL-BREF validated as a general life quality questionnaire and Visual Analogue Scale of pain. Internal consistency, reliability and construct validity of the questionnaires were determined, as were the standard error of measurement (SEM) and minimal detectable change (MDC) scores. Results The Hungarian ODI consisted of one factor that showed good internal consistency (Cronbach-α 0.890). The QDS showed a four-factor structure with Cronbach-α values between 0.788 and 0.917. No significant floor or ceiling effects were observed. The test–retest analysis showed excellent reliability of the Hungarian ODI and QDS. The intraclass correlation coefficients (ICC) were 0.927 and 0.923, respectively. SEM values of 4.8 and 5.2 resulted in a MDC of 13 and 14 points in the Hungarian ODI and QDS, respectively. The correlation coefficient (r) between pain and ODI was 0.680 (p < 0.001) and the correlation between the ODI and the physical subscale of WHOQoL was also very good (r = −0.705, p < 0.001). The QDS total score and its four subscales correlated significantly with pain and with the physical subscale of WHOQoL (r > 0.4, p < 0.001). The level of disability measured by the Hungarian ODI and QDS was significantly higher in the surgical subgroup than in non-surgically treated patients (p < 0.001). Conclusions Translation and cultural adaptation of the ODI and QDS were successful. Hungarian versions of the ODI and QDS proved to be reliable, valid PROMs confirming that they can be used in future clinical and scientific work with Hungarian-speaking spine patients.
    Full-text · Article · Jan 2013 · European Spine Journal
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    ABSTRACT: Study Design: Cross cultural adaptation and psychometric testing.Objective: To conduct the cross-cultural adaptation of the Quebec Back Pain Disability Scale (QBPDS) and investigate its reliability and validity in patients with chronic low back pain (CLBP).Summary of Background Data: The QBPDS is one of the most commonly used scales to evaluate functional incapacity resulting from low back pain. Although measuring disability is an important outcome in physiotherapy care there is no previous research relating to the cultural adaptation and psychometric testing of the QBPDS in the Portuguese speaking population.Methods: The questionnaire was first translated and back translated following the published guidelines. The Portuguese version of the QBPDS was then piloted in a Portuguese sample of 40 patients with CLBP. Psychometric properties were evaluated in a new sample of 132 patients with CLBP. Exploratory factor analysis was performed in order to confirm its unidimensionality. Reliability was evaluated through internal consistency and reproducibility, using Cronbach's alpha and intraclass correlation coefficient (ICC2,1), respectively. Construct validity was assessed with correlations between the QBPDS and the Roland Morris Disability Questionnaire (RMDQ), and Visual Analogue Pain Scale (VAS) for convergent validity, and pain localization for discriminative validity, using Spearman's correlation analysis and the Mann- Withney Test.Results: Exploratory factor analysis revealed the existence of one major factor that explains the 52.1% of the variance. One week test- retest reliability was 0.7 and internal consistency was 0.95. The QBPDS correlated strongly with the RMDQ (0.62, p< 0.001), moderately with pain (0.38, p<0.001), and shows capability to discriminate between patients with localized and referred pain (U = 1218, p<0.0005).Conclusion: The reliability and construct validity of the Portuguese version of the QBPDS is acceptable to assess functional status of Portuguese speaking patients with CLBP.
    Full-text · Article · Jul 2013 · Spine