Translation, Cultural Adaptation and Validation of the Nurick Scale Into Portuguese

Abstract

Introduction: Degenerative cervical myelopathy stands as the primary non-traumatic cause of spinal cord dysfunction in adults. Neurological assessment tools rooted in functionality, such as the Nurick scale and the Japanese Orthopaedic Association Score (JOA), are commonly employed. The latter was revised and culturally adapted to Western norms by Chiles et al. in 1999, resulting in the modified JOA score (mJOA). This study aims to translate, cross-culturally validate, and assess the reproducibility of the Nurick scale into Brazilian Portuguese among patients with cervical degenerative myelopathy. Material And Methods: This study comprised two phases: initial translation, back-translation, final version assessment, and application test evaluation. A total of 70 individuals were evaluated, with 36 in the cervical myelopathy group and 34 in the control group. Subsequently, both groups underwent assessment using the mJOA and the NURICK-BRAZIL version, with data collection following. Data analysis employed Mann-Whitney tests and Spearman’s correlation tests. Analyses were executed using the statistical package R, with a significance level set at 5%. Results: Mann-Whitney comparison tests revealed significant differences in the NURICK-BRAZIL scale between the control and patient groups. Spearman’s correlation coefficient indicated a robust negative correlation between the NURICK-BRAZIL and mJOA scales. These findings suggest that the adapted Nurick scale in Brazilian Portuguese (NURICK-BRAZIL) holds potential for validation in evaluating patients with degenerative cervical myelopathy. Conclusion: The translation, adaptation, and validation of the original Nurick scale in Brazilian Portuguese (NURICK-BRAZIL) demonstrate similarity, applicability, good comprehension, and significant potential for widespread utilization as a valuable clinical and scientific evaluation tool for cervical myelopathy patients. Level of evidence III; Case-control study.