Adaptation and crosscultural validation of the foot impact scale for rheumatoid arthritis using Rasch analysis

Abstract

Objective. To adapt and crossculturally validate the Foot Impact Scale for Rheumatoid Arthritis (FIS-RA) using Rasch analysis. Methods. The FIS-RA was translated from English to German, Hungarian, and Dutch target languages and administered to 653 rheumatoid arthritis patients. Rasch analysis was undertaken on the impairment/footwear (FIS-RA IF ) and activity limitation/participation restriction subscales for each language version separately and for pooled data. Overall fit to the Rasch model, item and person fit, unidimensionality, differential item function (DIF), and local response dependency were tested. To meet Rasch model assumptions, item deletion, subtests analysis, and item-splitting strategies were adopted. Results. With the exception of the Hungarian FIS-RA IF subscale, preliminary fit to the Rasch model was unsuccessful for all target languages individually and for pooled data. Multidimensionality, misfitting items, local dependency, and DIF by age, sex, disease duration, and language were observed. With adjustment, fit to the Rasch model was satisfactorily achieved for all language versions. For the pooled data, the Rasch model assumptions for crosscultural validity were met following item deletion, subtest analysis, and item splitting for language DIF. Conclusion. With adaptations, the FIS-RA was successfully translated and crossculturally validated for use in 4 European languages. The 2 subscales can be used at the individual level for patient assessment and at the group level for research purposes.

The foot function index is more sensitive to change than the Leeds Foot Impact Scale for evaluating rheumatoid arthritis patients after forefoot or hindfoot reconstruction

“…The Leeds Foot Impact Scale for Rheumatoid Arthritis (LFIS-RA) described by Helliwell et al is a PROM used to measure the outcome (impairment and activity limitations) in RA patients with foot deformities, in mostly eastern Europe countries, including England, Germany, Hungary and the Netherlands [14]. Initial results showed good psychometric properties [15].…”

Prevalence of foot problems in people with inflammatory arthritis in Singapore

“…Others such as the Foot Function Index, a generic foot scale, has undergone successful cross-cultural validation in several languages including Dutch, German and Taiwan Chinese [ 45 – 47 ]. The Leeds Foot Impact Scale is disease-specific, has been translated to Dutch, German and Hungarian [ 48 ]. Singapore’s majority population is Chinese and many older Singaporeans are not sufficiently proficient in the English language to enable questionnaire data to be collected without the aid of a translator.…”

Measures of Foot Pain, Foot Function, and General Foot Health

“…However, the original validation did not include strict tests of unidimensionality. In a subsequent adaptation and cross‐cultural validation study, the original UK version demonstrated multidimensionality and limited fit to the Rasch model, but adaptation satisfactorily resolved these violations of the Rasch model .…”

“…The LFIS‐RA can be viewed in an appendix to an article describing its translation and cross‐cultural validation for use in four European languages . Users are required to register use with the University of Leeds (Leeds, UK) at https://eprovide.mapi-trust.org/instruments/leeds-foot-impact-scale-for-rheumatoir-arthristis.…”