Cross-Cultural Adaptation and Clinimetric Testing of Functional Rating Index (FRI) Outcome Measure into the Arabic Language

Abstract

Background. The Functional Rating Index (FRI) is a self-report scale widely used to determine the level of disability in low back pain (LBP) populations. Objectives. This study was aimed at conducting the cross-cultural adaptation of the FRI-Arabic version (FRI-Ar) and testing the clinometric properties of FRI-Ar. Methods. The cross-cultural adaptation process was used to develop the FRI-Ar. This study included acute and subacute LBP patients. Each patient was asked to complete the questionnaires at three time points: baseline, 24-hour follow-up, and two-week follow-up. The questionnaires used were FRI-Ar, Roland-Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), Numerical Pain Rating Scale (NPRS), Global Perceived Effect Scale (GPE), and Patient-Specific Functional Scale (PSFS). Statistical analysis was carried out to measure the instrument’s reliability, validity, and responsiveness. Results. The FRI was cross-culturally adapted to the Arabic language, and the adapted version was validated. Two hundred patients completed the questionnaires at the baseline; however, 120 patients completed the questionnaires at 24-hour and two-week follow-up. Cronbach’s alpha, interclass correlation coefficient (ICC2,1), standard error of measurement (SEM), and minimal detectable change (MDC95%) for the FRI-Ar were observed as 0.85, 0.85, 1.17 (2.9%), and 3.24, respectively. The FRI-Ar showed a moderate positive correlation only with the RMDQ, ODI, and NPRS ( p < 0.05 ). Also, it showed the responsiveness with a small effect size ( ES = 0.29 ) and standardized response mean ( SRM = 0.44 ). Conclusion. The FRI-Ar was developed, and it showed good reliability and validity. However, it revealed the responsiveness with the small change. It can evaluate both pain and functional limitations in acute and subacute LBP patients. Before using it in the Arabic population with acute and subacute LBP, it is recommended to conduct further research to test internal and external responsiveness using an external criterion with a more extended follow-up period and suitable interventions.

Developing a Content Model of a Mobile-Based Application to Manage Patients with Low-Back and Neck Pain

“…In the clinical guidelines for neck pain of the American Physical Therapy Association, exercise and patient education are recommended [ 47 ]. The recommendations of the guidelines confirm the findings of the current study on physiotherapy data [ 44 , 47 ]. Also, various studies have investigated the effectiveness of various web-based systems for performing physiotherapy exercise programs at home and the use of apps to train patients, which have had positive results [ 48 , 49 ].…”

“…The FRI was developed by Feise and Menke in 2001, and its validity and reliability have been confirmed in several languages. It is a 5-point Likert scale from 0 (no pain) to 4 (worst possible pain) [ 43 , 44 ]. The Persian version of this scale was translated by Dr. Ansari et al, in 2012, which has sufficient validity and reliability [ 42 ].…”

“…The data elements of this axis were selected based on the FRI scale. It is useful for evaluating pain intensity and can report 10 International Journal of Telemedicine and Applications a patient's condition [43,44]. Currently, pain intensity measures are widely used as valuable tools for researchers, physicians, patients, and payers.…”

Arabic-Translated Versions of Patient-Reported Outcome Measures Utilized in Spine Research: A Review of Validated Studies

“…Low Back Pain Roland-Morris Disability Questionnaire RMDQ [19,24] Fear Avoidance Beliefs Questionnaire FABQ [20,27] Back Beliefs Questionnaire BBQ [26,28] Quebec Back Pain Disability Scale QBPDS [21] Oswestry Disability Index ODI [23] Japanese Orthopaedic Association Back Pain Evaluation Questionnaire JOA-BPEQ [29] STarT Back Tool SBT [32] Core Outcome Measures Index COMI [35] Bournemouth questionnaire BQ [36] Tampa Scale of Kinesiophobia TSK [37] Back Pain Attitudes Questionnaire Back-PAQ [41] Low Back Pain Knowledge Questionnaire LBP-KQ [42] Low Back Pain Treatment Beliefs Questionnaire LBP-TBQ [43] Functional Rating Index FRI [44] Orebo Musculoskeletal Pain Questionnaire OMPQ [46] Pain Self-Efficacy Questionnaire PSEQ [48] Neck Pain and Cervical Myelopathy Modified Japanese Orthopaedic Association Cervical Myelopathy Score mJOA-CMS [38,39] Neck Disability Index NDI [22] Copenhagen Neck Functional Disability Scale CNFDS [31] Spine Pain McGill Pain Questionnaire-Short Form MPQ-SF [30] Scoliosis Scoliosis Research Society Questionnaire-22 SRS-22 [25] Early Onset Scoliosis 24 Items Questionnaire EOS-24 [34] Italian Spine Youth Quality of Life ISYQOL [40] Scoliosis Research Society Questionnaire-30 SRS-30 [45] Spinal Cord Injury Patient Health Questionnaire-9 PHQ-9 [33] Neurogenic Bladder Symptoms Score-Short Form NBSS-SF [47] The results of the quality assessment of the CCA are summarized in Table 3. Most studies had good ratings in initial translation (83%), synthesis (77%), back translation (87%) and expert committee review (83%).…”

“…Initial Translation 25(83%) [19,20,22,[24][25][26][27][28][30][31][32][34][35][36][38][39][40][41][42][43][44][45][46][47][48] 2(7%) [23,29] 3(10%) [21,33,37] Synthesis 23(77%) [19,22,24,[26][27][28][30][31][32][34][35][36][38][39][40][41][42][43][44][45][46][47][48] ...…”