Cross-cultural adaptation and psychometric testing of the Arabic version of the Modified Low Back Pain Disability Questionnaire

Abstract

BackgroundThe Modified Oswestry Low Back Pain Disability Questionnaire (MODQ) is used for evaluating the functional disability in patients with low back pain (LBP). However, the measurement characteristics of the MODQ among Arab patients are unknown. In this study, we aimed to translate and cross-culturally adapt the MODQ into Arabic and evaluate its psychometric properties. MethodsAn Arabic version of the MODQ was developed through forward translation, translation synthesis, and backward translation. Sixty-eight patients (55 males and 13 females) with a mean age 37.01 ± 7.57 years were recruited to assess its psychometric properties. Reliability was evaluated using internal consistency (Cronbach's α), test retest reliability (utilizing intraclass correlation coefficient [ICC]), standard error of measurement (SEM), minimal detectable change at 95% confidence level (MDC 95% ), and 95% limits of agreement (LOA). The construct validity was investigated by correlating the new translation with four other measures of LBP (using Spearman's rho). Finally, receiver operating characteristic curve was constructed to compute the sensitivity, using the area under the curve (AUC), and the minimum important change (MIC). An alpha level of 0.05 was set for statistical tests and all the psychometric values were tested against a priori hypotheses. ResultsThe culturally aligned MODQ showed good internal consistency (Cronbach's α = 0.85). The ICC, SEM, MDC 95% , and LOA between baseline and two days later were 0.98, 1.60, 4.43, and -4.23 to 7.70, respectively, while the values between baseline and 14 days later were PLOS ONE PLOS ONE | https://doi.

Urdu Version of Oswestry Disability Index; A Reliability and Validity Study

“…(1,14,17,35,42). In present study, mean age of patients was 39.7 years, that is quite similar (36-40 years) to the previous research studies (1,14,32,55) but in contrast few studies have enrolled patients with slightly higher mean age (40-52 years) (17,35,42,52) In the present study, internal consistency was found to be excellent with 0.89 Cronbach's alpha value, which is also in the range of results of previous studies (0.75-0.99) (3,36,47,(56)(57)(58)(59)(60)(61) The item total correlation between single item and total score of ODI-U ranged between 0.51-0.76 which is quite similar to the ndings of German version of ODI (0.58-0.72). (62) However, in the study of Liu et al (Chinese ODI version) the item total correlation was reported as slightly high (0.59-0.83).…”

“…The current study has recruited more males 61 (56.45%) than females 47 (44%) which is comparable to the previous studies (54-80%) (32,52,55). However many studies have recruited more females (52-66%) than males.…”

“…No oor and ceiling effect of ODI-U total score were observed, showing good content validity which is also indicating appropriate reliability. (27,32) As shown in Table-5, there was a signi cant difference in ODI-U total scores between healthy participants and patients (P<0.001) demonstrating signi cant construct (discriminative) validity. However, the construct (convergent) validity between ODI-U and other scales was moderate when calculated through Pearson's correlation coe cient.…”

“…(30) Spearman rank correlation coe cient values were interpreted as little or no relationship, fair, moderate and excellent relationship with values <0.25, 0.25-0.50, 0.50-0.75 and ≥ 0.75, respectively. (31,32) Measurement error was calculated through Standard error of measurement (SEM) and smallest detectable change (SDC). The formulas used to calculate SEM and SDC are SEM = SD × √ 1 -ICC (31) and SDC = 1.96 × √2 × SEM, (33) respectively.…”

“…The instrument is considered more reliable if the value of SEM is less. (32) SEM values ≤ 2.15-6.5 (32,(34)(35)(36)(37)(38)(39)and SDC values between ≤ 6-13.7 (32,(40)(41)(42)are considered to be acceptable.…”