TRANSLATION AND CROSS-CULTURAL ADAPTATION OF THE LOWER EXTREMITY FUNCTIONAL SCALE INTO HINDI VERSION AND VALIDATION ON INDIAN VETERAN RUNNERS

R. Sharma¹, J.K. Chawla¹, M. Garg¹, P. Kumar¹

¹Amity University, Amity Institute of Physiotherapy, Noida, India

Background: Increasing number and incidence of musculoskeletal injuries amongst runners is a major health concern. Running, in excess, can predispose the weight-bearing lower extremities, especially the knee joint to repetitive stress thereby causing injuries and development of osteoarthritis. Patient-reported outcome measures are being increasingly used in clinical practice and there is a requirement for a validated outcome measure in Hindi language. The Lower Extremity Functional Scale (LEFS) and WOMAC (Western Ontario and McMaster Universities Arthritis Index) are one of the most commonly used patient outcome-related scoring system. Therefore, the current study was designed with the intent to test and validate the scales measuring the lower extremity function of the Indian population with Hindi as their native language.

Purpose: The current study was designed to test and validate cross-cultural adaptation and translated Hindi version of LEFS among veteran Indian runners.

Methods: The Hindi version of the LEFS was formulated as per recommendations for cross-cultural adaptation and translation. LEFS was tested on 86 Indian runners above 40 years of age using standard forward and backward translation protocol. The validity was assessed using LEFS Hindi and WOMAC. Reliability was documented by calculating internal consistency, test-retest reliability.

Results: The translation was performed with no major difficulty. The Hindi version of LEFS shows good internal consistency, construct validity, high level of association with other outcome measures. Internal consistency and test-retest – reliability was done using Cronbach’s alpha for the English version it was (0.97). the internal consistency of the E-LEFS was considered good. The ICC value was 0.97 (95%, CI, 0.95-0.98), indicating that the E – LEFS has good test–retest reliability. The SEM and MDC95 were 3.3 and 9.2 respectively. To find the correlation between the 2 versions of LEFS and other self-reported outcome measures we used Karl – Pearson Coefficient There is a positive correlation between WOMAC total, English, and Hindi LEFS scores (r = .86, r= .87).

Conclusions: Translated Hindi version of LEFS has a good equivalence(0.97) and is found to be fit to be used in further assessing the functional status of the targeted population.

Implications: Long-term exposure of running can have a detrimental impact on the joint structures which makes it important to constantly monitor the functional status and outcome of health interventions. The translated scale will serve as a patient-centric self-assessment tool that will add value in assessment and monitoring the functionality index in various musculoskeletal conditions. Further, the study provides a valuable basis for the conduct of studies concerning patient self-assessed scores in Asian languages in various clinical practices.

Funding acknowledgements: Nil.

Keywords:
Lower extremity functional scale
veteran runners
cross-cultural adaptation

Topics:
Musculoskeletal: lower limb
Research methodology, knowledge translation & implementation science
Sport & sports injuries

Did this work require ethics approval? Yes

Institution: Amity Institute of Physiotherapy

Committee: Institutional Ethics Committee, Amity University, Noida, Uttar Pradesh

Ethics number: NTCC/MPT-Sports/22-23/July 2022/22 and CTRI/2022/09/045904