Abstract
Introduction
The Lower Extremity Functional Scale is a widely used questionnaire to evaluate the functional impairment in lower extremities. To date, the Lower Extremity Functional Scale has not been translated into Turkish. The aim of this study is to translate and culturally adapt the Lower Extremity Functional Scale into a Turkish version, and evaluate the psychometric properties of this version in patients with knee injuries.
Materials and methods
The translation of the English version of the Lower Extremity Functional Scale into a Turkish version was performed using standard guidelines. Validity and reliability of Turkish version were tested in 134 patients with knee injuries. Association level between other outcomes measures (Kujala Patellofemoral Score, the Western Ontario and McMaster Universities Osteoarthritis Index, Lysholm Knee Scoring Scale and a Visual Analog Scale) and Turkish version of the Lower Extremity Functional Scale was analyzed to assess validation. Participants completed the questionnaire at baseline and after 2 days to test reliability.
Results
The Turkish version of the Lower Extremity Functional Scale was showed a high degree of internal consistency (Cronbach α = 0.93). ICCs were 0.96 and no floor or ceiling effects. The Lower Extremity Functional Scale had a high level of association with the Kujala Patellofemoral Score (r = 0.82), Lysholm Knee Scoring Scale (r = 0.80) and the Western Ontario and McMaster Universities Osteoarthritis Index scores (r = 0.69) (all, p < 0.05).
Conclusion
The Turkish version of the Lower Extremity Functional Scale is a valid and reliable questionnaire that can be used to evaluate functional status in Turkish speaking patients with different knee disorders.
Level of evidence: III.
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References
Metsavaht L, Leporace G, Riberto M, Sposito MM, Del Castillo LN, Oliveira LP, Batista LA (2012) Translation and cross-cultural adaptation of the lower extremity functional scale into a Brazilian Portuguese version and validation on patients with knee injuries. J Orthop Sports Phys Ther 42(11):932–939. doi:10.2519/jospt.2012.4101
Guccione AA, Mielenz TJ, Devellis RF, Goldstein MS, Freburger JK, Pietrobon R, Miller SC, Callahan LF, Harwood K, Carey TS (2005) Development and testing of a self-report instrument to measure actions: outpatient physical therapy improvement in movement assessment log (OPTIMAL). Phys Ther 85(6):515–530
Horn KK, Jennings S, Richardson G, Vliet DV, Hefford C, Abbott JH (2012) The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure. J Orthop Sports Phys Ther 42(1):30–42. doi:10.2519/jospt.2012.3727
Pereira LM, Dias JM, Mazuquin BF, Castanhas LG, Menacho MO, Cardoso JR (2013) Translation, cross-cultural adaptation and analysis of the psychometric properties of the lower extremity functional scale (LEFS): LEFS- BRAZIL. Braz J Phys Ther 17(3):272–280
Hoogeboom TJ, de Bie RA, den Broeder AA, van den Ende CH (2012) The Dutch Lower Extremity Functional Scale was highly reliable, valid and responsive in individuals with hip/knee osteoarthritis: a validation study. BMC Musculoskelet Disord 13:117. doi:10.1186/1471-2474-13-117
Hernandez-Sanchez S, Hidalgo MD, Gomez A (2011) Cross-cultural adaptation of VISA-P score for patellar tendinopathy in Spanish population. J Orthop Sports Phys Ther 41(8):581–591. doi:10.2519/jospt.2011.3613
Tuzun EH, Eker L, Aytar A, Daskapan A, Bayramoglu M (2005) Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 13(1):28–33. doi:10.1016/j.joca.2004.10.010
Celik D, Coskunsu D, Kilicoglu O (2013) Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res 471(8):2602–2610. doi:10.1007/s11999-013-3046-z
Kuru T, Dereli EE, Yaliman A (2010) Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthop Traumatol Turc 44(2):152–156. doi:10.3944/AOTT.2010.2252
Alcock GK, Werstine MS, Robbins SM, Stratford PW (2012) Longitudinal changes in the lower extremity functional scale after anterior cruciate ligament reconstructive surgery. Clin J Sport Med 22(3):234–239. doi:10.1097/JSM.0b013e31824cb53d
Binkley JM, Stratford PW, Lott SA, Riddle DL (1999) The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther 79(4):371–383
Pua YH, Cowan SM, Wrigley TV, Bennell KL (2009) The Lower Extremity Functional Scale could be an alternative to the Western Ontario and McMaster Universities Osteoarthritis Index physical function scale. J Clin Epidemiol 62(10):1103–1111. doi:10.1016/j.jclinepi.2008.11.011
Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432
Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25(24):3186–3191
Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O (1993) Scoring of patellofemoral disorders. Arthroscopy 9(2):159–163
Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10(3):150–154
McHorney CA, Tarlov AR (1995) Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 4(4):293–307
Anthoine E, Moret L, Regnault A, Sébille V, Hardouin JB (2014) Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health Qual Life Outcomes 12:176. doi:10.1186/s12955-014-0176-2
Cruz-Diaz D, Lomas-Vega R, Osuna-Perez MC, Hita-Contreras F, Fernandez AD, Martinez-Amat A (2014) The Spanish lower extremity functional scale: a reliable, valid and responsive questionnaire to assess musculoskeletal disorders in the lower extremity. Disabil Rehabil 36(23):2005–2011. doi:10.3109/09638288.2014.890673
Cacchio A, De Blasis E, Necozione S, Rosa F, Riddle DL, di Orio F, De Blasis D, Santilli V (2010) The Italian version of the lower extremity functional scale was reliable, valid, and responsive. J Clin Epidemiol 63(5):550–557. doi:10.1016/j.jclinepi.2009.08.001
Negahban H, Hessam M, Tabatabaei S, Salehi R, Sohani SM, Mehravar M (2014) Reliability and validity of the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower limb musculoskeletal disorders. Disabil Rehabil 36(1):10–15. doi:10.3109/09638288.2013.775361
Watson CJ, Propps M, Ratner J, Zeigler DL, Horton P, Smith SS (2005) Reliability and responsiveness of the lower extremity functional scale and the anterior knee pain scale in patients with anterior knee pain. J Orthop Sports Phys Ther 35(3):136–146. doi:10.2519/jospt.2005.35.3.136
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Citaker, S., Kafa, N., Hazar Kanik, Z. et al. Translation, cross-cultural adaptation and validation of the Turkish version of the Lower Extremity Functional Scale on patients with knee injuries. Arch Orthop Trauma Surg 136, 389–395 (2016). https://doi.org/10.1007/s00402-015-2384-6
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DOI: https://doi.org/10.1007/s00402-015-2384-6