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Cross-cultural adaption and validation of simplified Chinese version of the lower extremity function scale in patients with knee osteoarthritis

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Abstract

Introduction

The lower extremity function scale (LEFS) is widely used to investigate patients’ functional status due to musculoskeletal dysfunction of the lower extremity. The aims of this study were to translate and cross-culturally adapt the LEFS into simplified Chinese (SC-LEFS) and evaluate the psychometric properties in patients with knee osteoarthritis (OA).

Methods

The SC-LEFS was translated and cross-culturally adapted on the basis of guideline. Patients scheduled for knee arthroplasty (108) were invited in this study. The Cronbach’s alpha coefficient was employed to assess the internal consistency. The test-retest reliability was determined by intra-class correlation coefficient (ICC). Pearson’s correlation coefficient was detected to evaluate the criterion validity between the SC-LEFS and WOMAC/SF-36/range of motion (ROM). Construct validity was assessed by exploratory factorial analysis. Additionally, responsiveness analysis was conducted with effect size (ES) and standardized response mean (SRM).

Results

The results revealed good internal consistency (Cronbach’s alpha = 0.975) and good test-retest reliability (ICC = 0.937). Strong correlations were observed between the SC-LEFS and WOMAC pain/function/total, physical component summary of SF-36, and ROM. We confirmed the SC-LEFS as a two-factor structure with factor 1 and factor 2 explaining 73.781% and 5.546% of the variance, respectively. The ES (1.74) and SRM (1.95) indicated a good responsiveness.

Conclusions

The SC-LEFS has been nicely adapted into simplified Chinese. It was proved to be reliable and valid for knee OA patients from China mainland who are undergoing arthroplasty. Furthermore, additional research should be conducted to assess these findings in other dysfunctions of lower extremity in a larger sample size.

Key Points

• The present study firstly cross-culturally adapted the lower extremity function scale (LEFS) into simplified Chinese and applied for patients with knee osteoarthritis in China mainland.

• The psychometric properties including reliability, validity, and responsiveness were evaluated in SC-LEFS.

• The SC-LEFS turned out to be a reliable and valid tool for clinical physicians and researchers assessing patients with knee osteoarthritis.

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Acknowledgments

The authors are grateful for all the participants in this study and the staff from inpatient and outpatient clinics. Special thanks are dedicated to the international students who are native English speakers.

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Author notes

  1. Ling Xu, Chen Wang, and Chen Zhang contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Orthopedics, Shanghai Tianyou Hospital, Shanghai, China

    Ling Xu

  2. Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China

    Chen Wang, Xinzhe Feng & Wenwen Tong

  3. Department of Orthopedics, General Hospital of Central Theater Command of Chinese People’s Liberation Army, Wuhan, China

    Chen Zhang

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  1. Ling Xu
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  2. Chen Wang
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Correspondence to Chen Wang.

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This study was approved by Shanghai Ethics Committee in April 2018 (No.CHEC2018-031).

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Xu, L., Wang, C., Zhang, C. et al. Cross-cultural adaption and validation of simplified Chinese version of the lower extremity function scale in patients with knee osteoarthritis. Clin Rheumatol 39, 3041–3048 (2020). https://doi.org/10.1007/s10067-020-05077-5

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  • DOI: https://doi.org/10.1007/s10067-020-05077-5

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