Abstract
BackgroundThe Lower Limb Functional Index (LLFI) is a relatively recently published regional outcome measure. The development article showed the LLFI had robust and valid clinimetric properties with sound psychometric and practical characteristics when compared to the Lower Limb Extremity Scale (LEFS) criterion standard.ObjectiveThe purpose of this study was cross cultural adaptation and validation of the LLFI Spanish-version (LLFI-Sp) in a Spanish population.MethodsA two stage observational study was conducted. The LLFI was initially cross-culturally adapted to Spanish through double forward and single backward translation; then subsequently validated for the psychometric characteristics of validity, internal consistency, reliability, error score and factor structure. Participants (n = 136) with various lower limb conditions of >12 weeks duration completed the LLFI-Sp, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Euroqol Health Questionnaire 5 Dimensions (EQ-5D-3 L). The full sample was employed to determine internal consistency, concurrent criterion validity, construct validity and factor structure; a subgroup (n = 45) determined reliability at seven days concurrently completing a global rating of change scale.ResultsThe LLFI-Sp demonstrated high but not excessive internal consistency (α = 0.91) and high reliability (ICC = 0.96). The factor structure was one-dimensional which supported the construct validity. Criterion validity with the WOMAC was strong (r = 0.77) and with the EQ-5D-3 L fair and inversely correlated (r = -0.62). The study limitations included the lack of longitudinal data and the determination of responsiveness.ConclusionsThe LLFI-Sp supports the findings of the original English version as being a valid lower limb regional outcome measure. It demonstrated similar psychometric properties for internal consistency, validity, reliability, error score and factor structure.
Highlights
Patient reported outcome (PRO) measures [1,2] are an integral part and process of the management of a patient’s health
The Lower Limb Functional Index (LLFI)-Sp supports the findings of the original English version as being a valid lower limb regional outcome measure
For the kinetic-region of the lower limb, various instruments have been designed to measure and evaluate symptomatology as a single kinetic chain [7,10,11,12,13,14,15] while others have focused on joints or conditions, for the hip and knee [16,17,18,19,20]
Summary
Patient reported outcome (PRO) measures [1,2] are an integral part and process of the management of a patient’s health. For the kinetic-region of the lower limb, various instruments have been designed to measure and evaluate symptomatology as a single kinetic chain [7,10,11,12,13,14,15] while others have focused on joints or conditions, for the hip and knee [16,17,18,19,20] Both regional and condition specific tools are used to indicate the effectiveness of an intervention but can assist in guiding the decision process on what treatments to continue, adopt or change. The development article showed the LLFI had robust and valid clinimetric properties with sound psychometric and practical characteristics when compared to the Lower Limb Extremity Scale (LEFS) criterion standard
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