Cross-cultural adaptation, reliability and validity of the Spanish version of the upper limb functional index

Antonio I Cuesta-Vargas,Philip C Gabel

doi:10.1186/1477-7525-11-126

Abstract

BackgroundThe Upper Limb Functional Index (ULFI) is an internationally widely used outcome measure with robust, valid psychometric properties. The purpose of study is to develop and validate a ULFI Spanish-version (ULFI-Sp).MethodsA two stage observational study was conducted. The ULFI was cross-culturally adapted to Spanish through double forward and backward translations, the psychometric properties were then validated. Participants (n = 126) with various upper limb conditions of >12 weeks duration completed the ULFI-Sp, QuickDASH and the Euroqol Health Questionnaire 5 Dimensions (EQ-5D-3 L). The full sample determined internal consistency, concurrent criterion validity, construct validity and factor structure; a subgroup (n = 35) determined reliability at seven days.ResultsThe ULFI-Sp demonstrated high internal consistency (α = 0.94) and reliability (r = 0.93). Factor structure was one-dimensional and supported construct validity. Criterion validity with the EQ-5D-3 L was fair and inversely correlated (r = −0.59). The QuickDASH data was unavailable for analysis due to excessive missing responses.ConclusionsThe ULFI-Sp is a valid upper limb outcome measure with similar psychometric properties to the English language version.

Highlights

Health outcome assessment is an important component of patient care
The Upper Extremity Functional Index (UEFI) [32] which is criticized due to it development methodology using a specific workers population in a small data set with a high average age [6,8]
The Neck and Upper Limb Index (NULI) [36] which has been demonstrated as having item-redundancy from excessive internal consistency [8] and development concerns [37]

Summary

Introduction

Patient reported outcome (PRO) measures [1,2] are primarily used to objectively reflect a patient’s health or functional status at any given time and to detect changes in this status as a response to an intervention [3]. The Upper Extremity Functional Index (UEFI) [32] which is criticized due to it development methodology using a specific workers population in a small data set with a high average age [6,8] It has been subsequently independently validated [33] but uses a matrix response format which has a high error tendency for completion and scoring [34]. The purpose of study is to develop and validate a ULFI Spanish-version (ULFI-Sp)

Objectives

Methods

Results

Discussion

Conclusion