Abstract
This study aimed to perform linguistic and cross-cultural adaptation to establish a Polish version of the Lower Limb Functional Index (LLFI) as well as an evaluation of the psychometric properties. This was a two-stage, cross-sectional study. The first stage—linguistic and cultural adaptation, complied with the International Society for Pharmacoeconomics and Outcomes Research guidelines to produce the Lower Limb Functional Index, Polish version (LLFI-PL). The subjects were recruited to the second stage of the study from a sample of convenience (n = 125, age = 52.86 ± 19.53 years, 56% female, symptoms duration = 17.69 ± 18.39 weeks). Baseline reliability was performed on the LLFI-PL with retest period at 3–7 days. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC), EuroQol Health Questionnaire 5-Dimensions 5-Level (EQ-5D-5L), and an 11-point Pain Numerical Rating Scale (P-NRS) were completed to assess the validity of the LLFI-PL. Statistical analysis showed high internal consistency (α = 0.94), and excellent test–retest reliability (ICC2.1 = 0.96). The measurement error was SEM = 1.69% with MDC90 = 3.93%. Construct validity demonstrated strong correlations between the LLFI-PL and WOMAC (r = 0.81) and moderate correlations with the EQ-5D-5L (r = −0.63) and P-NRS (r = −0.39). Exploratory factor analysis confirmed a single-factor structure. The LLFI-PL is a psychometrically sound questionnaire for Polish-speaking patients with lower limb musculoskeletal conditions. The results support findings from the previous original English, Spanish, and Turkish versions.
Highlights
As a result of the translation and cross-cultural adaptation of the Lower Limb Functional Index (LLFI) to the Polish version, changes were introduced at several stages of the process as follows: Step 2
The reconciliation meeting determined some acceptable differences between the two forward translations, resulting from the many Polish language equivalents that could have been used by the translators
The back translation review agreed that a change be made to item #24
Summary
Lower limb problems and dysfunction are an increasing concern in society, regardless of age, culture, and underlying health status [1]. Problems, including pain on movement and at rest plus impaired functions limiting the activities of daily living (ADL) and participation in social life, lead to decreased quality of life [1]. Patient opinions about their own health and functional status may differ from objective evaluations provided by different professionals. Patient reported outcome measures (PROMs) are recommended to enable the standardization of the data collected and to provide an accurate representation of the patient’s subjective opinions of their functional capabilities [2]
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