Translation into Brazilian Portuguese, cross-cultural adaptation, reliability and validation of the Functional Ambulation Classification for the categorization of ambulation following a stroke in a clinical setting.

Abstract

The Functional Ambulation Classification (FAC) is the only scale that classifies the gait of individuals with multiple sclerosis and stroke victims into ambulation categories. However, the FAC is only available in English and studies conducted in Brazil have used the FAC without an adequate translation and analysis of its measurement properties. To translate, cross-culturally adapt the FAC to Brazilian Portuguese, test its reliability and concurrent validity on stroke survivors. The translation and cross-cultural adaptation involved six steps. Inter-observer reliability was tested with five physiotherapists who watched videos of the gait of the stroke survivors and watched a second time after at least one week for the determination of intra-observer reliability. Concurrent validity was determined by correlating the FAC with the result of the 10-meter Walk Test (10mWT). Intra-observer reliability ranged from kappa 0.680 to 0.952 (p = 0.001) and inter-observer reliability ranged from kappa 0.517 to 0.794 (p = 0.001). The correlation between the FAC and 10mWT was rs = 0.771 (p = 0.001). The translation, cross-cultural adaptation and measurement properties demonstrated that the FAC is a valid, reliable clinical measure for the categorization of ambulation in the Brazilian population of stroke survivors in a clinical setting.