Urdu Translation and Adaptation of the Boston Carpal Tunnel Questionnaire: A Reliability and Validity Study

Abstract

Background: Carpal Tunnel Syndrome (CTS) is a common neuropathic disorder, and its assessment often relies on the Boston Carpal Tunnel Questionnaire (BCTQ). However, there is a lack of a validated Urdu version of this tool for use in Pakistan. Objective: To translate and adapt the BCTQ into Urdu and to validate this version among native Urdu-speaking patients diagnosed with CTS. Methods: A cross-sectional observational study was conducted at the University of Lahore over six months. The study involved 142 native Urdu-speaking CTS patients. The translation followed Beaton's guidelines and included forward translation, reconciliation, back-translation, expert committee review, pre-testing, and cognitive debriefing. The translated questionnaire's reliability and validity were assessed using Cronbach's Alpha, the Intraclass Correlation Coefficient (ICC), and correlation analyses. Floor and ceiling effects were also examined. Results: The Urdu BCTQ demonstrated high internal consistency (Cronbach's Alpha: 0.85 for SSS and 0.87 for FSS) and good test-retest reliability (ICC: 0.75 for SSS and 0.78 for FSS). Construct validity was confirmed with substantial correlations with established measures (0.65 for SSS and 0.70 for FSS), and the questionnaire showed responsiveness to treatment effects (statistical significance at 0.05). Demographic analysis indicated a balanced representation of participants, and minimal floor and ceiling effects were observed. Conclusion: The Urdu version of the BCTQ is a reliable and valid tool for assessing CTS in Urdu-speaking patients. Its high internal consistency, good test-retest reliability, and proven construct validity make it an effective instrument for clinical and research settings in Pakistan.