Validation of a translated version of the modified Japanese Orthopedic Association (mJOA) cervical myelopathy score in an Arabic speaking population

Belal Elnady,Khaled Mohamed Hassan,Ahmed Abdelazim A Hassan,Hassan Mohamed Ali

doi:10.1051/sicotj/2021043

Belal Elnady, Khaled Mohamed Hassan + Show 2 more

Open Access

https://doi.org/10.1051/sicotj/2021043

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Journal: SICOT-J	Publication Date: Jan 1, 2021
Citations: 2	License type: CC BY 4.0

Affiliation: Assiut University Hospitals

Abstract

Introduction: Degenerative Cervical Myelopathy (DCM) is a growing disorder. Standardization of its assessment tools is an integral part of its management. The modified Japanese orthopedic association (mJOA) score is one of the most commonly used tools. Currently, there is no available Arabic translated version of any cervical myelopathy functional score. This study aimed to translate, culturally adapt, and measure the psychometric properties of an Arabic translated version of the mJOA. Methods: After translation of the score using the standard forward-backward translation procedure, a validation study including 100 patients was carried out from June 2019 to June 2020. The following psychometric properties were measured: feasibility, reliability, internal consistency, validity, minimal clinically important difference (MCID), ceiling, and floor effect. Results: No problems were encountered during the process of translation and cross-cultural adaptation of the score. The mJOA-AR was found to be a feasible score. It showed high inter-observer reliability (r = 0.833, P < 0.001), test-retest reliability (r = 0.987, P < 0.001) and good internal consistency using Cronbach’s alpha (0.777) and Pearson interclass correlation coefficient (r = 0.717). The score showed good convergent and divergent construct validity correlating it to the Arabic validated version of the neck disability index (NDI). The mJOA-AR had an MCID of 1.506. Both the ceiling and floor effects of the total score and the first and second domains were within the acceptable range, while the third and fourth domains had a high ceiling effect (30% and 39%, respectively). Discussion: Our translated version of the mJOA score was found to be a feasible score with acceptable psychometric properties. This score can be utilized as a good outcome measure tool in Arabic-speaking countries.

Highlights

Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction with increasing incidence in countries with an aging population
The modified Japanese Orthopedic Association score is considered one of the most accepted and widely used scores to assess the functional status of patients [3]
The modified Japanese Orthopedic Association (mJOA) has been well studied in people suffering from DCM and is considered one of the predictors of the outcome after surgical intervention [3,4,5]

Summary

Introduction

Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction with increasing incidence in countries with an aging population. DCM is an incapacitating disease that hinders individuals from performing their simple daily activities and greatly affects their quality of life. It is considered a burden from both the economic and social points of view [1, 2]. With the growing disease burden, objective assessment of patients with DCM became a pivotal point in managing the disease. The modified Japanese Orthopedic Association (mJOA) score is considered one of the most accepted and widely used scores to assess the functional status of patients [3]. The mJOA has been well studied in people suffering from DCM and is considered one of the predictors of the outcome after surgical intervention [3,4,5]

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