DefinePK

Research Objective

To translate and cross-culturally adapt the Quebec Back Pain Disability Scale (QBPDS) into Urdu (QBPDS-U) and to evaluate its psychometric properties in patients with non-specific low back pain (NLBP).

Methodology

The study involved forward and backward translation and cultural adaptation of the QBPDS into Urdu following Mapi Research Trust Guidelines. Psychometric properties were evaluated in 200 NLBP patients and 50 healthy individuals using the QBPDS-U, Oswestry Disability Index (ODI), Visual Analogue Scale for Pain (VASpain), Visual Analogue Scale for Disability (VASdisability), and Global Rating of Change scale (GROC). Reliability, factor analysis, validity, and responsiveness were assessed.

Methodology Flowchart

                        graph TD
    A["Obtain Ethical Approval"] --> B["Forward and Backward Translation of QBPDS to Urdu"];
    B --> C["Cultural Adaptation based on Mapi Research Trust Guidelines"];
    C --> D["Develop 1st Version of QBPDS-U"];
    D --> E["Backward Translation and Comparison"];
    E --> F["Develop 2nd Version of QBPDS-U"];
    F --> G["Pilot Testing on NLBP Patients"];
    G --> H["Refine Items based on Feedback"];
    H --> I["Develop 3rd Version of QBPDS-U"];
    I --> J["Proofreading and Finalization"];
    J --> K["Recruit Participants: 200 NLBP Patients, 50 Healthy Individuals"];
    K --> L["Administer QBPDS-U, ODI, VASpain, VASdisability on Day 1"];
    L --> M["Administer QBPDS-U again after 48 hours for test-retest reliability"];
    M --> N["Administer QBPDS-U, ODI, VASpain, VASdisability, GROC after 3 weeks of PT"];
    N --> O["Data Analysis: Reliability, Factor Analysis, Validity, Responsiveness"];
    O --> P["Report Findings"];                    

Discussion

The translation and adaptation process involved resolving minor discrepancies and making culturally relevant modifications to certain items (e.g., item 11 and 16) to ensure clarity and applicability for the Urdu-speaking population. The psychometric properties, including reliability, validity, and responsiveness, were found to be robust, comparable to or exceeding those of previous versions of the QBPDS in other languages. The single-factor structure identified in this study aligns with some previous versions, though variations exist across different language adaptations.

Key Findings

The QBPDS-U demonstrated high internal consistency (Cronbach's alpha=0.96) and excellent test-retest reliability (ICC=0.93). Factor analysis revealed a single-factor structure. The QBPDS-U showed moderate correlations with VASdisability (r=0.65) and VASpain (r=0.65), and a strong correlation with ODI (r=0.73). Discriminative validity was confirmed by significant differences between healthy individuals and patients (P<0.001). Responsiveness was verified by significant differences in change scores between stable and better groups (P<0.001).

Conclusion

The Urdu version of the Quebec Back Pain Disability Scale (QBPDS-U) is a reliable, valid, and responsive instrument for assessing functional disability in Urdu-speaking patients with non-specific low back pain.

Fact Check

1. Cronbach's alpha: The QBPDS-U showed high internal consistency with a Cronbach's alpha of 0.96. This is within the acceptable range for high internal consistency (0.70 to 0.95).
2. Test-retest reliability: The QBPDS-U demonstrated excellent test-retest reliability with an intra-class correlation coefficient (ICC) of 0.93. This is above the threshold of 0.80 considered excellent reliability.
3. Sample size for psychometric evaluation: 200 NLBP patients and 50 healthy individuals were recruited for the psychometric evaluation.

Mind Map