Translation, Cultural Adaptation and Psychometric Properties of Urdu Version of Upper Limb Functional Index Questionnaire in Patients With Upper Limb Musculoskeletal Disorders
Condition: Upper Limb Nerve Lesion; Reliability; Validity
MeSH terms: Musculoskeletal Diseases
Study type: Observational [Patient Registry]

Summary: 
      A reliability and validity study for the cross culturally adapted and translated version of
      Upper limb musculoskeletal index questionnaire into Urdu language. This can be used for the
      reporting of upper limb musculoskeletal disorders including hand, shoulder and arm
      pathologies, carpel tunnel syndrome, osteoarthritis etc.
    

Detailed description: 
      Upper limb functional disorders are quite common among Pakistani population due to high
      demands of work either manual or using technologies, so these disorders are also of great
      matter of interest. Therefore, for evaluations, diagnosis and for better treatment, a
      subjective questionnaire is required and hence, ULFI is a commonly used outcome measure for
      upper limb.

      It has been previously translated into many languages i.e. in native languages of respective
      countries for better understanding.

      Upper limb functional index (ULFI) is originally in English language and much of the
      Pakistani population is Urdu speaking. That is why it is required to translate the ULFI
      questionnaire in Urdu language.

      Translation guidelines from Beaton and colleagues followed. The patients with upper limb
      musculoskeletal disorders will be recruited.

      Data collection procedure started after the approval from institution review board committee
      with reference no. IRB-UOL-FAHS/882/2021. Data were collected from the patients after taking
      consent from them. Data collected on their first visit and second reading taken after 1 week,
      after that treatment will be given.

      Data Analysis:

      Reliability:

      The ULFI-Urdu will be applied two times by a physiotherapist to determine test-retest
      reliability. On the first day of assessment the physiotherapist will collect demographic data
      and patients will answer ULFI-Urdu. For intra-rater reliability, ULFI-Urdu will be reapplied
      48 hours later. Between two assessments, no treatment will be provided to minimize clinical
      differences. The first visit of the patient will be comprised of complete assessment along
      with the completion of outcome measures and upon his/her second visit the patient outcome
      measures will be completed before giving any treatment.

      Validity:

      Construct validity will be assessed by determining pearson correlation between ULFI-Urdu and
      DASH, ULFI-Ur and SF-12 Ur questionnaire.

      Statistical Analysis:

      The Kaiser-Meyer-Olkin measure of sampling adequacy will be used to assess for factor
      analysis and the Barlett test of sphericity, to ensure sampling adequacy. Reliability will be
      assessed with Cronbach alpha, split half test and test-retest method. Floor and ceiling
      effects will be determined by calculating the rate of participants that obtained the lowest
      (0) or highest (80) scores and will be considered present if more than 15 % of the
      participants achieved the highest or lowest score. Validity will be assessed by explanatory
      factorial analysis of the ULFI scores obtained at the first meeting. Principal components
      analysis will be performed with varimax rotation if it will be necessary. The number of
      potential factors will be suggested by scree plot, Eugen value cut-off >1.0, and 10 %
      variance. Convergent and divergent validity will be assessed with correlation between pain at
      rest, activity, DASH score, stiffness, physical function, total score and ULFI score.
    

Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Subjects with upper limb musculoskeletal disorders will be enrolled in the study with age
        limits from 18-40 years. Data will be entered for the first and then after a duration of
        few days for reliability and validity of questionairre.
      
Keywords: Translation; Musculoskeletal injury; Upper limb