Cross-cultural adaptation and validation of the Kazakh version of American Orthopaedic Foot and Ankle Society Score (AOFAS) questionnaire

Cross-cultural adaptation and validation of the Kazakh version of American Orthopaedic Foot and Ankle Society Score (AOFAS) questionnaire

Authors

Keywords:

AOFAS score, Kazakh translation, ankle, cultural adaptation, reliability, validity

Abstract

Background and aim: The AOFAS-AHS questionnaire is used to evaluate the function of the ankle joint. However, its use in the Republic of Kazakhstan is difficult due to the unavailability of the questionnaire in the Kazakh language. This study aimed to translate and culturally adapt the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) into Kazakh (AOFAS-KLV) and evaluate its reliability and validity.

Methods: 66 Kazakh-speaking patients with ankle and hindfoot pathologies participated. Statistical analyses included descriptive methods for patient characteristics and questionnaire scores, alongside psychometric analyses to assess reliability (internal consistency and test-retest reliability) and construct validity using guidelines from the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN).

Results: The AOFAS-KLV demonstrated adequate reliability with a Cronbach’s α of 0.724 for the total score. Test-retest reliability was confirmed with intraclass correlation coefficients (ICC) ranging from 0.853 to 0.958. Content validity showed minimal ceiling and floor effects. Construct validity was acceptable, with Spearman’s rank correlations supporting predefined hypotheses. The Bland-Altman analysis indicated no systematic bias.

Conclusions: The culturally adapted AOFAS-KLV is a valid and reliable instrument for assessing foot and ankle pathologies in Kazakh patients, contributing to standardized clinical evaluations and long-term patient monitoring in Kazakhstan. Further research should focus on responsiveness and longitudinal validity.

Author Biographies

Meruyert Makhmetova, Research School, Astana Medical University, Astana, Kazakhstan

PhD student, Research School

Kazybek Baktybergen, School of Medicine, Nazarbayev University, Astana, Kazakhstan

Resident in Orthopaedics and Traumatology Program, School of Medicine

Yerik Raimagambetov, Department of Orthopaedics No. 5, National Scientific Centre of Traumatology and Orthopaedics named after Academician Batpenov N.D., Astana, Kazakhstan

Head of Orthopaedics Department No. 5

Bagdat Balbossynov, Department of the Arthroscopy and Sports Trauma, National Scientific Centre of Traumatology and Orthopaedics named after Academician Batpenov N.D., Astana, Kazakhstan

Head of the Arthroscopy and Sports Trauma Department

Dina Saginova, Centre for Science and Education, National Scientific Centre of Traumatology and Orthopaedics named after Academician Batpenov N.D., Astana, Kazakhstan

Head of the Centre for Science and Education

References

Walls RJ, Ross KA, Fraser EJ, et al. Football injuries of the ankle: A review of injury mechanisms, diagnosis and management. World J Orthop. 2016 Jan 18;7(1):8-19. doi: 10.5312/wjo.v7.i1.8

Dahmen J, Lambers KTA, Reilingh ML, van Bergen CJA, Stufkens SAS, Kerkhoffs GMMJ. No superior treatment for primary osteochondral defects of the talus. Knee Surg Sports Traumatol Arthrosc. 2018 Jul;26(7):2142-2157. doi: 10.1007/s00167-017-4616-5.

Brown TD, Johnston RC, Saltzman CL, Marsh JL, Buckwalter JA. Posttraumatic osteoarthritis: a first estimate of incidence, prevalence, and burden of disease. J Orthop Trauma. 2006 Nov-Dec;20(10):739-44. doi: 10.1097/01.bot.0000246468.80635.ef.

Barg A, Pagenstert GI, Hügle T, et al. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot Ankle Clin. 2013 Sep;18(3):411-26. doi: 10.1016/j.fcl.2013.06.001.

Richter M, Agren PH, Besse JL, et al. EFAS Score - Multilingual development and validation of a patient-reported outcome measure (PROM) by the score committee of the European Foot and Ankle Society (EFAS). Foot Ankle Surg. 2018 Jun;24(3):185-204. doi: 10.1016/j.fas.2018.05.004.

Dawson J, Boller I, Doll H, et al. The MOXFQ patient-reported questionnaire: assessment of data quality, reliability and validity in relation to foot and ankle surgery. Foot (Edinb). 2011 Jun;21(2):92-102. doi: 10.1016/j.foot.2011.02.002.

Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993 Dec;46(12):1417-32. doi: 10.1016/0895-4356(93)90142-n.

Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994 Jul;15(7):349-53. doi: 10.1177/107110079401500701.

Madeley NJ, Wing KJ, Topliss C, Penner MJ, Glazebrook MA, Younger AS. Responsiveness and validity of the SF-36, Ankle Osteoarthritis Scale, AOFAS Ankle Hindfoot Score, and Foot Function Index in end stage ankle arthritis. Foot Ankle Int. 2012 Jan;33(1):57-63. doi: 10.3113/FAI.2012.0057.

Westphal T, Piatek S, Halm JP, Schubert S, Winckler S. Outcome of surgically treated intraarticular calcaneus fractures--SF-36 compared with AOFAS and MFS. Acta Orthop Scand. 2004 Dec;75(6):750-5. doi: 10.1080/00016470410004148.

Van Lieshout EM, De Boer AS, Meuffels DE, et al. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score: a study protocol for the translation and validation of the Dutch language version. BMJ Open. 2017 Feb 27;7(2):e012884. doi: 10.1136/bmjopen-2016-012884.

de Boer AS, Tjioe RJC, Van der Sijde F, et al. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale; translation and validation of the Dutch language version for ankle fractures. BMJ Open. 2017 Aug 3;7(8):e017040. doi: 10.1136/bmjopen-2017-017040.

De Boer AS, Meuffels DE, Van der Vlies CH, et al. Validation of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale Dutch language version in patients with hindfoot fractures. BMJ Open. 2017 Nov 14;7(11):e018314. doi: 10.1136/bmjopen-2017-018314.

Alhadhoud M, Alsiri N, Alsaffar M, Glazebrook M. Cross-cultural adaptation and validation of an Arabic version of the American Orthopedics Foot and Ankle Score (AOFAS). Foot Ankle Surg. 2020 Dec;26(8):876-882. doi: 10.1016/j.fas.2019.11.001.

Vosoughi AR, Roustaei N, Mahdaviazad H. American Orthopaedic Foot and Ankle Society ankle-hindfoot scale: A cross-cultural adaptation and validation study from Iran. Foot Ankle Surg. 2018 Jun;24(3):219-223. doi: 10.1016/j.fas.2017.02.007.

Analay Akbaba Y, Celik D, Ogut RT. Translation, Cross-Cultural Adaptation, Reliability, and Validity of Turkish Version of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. J Foot Ankle Surg. 2016 Nov-Dec;55(6):1139-1142. doi: 10.1053/j.jfas.2016.06.001.

Erichsen J, Froberg L, Viberg B, Damborg F, Jensen C. Danish Language Version of the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) in Patients with Ankle-Related Fractures. J Foot Ankle Surg. 2020 Jul-Aug;59(4):657-663. doi: 10.1053/j.jfas.2019.08.027.

Leigheb M, Janicka P, Andorno S, Marcuzzi A, Magnani C, Grassi F. Italian translation, cultural adaptation and validation of the "American Orthopaedic Foot and Ankle Society's (AOFAS) ankle-hindfoot scale". Acta Biomed. 2016 May 6;87(1):38-45. PMID: 27163894.

Sayyed-Hosseinian SH, Hassankhani GG, Bagheri F, Alavi N, Shojaie B, Mousavian A. Validation of the Persian Version of the American Orthopedic Foot and Ankle Society Score (AOFAS) Questionnaire. Arch Bone Jt Surg. 2018 May;6(3):233-239. PMID: 29911141; PMCID: PMC5990714.

Kostuj T, Krummenauer F, Schaper K, et al. Analysis of agreement between the German translation of the American Foot and Ankle Society's Ankle and Hindfoot Scale (AOFAS-AHS) and the Foot Function Index in its validated German translation by Naal et al. (FFI-D). Arch Orthop Trauma Surg. 2014 Sep;134(9):1205-10. doi: 10.1007/s00402-014-2046-0.

EuroQol. http://www.euroqol.org (date last accessed 21 March 2024).

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91. doi: 10.1097/00007632-200012150-00014.

Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010 May;19(4):539-49. doi: 10.1007/s11136-010-9606-8.

Pinsker E, Inrig T, Daniels TR, Warmington K, Beaton DE. Reliability and validity of 6 measures of pain, function, and disability for ankle arthroplasty and arthrodesis. Foot Ankle Int. 2015 Jun;36(6):617-25. doi: 10.1177/1071100714566624.

Paget LDA, Sierevelt IN, Tol JL, Kerkhoffs GMMJ, Reurink G. The completely patient-reported version of the American Orthopaedic Foot and Ankle Society (AOFAS) score: A valid and reliable measurement for ankle osteoarthritis. J ISAKOS. 2023 Oct;8(5):345-351. doi: 10.1016/j.jisako.2023.07.003.

Fomichev VA, Sorokin EP, Konovalchuk NS, Pashkova EA, Sereda AP. Cross-Cultural Adaptation and Validation of the Russian-Language Version of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS). Traumatology and Orthopedics of Russia 2023;29(4):78-86. doi: 10.17816/2311-2905-16494. (In Russian).

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Published

29-10-2024

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Section

ORTHOPAEDICS AND SURGERY

How to Cite

1.
Makhmetova M, Baktybergen K, Raimagambetov Y, Balbossynov B, Saginova D. Cross-cultural adaptation and validation of the Kazakh version of American Orthopaedic Foot and Ankle Society Score (AOFAS) questionnaire. Acta Biomed. 2024;95(5):e2024177. doi:10.23750/abm.v95i5.16236