Main Article Content
evaluation scale, hallux, validation, Italian, cultural adaptation, metatarsophalangeal joint (MTP), AOFAS
Background and Aim of the work: An incorrect interpretation or patients’ misunderstanding of evaluation scales can induce a mistake; therefore the real applicability of an evaluation scale should be determined by procedures that take care of cultural adaptability and not only of scientific validity. Our purpose was to translate and culturally adapt into Italian the AOFAS-MTP-IP scale for hallux, and to check its reproducibility and validity. Methods: The AOFAS-MTP-IP scale was processed for translation and checked for medical part coherence. The scale was submitted to 10 patients to verify a correct cultural adaptation. Then, the scale was submitted to 50 randomized patients operated at their hallux. Intra and inter-observer reproducibility was checked by two interviewers and a repeated interview. Short-Form-36-questionnaire for Quality of Life and Visual-Analogue-Scale for pain were also administered to perform validation analysis. The Pearson’s-Correlation-Coefficient and the Intra-Class-Correlation coefficient were calculated to analyse the scale reproducibility and validation. Results: Cultural adaptation of the translated version of the scale resulted good in terms of understandability by patients. An optimal correlation of the inter and intra-observer reproducibility was obtained. The correlation with well-known validated scales as SF-36 and VAS has shown good correlation indicating success in the validation process. Conclusions: Validation of the Italian version of the AOFAS-MTP-IP evaluation scale for hallux has been performed successfully. Therefore its use can be considered appropriate and suggested in Italian clinical practice.
2) 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; 46: 1417-1432.
3) 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; 87: 38-45.
4) Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society Clinical Rating Scales. J Foot Ankle Surg. 2007; 46: 65–74.
5) 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; 15: 349-353.
6) Guillemin F. Cross cultural adaptation and validation of health status measures. Scand J Rheumatol 1995; 24: 61-63.
7) Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000; 25: 3186–3191.
8) Pinsker E, Daniels TR, Inrig T, Warmington K, Beaton DE. The ability of outcome questionnaires to capture patient concerns following ankle reconstruction. Foot Ankle Int. 2013; 34: 65-74.
9) Nilgün B, Gürsoy C, Gizem İK, Sevilay K. Development of Multidimensional Nil Hallux Valgus Scale: a reliability and validity study. Acta Orthop Traumatol Turc 2016;50(3):269–276.
10) SooHoo NF, Shuler M, Fleming LL. Evaluation of the validity of the AOFAS clinical rating systems by correlation to the SF-36. Foot Ankle Int 2003; 24: 50-55.