Translation, Validation and Cultural Adaptation of the ‘activities of Daily Living’ Scale (adls)

INTRODUCTION There is a consensus in literature about the need of an evaluation scale for treatment outcomes in individuals with knee injuries in order to provide a standardized method that may be consistently reproduced and report the outcomes of established treatments(1). The use of questionnaires as evaluation parameters is useful, because it enables to standardize, equalize and reproduce the intended measurements(2). However, the selection of an evaluation segment should consider if its components are clear, simple, easy to understand and to apply, and if they have an appropriate application time(3). When a questionnaire is prepared, its measurement properties must be first tested and validated in a group of patients, so that it can be subsequently used in population-based studies(4). With the development of translation and cultural adaptation methods, it is much likely that an instrument developed for use in a given language and culture could also be used after translated and adapted in another language and cultural context(5). After performing a literature review, with the analysis of translation and cultural adaptation methodologies designed for questionnaires addressing quality of life, where differences were seen particularly regarding the number and qualification of the involved translators in each phase, Guillemin et al.(6), proposed a standardization for process development, providing guidance regarding the number, sequence and complexity of the phases to be followed. It is important to highlight that, by describing how compromised an individual’s quality of life or health status is, although assessing it from a broader view, we can show how impacting is a condition to the social or health aspects of an individual(7). The knee is a load joint, with wide range of motion, located at the central portion of the lower limb. Joint surfaces formed by femoral condyles, by tibial plateau, and by the patella allow for some medial and lateral rolling, sliding and rotational movements. Supported by static (meniscus, ligaments and capsules) and dynamic stabilizers (muscles and tendons), this is a joint subjected to a higher number of mechanical conditions(8). Due to the importance of knee joint and to the large number of injuries in it (8), the activities of daily living are usually likely to change when some condition is detected in this segment of lower limbs, but that makes difficult to measure to what extension this condition impacts an individual’s quality of life. O’Donoghue(9) was the first to develop a system for assessing outcomes. Larson(10) developed a scale with 100 score points based on subjective, objective and functional criteria. Irrgang et al.(11) developed and validated the ADLS questionnaire, which intends to show a functional measurement for knee conditions during the activities of daily life. This questionnaire is constituted of 14 items, with closed answers alternatives, being divided as follows: items 1-6 measure commonly expressed symptoms during activities of daily living by an individual with knee pathology and injury; items 7-14 address the function during activities of daily life. The score includes only those 14 items, reaching to a maximum score of 70 points, and these are factored out in the measurement, which is graded 0 -100(10). SUMMARY