Validity and Reliability of Persian Version of Brace Questionnaire to Assess the Quality of Life in Subjects with Scoliosis

Objective: Deformity of spine is considered as any abnormality of the shape and alignment of the vertebral column which is commonly involve adolescent, idiopathically. The deformity requires prompt attention because it can reduce person’s quality of life (QOL). World health organization (WHO) describes the quality of life in various domains in life like personal and social well-being. A specific tool is used to measure health-related quality of life. It is so hard to make a long term measurements of QOL because people may experience new expression within a long period. So, benefit of having a self and rapid assessment questionnaire is easily understood. Brace questionnaire (BrQ) is such a self-assessment tool designed to evaluate the quality of life in subjects diagnosed with Adolescent Idiopathic Scoliosis (AIS) whose underwent brace treatment. As we know, this questionnaire is only available in English and Italian. A Persian version of the questionnaire is definitely needed for both research and clinical aims. Therefore, this study was aimed to translate and culturally adapt the Brace questionnaire into Persian language and also to determine its reliability and validity. Materials and methods: Present study was conducted and approved by Isfahan university of medical sciences (research code: 294124, ethic committee code: IR.MUI.REC.1394.2.124). In this clinical measurement study, fifty subjects with scoliosis deformity (target population) were participated. The mean age of participants was 15.41 years +1/77 standard deviation. All subjects had an experience in 4 months of wearing spinal braces. They all agreed to sign the consent form before entering to our study. The BrQ consists of 34 self-reported items which has been divided into 8 domains of general health, physical functioning, emotional functioning, self-esteem and aesthetics, vitality, school activity, bodily pain, and social functioning. BrQ was translated based on Beaton guidelines and culturally adapted into Persian language. It consist 6 stages of; forward translation of original questionnaire by three bilingual speakers (native in English and Persian languages), comparing two translated draft by specialists and interpreters, backward translation of initial translated version, achieve agreement with developer. Finally pilot testing of pre-final version of BrQ-P was carried out in which ten specialists and ten subjects with scoliotic curve whose experienced wearing brace for at least 4 months, filled out the pre-final version of BrQ-P. Pilot population revealed all sentences and items were easily understood. At the end, the pre-final version was adopted as the final version of BrQ-P. Subsequently, the BrQ-P and Scoliosis Research Society questionnaire (SRS-22r) were completed by target population to assess validity. To determine test-retest reliability, all subjects completed both questionnaires within 7 day interval. Data were analyzed using SPSS software (version 17). The level of statistical significance was set at P<.05. Results: All 10 specialists in Orthotic and Prosthetic and also 10 subjects with scoliotic curve confirmed that the pre-final version of BrQ-P was completely easy to understand and there was no difficulty to choose the suitable answer for items. The internal consistence of BrQ-P was good with Cronbach’s alpha of 0/935. Intra-class correlation coefficient (ICC) was 0/93 with the confident interval of 95% (0/90-0/95) demonstrating good test-retest reliability. Also, the relationship between the Persian version of brace questionnaire and SRS-22r questionnaire was measured using Pearson’s correlation coefficient. It was found 0/90 revealed a very good relationship between two questionnaires (P<0.001). Conclusion: The BrQ-P is a valid and reliable tool to assess the amount of quality of life in subjects with spinal scoliosis.