Urdu Translation and Adaptation of the Boston Carpal Tunnel Questionnaire: A Reliability and Validity Study

Main Article Content

Iqra Khalid
Hafiza Sana Ashraf
Masooma Saleem
Atta Muhammad
Rabbia Fayyaz
Umber Nawaz

Abstract

Background: Carpal Tunnel Syndrome (CTS) is a common neuropathic disorder, and its assessment often relies on the Boston Carpal Tunnel Questionnaire (BCTQ). However, there is a lack of a validated Urdu version of this tool for use in Pakistan.


Objective: To translate and adapt the BCTQ into Urdu and to validate this version among native Urdu-speaking patients diagnosed with CTS.


Methods: A cross-sectional observational study was conducted at the University of Lahore over six months. The study involved 142 native Urdu-speaking CTS patients. The translation followed Beaton's guidelines and included forward translation, reconciliation, back-translation, expert committee review, pre-testing, and cognitive debriefing. The translated questionnaire's reliability and validity were assessed using Cronbach's Alpha, the Intraclass Correlation Coefficient (ICC), and correlation analyses. Floor and ceiling effects were also examined.


Results: The Urdu BCTQ demonstrated high internal consistency (Cronbach's Alpha: 0.85 for SSS and 0.87 for FSS) and good test-retest reliability (ICC: 0.75 for SSS and 0.78 for FSS). Construct validity was confirmed with substantial correlations with established measures (0.65 for SSS and 0.70 for FSS), and the questionnaire showed responsiveness to treatment effects (statistical significance at 0.05). Demographic analysis indicated a balanced representation of participants, and minimal floor and ceiling effects were observed.


Conclusion: The Urdu version of the BCTQ is a reliable and valid tool for assessing CTS in Urdu-speaking patients. Its high internal consistency, good test-retest reliability, and proven construct validity make it an effective instrument for clinical and research settings in Pakistan.

Article Details

How to Cite
Khalid, I., Sana Ashraf, H., Saleem, M., Muhammad, A., Fayyaz, R., & Nawaz , U. (2023). Urdu Translation and Adaptation of the Boston Carpal Tunnel Questionnaire: A Reliability and Validity Study. Journal of Health and Rehabilitation Research, 3(2), 389–394. https://doi.org/10.61919/jhrr.v3i2.124
Section
Articles

References

Ashworth NL, Bland JDP, Chapman KM, Tardif G, Albarqouni L, Nagendran A. Local corticosteroid injection versus placebo for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2023;2(2):Cd015148.

Billig JI, Gunaseelan V, Yazdanfar M, Sears ED, Iwashyna TJ, Chang T, et al. Gabapentinoid Prescribing for Carpal Tunnel Syndrome. Hand (New York, NY). 2023;18(1_suppl):106s-13s.

Bland JDP. Carpal tunnel syndrome in pregnancy. Muscle Nerve. 2023;68(4):345-7.

Bland JDP. Use of nerve conduction studies in carpal tunnel syndrome. The Journal of hand surgery, European volume. 2023;48(10):976-85.

Bollmann G, Bouvet C, Beaulieu JY. Recurrent carpal tunnel syndrome: Outcomes after neurolysis and synovial flap. Hand surgery & rehabilitation. 2023;42(3):236-42.

Du J, Yuan Q, Wang XY, Qian JH, An J, Dai Q, et al. Manual Therapy and Related Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis. Journal of integrative and complementary medicine. 2022;28(12):919-26.

Malakootian M, Soveizi M, Gholipour A, Oveisee M. Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review. Cellular and molecular neurobiology. 2023;43(5):1817-31.

Rotem G, Arami A. Carpal Tunnel Syndrome. The Israel Medical Association journal : IMAJ. 2023;25(7):507-10.

Gao N, Yan L, Ai F, Kang J, Wang L, Weng Y. Comparison of the Short-Term Clinical Effectiveness of 5% Dextrose Water, Platelet-rich Plasma and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Archives of physical medicine and rehabilitation. 2023;104(5):799-811.

Garcia JO, Scott D, Parikh P, Curley KL, Turkmani A. Understanding carpal tunnel syndrome. JAAPA : official journal of the American Academy of Physician Assistants. 2022;35(12):19-26.

Karjalainen TV, Lusa V, Page MJ, O'Connor D, Massy-Westropp N, Peters SE. Splinting for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2023;2(2):Cd010003.

Chen FR, Kerluku J, Manzi JE, Chen AZ, Nguyen JT, Wessel LE, et al. Boston Carpal Tunnel Questionnaire Scores Alone Do Not Predict Surgical Intervention for Patients With Carpal Tunnel Syndrome. Hand (New York, NY). 2023;18(1_suppl):71s-6s.

De Kleermaeker FG, Boogaarts HD, Meulstee J, Verhagen WI. Minimal clinically important difference for the Boston Carpal Tunnel Questionnaire: new insights and review of literature. Journal of Hand Surgery (European Volume). 2019;44(3):283-9.

De Kleermaeker FG, Levels M, Verhagen WI, Meulstee J. Validation of the Dutch version of the boston carpal tunnel questionnaire. Frontiers in Neurology. 2019;10:1154.

Ijaz MJ, Karimi H, Gillani SA, Ahmad A, Chaudhary MA. Response to Muhammad Junaid Ijaz et al (JPMA, Vol 72, No-04, April 2022)-Effect of median nerve neuromobilization on functional status in patients with carpal tunnel syndrome: A double blinded randomized control trial. Journal of Pakistan Medical Association. 2022;72(9):1887-.

Multanen J, Ylinen J, Karjalainen T, Ikonen J, Häkkinen A, Repo JP. Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale: a Rasch analysis one year after surgery. BMC musculoskeletal disorders. 2020;21:1-14.

Hamzeh HH, Alworikat NA. Cross cultural adaptation, reliability and construct validity of the Boston Carpal Tunnel Questionnaire in standard Arabic language. Disabil Rehabil. 2021;43(3):430-5.

Alanazy MH, Alaboudi M, Almaari A, Alhumayyd Z, Albulaihe H, Muayqil T. Translation and validation of the Arabic version of the Boston carpal tunnel syndrome questionnaire. Neurosciences. 2019;24:296+.

Arooj A, Amjad F, Tanveer F, Arslan AU, Ahmad A, Gilani SA. Translation, cross-cultural adaptation and psychometric properties of Urdu version of upper limb functional index; a validity and reliability study. BMC musculoskeletal disorders. 2022;23(1):691.

Karabinov V, Slavchev SA, Georgiev GP. Translation and validation of the Bulgarian version of the Boston Carpal Tunnel Questionnaire. Cureus. 2020;12(10).

Bulatovic D, Nikolic D, Hrkovic M, Filipovic T, Cirovic D, Radosavljevic N, et al. Reliability, Validity and Temporal Stability of the Serbian Version of the Boston Carpal Tunnel Questionnaire. Medicina. 2022;58(11):1531.

Bianchi M, Coratella G, Dello Iacono A, Beato M. Comparative effects of single vs. double weekly plyometric training sessions on jump, sprint and change of directions abilities of elite youth football players. J Sports Med Phys Fitness. 2019;59(6):910-5.

Keramat KU, Babur MN, Mcloughlin P, Bhutta NI, Bhutta AH, Khattak P, et al. Translation and cultural adaptation of Shoulder Pain and Disability Index in Urdu (SPADI-U). Rehman Journal of Health Sciences. 2021;3(1):10-6.

FATIMA NUA, QURAT-UL-AIN FK, RAZA MA, WARIS M. Urdu Translation and Validation of Activities-Specific Balance Confidence (ABC) Scale.

Ramdan IM. Reliability and validity test of the Indonesian version of the hamilton anxiety rating scale (ham-a) to measure work-related stress in nursing. 2019.

Multanen J, Ylinen J, Karjalainen T, Kautiainen H, Repo JP, Häkkinen A. Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients. Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. 2020;109(4):343-50.

Sarhan FMA, Al-Jasim A, Abu Al-Halawa D, Dukmak ON, Ayyad R, Odeh MA. The applicability of Boston Carpal Tunnel Questionnaire as a screening tool for carpal tunnel syndrome among potential high-risk female population in the West Bank: a cross-sectional study. Annals of medicine and surgery (2012). 2023;85(4):650-4.

Teunis T, Domico A, Ring D, Fowler J. Correspondence of the Boston Carpal Tunnel Questionnaire with severity of median neuropathy. The Journal of hand surgery, European volume. 2023;48(10):1006-13.