Arabic version of the Extended Nordic Musculoskeletal Questionnaire, cross-cultural adaptation and psychometric testing.

Abstract

The Extended Nordic Musculoskeletal Questionnaire (NMQ-E) had never been adapted into Arabic. We culturally adapted the NMQ-E to Arabic in five stages and investigated its psychometric properties. After translating and cross-culturally adapting the NMQ-E into Arabic, through forward translation, translation synthesis, backward translation, expert committee review, and pilot testing, the psychometric properties were investigated. The construct validity was assessed by having the participants completing the Arabic version of the NMQ-E with four Arabic scales that measured musculoskeletal pain in all regions covered in the NMQ-E. Participants' baseline records were also used to evaluate internal consistency (Cronbach's α). Seven days later, participants completed the Arabic NMQ-E again to evaluate its test-retest reliability employing intraclass correlation coefficient (ICC) and standard error of measurement (SEM) for the age questions, and Cohen's kappa coefficient (κ), the proportion of observed agreement (P_o), the proportion of positive agreement (P_pos), and the proportion of negative agreement (P_neg) for the dichotomous items. A total of 127 participants, 70 males and 57 females with mean age 32.5 ± 12.2 years, were included. Significant differences were found between participants with and without musculoskeletal pain in the corresponding scales, signifying the content validity of the questionnaire. Cronbach's α for both the prevalence and consequences pain sections combined ranged from 0.30 to 1.00. The test-retest reliability of the age questions was excellent, with ICC values ranging between 0.995 and 1.00. The SEM was 0.77 for the neck region and 0 for the rest of the regions. The prevalence questions demonstrated almost perfect agreement, with κ values ranging between 0.82 and 1.00, the P_o between 0.94 and 1.00, the P_pos between 0.80 and 1.00, and the P_neg between 0.93 and 1.00. The consequences of pain questions showed moderate-to-perfect agreement, with κ values ranging between 0.57 and 1.00, between 0.83 and 1.00 for the P_o, between 0.50 and 1.00 for the P_pos, and between 0.86 and 1.00 for the P_neg. The results suggest that the Arabic NMQ-E is a valid and reliable tool that can be used to screen Arab adults for the prevalence and consequences of musculoskeletal pain.