Dutch normative values for the LIMB-Q: A step toward international standardization of patient-reported outcomes after lower extremity trauma.

Abstract

The LIMB-Q is a patient-reported outcome measure (PROM) developed to assess multiple key health-related domains after lower extremity trauma. This study aimed to translate the LIMB-Q into Dutch and establish normative data for the Dutch population. The LIMB-Q was translated and culturally adapted in line with established international guidelines using forward and backward translation. A representative general population sample was recruited via an online research panel. Participants completed the Dutch LIMB-Q (33 items) and reported sociodemographic and health information. Poststratification weights were applied based on the 2025 Statistics Netherlands [Centraal Bureau voor de Statistiek (CBS)] age-sex distribution. Descriptive statistics and multivariable regression analyses were performed for all domains. A total of 1188 respondents were included in the analyses. The sample reflected the Dutch adult population (55.7% women; mean age, 49.6 years). On a 0 to 100 scale, the mean (standard deviation) scores were 87.3 (17.3) for appearance, 81.6 (19.8) for function, and 85.3 (18.0) for symptoms. The ceiling effects were modest (≤11%). The scores were stable across age groups, with slight declines in older adults. In multivariable regression, comorbidity was significantly associated with lower scores in all domains (p<0.001), whereas sex and age were not significantly associated (p>0.27). Weighted and unweighted results were nearly identical, confirming demographic representativeness. This study provided the first Dutch translation and normative reference values for the LIMB-Q. It aimed to support clinicians and researchers in interpreting patient-reported outcomes after lower extremity trauma by offering population-based reference data.