Validity of the Arabic version of AAOS-foot and ankle outcomes questionnaire in patients with traumatic foot and ankle injuries.

Abstract

Background: Arabic-speaking patients are underrepresented in orthopedic clinical studies, particularly in foot and ankle trauma research. The lack of validated Arabic language tools hinders their inclusion, creating a need for culturally and linguistically adapted instruments. The American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire (AAOS-FAOQ) is a widely used tool but has not been adapted for Arabic-speaking patients.

Aim: To translate, cross-culturally adapt, and validate the AAOS-FAOQ for Arabic-speaking patients with traumatic foot and ankle injuries.

Methods: The cross-cultural adaptation followed established guidelines, involving forward and backward translations, expert review, and pre-testing. The final Arabic version was administered alongside the Arabic Short-Form 36 (SF-36) to 100 patients for validity testing. Reliability was assessed through test-retest methods with 20 patients completing the questionnaire twice within 48 hours. Pearson correlation coefficients measured convergent and divergent validity with SF-36 subscales, while Cronbach's alpha and intraclass correlation coefficients (ICC) determined internal consistency and reliability.

Results: Out of 100 patients, 92 completed the first set of questionnaires. The Arabic AAOS-FAOQ showed strong correlations with the SF-36 subscales, particularly in physical function and bodily pain (r > 0.6). Test-retest reliability was robust, with ICCs of 0.69 and 0.66 for the Global Foot and Ankle Scale and Shoe Comfort Scale, respectively. Cronbach's alpha for internal consistency ranged from 0.7 to 0.9.

Conclusion: The Arabic version of the AAOS-FAOQ demonstrated validity and reliability for use in Arabic-speaking patients with traumatic foot and ankle injuries. This adaptation will enhance the inclusion of this population in orthopedic clinical studies, improving the generalizability of research findings and patient care.