Department of Neurosurgery, Shahid Beheshti, University of Medical Sciences, Tehran, Iran.
BMC Neurol. 2012 Sep 24;12:101. doi: 10.1186/1471-2377-12-101.
Neurogenic claudication (NC) is a common symptom in patients with lumbar spinal stenosis (LSS). The Neurogenic Claudication Outcome Score (NCOS) is a very short instrument for measuring functional status in these patients. This study aimed to translate and validate the NCOS in Iran.
This was a prospective clinical validation study. The 'forward-backward' procedure was applied to translate the NCOS from English into Persian (Iranian language). A total of 84 patients with NC were asked to respond to the questionnaire at two points in time: at preoperative and at postoperative (6 months follow-up) assessments. The Oswestry Disabiltiy Index (ODI) also was completed for patients. To test reliability, the internal consistency was assessed by Cronbach's alpha coefficient. Validity was evaluated using known groups comparison and criterion validity (convergent validity). Internal responsiveness of the NCOS to the clinical intervention (surgery) also was assessed comparing patients' pre- and postoperative scores.
The Cronbach's alpha coefficients for the NCOS at preoperative and postoperative assessments were 0.77 and 0.91, respectively. Known groups analysis showed satisfactory results. The instrument discriminated well between sub-groups of patients who differed in claudication distance as measured by the Self-Paced Walking Test (SPWT). The change in the ODI after surgery was strongly correlated with change in the NCOS, lending support to its good convergent validity (r = 0.81; P < 0.001). Further analysis also indicated that the questionnaire was responsive to the clinical intervention (surgery) as expected (P < 0.0001).
In general, the Iranian version of the NCOS performed well and the findings suggest that it is a reliable and valid measure of functionality in patients with lumbar spinal stenosis who are suffering from neurogenic claudication.
神经源性跛行（NC）是腰椎管狭窄症（LSS）患者的常见症状。神经源性跛行结局评分（NCOS）是一种非常简短的工具，用于测量这些患者的功能状态。本研究旨在将 NCOS 翻译成伊朗语并进行验证。
这是一项前瞻性临床验证研究。采用“前后”程序将 NCOS 从英语翻译成波斯语（伊朗语）。共有 84 名 NC 患者被要求在两个时间点回答问卷：术前和术后（6 个月随访）评估。还为患者完成了 Oswestry 残疾指数（ODI）。为了测试可靠性，通过 Cronbach's alpha 系数评估内部一致性。通过已知组比较和标准有效性（收敛有效性）评估有效性。还通过比较患者术前和术后的评分来评估 NCOS 对临床干预（手术）的内部反应性。
NCOS 在术前和术后评估的 Cronbach's alpha 系数分别为 0.77 和 0.91。已知组分析显示出满意的结果。该工具在 SPWT 测量的跛行距离不同的患者亚组之间具有良好的区分能力。手术后 ODI 的变化与 NCOS 的变化强烈相关，表明其具有良好的收敛有效性（r=0.81；P<0.001）。进一步的分析还表明，问卷如预期的那样对临床干预（手术）有反应（P<0.0001）。
总体而言，伊朗版的 NCOS 表现良好，研究结果表明，它是一种可靠且有效的工具，用于衡量患有神经源性跛行的腰椎管狭窄症患者的功能。
