Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Medicine/Rheumatology, University of California San Francisco, San Francisco, California, USA.
RMD Open. 2024 Oct 23;10(4):e004696. doi: 10.1136/rmdopen-2024-004696.
The modified Short QUestionnaire to ASsess Health-enhancing physical activity (mSQUASH) was originally developed and validated in Dutch patients with axial spondyloarthritis (axSpA). To support world-wide distribution, applicability and comparability of measuring physical activity, our aim was to perform translation and cross-cultural adaptation of the mSQUASH into English, field testing in other rheumatic diseases and clinical validation in patients with axSpA.
The Dutch mSQUASH was translated into English according to forward-backward Beaton protocol. Semistructured interviews were conducted in representative samples of patients with axSpA (n=13), Sjögren's disease (n=10), systemic lupus erythematosus (n=10) and giant cell arteritis/polymyalgia rheumatica (n=10) to verify relevance, comprehensiveness and comprehensibility. For construct validity (n=95), Spearman correlations were used with clinical outcome assessments. For test-retest reliability (n=82), intraclass correlation coefficients (ICC) were calculated. For responsiveness (n=80), standardised response means (SRM) were calculated stratified by Anchor method.
Translation and cross-cultural adaptation of the mSQUASH into English were successfully carried out, which can serve as basis for other translations. Only minor adaptations and clarifications were implemented. Fair correlations were found between mSQUASH and Axial Spondyloarthritis Disease Activity Score (ρ=-0.31), Bath Ankylosing Spondylitis Functional Index (ρ=-0.37) and Assessment of SpondyloArthritis International Society-Health Index (ρ=-0.30). Test-retest reliability was very good (ICC: 0.87). Responsiveness corresponded to the direction of self-reported changes in physical activity (SRM: 0.72 for improved, 0.06 for stable and -0.74 for worsened).
The mSQUASH showed good linguistic and face validity according to field testing in different rheumatic diseases. Clinical validation confirmed good construct validity, test-retest reliability and responsiveness in patients with axSpA, which supports the use of the mSQUASH in clinical practice and research.
改良的短问卷评估健康促进体力活动（mSQUASH）最初是在荷兰的轴性脊柱关节炎（axSpA）患者中开发和验证的。为了支持全球范围内测量体力活动的适用性和可比性，我们的目标是将 mSQUASH 翻译成英语，并在其他风湿性疾病中进行现场测试，并在 axSpA 患者中进行临床验证。
根据 Beaton 前后翻译协议，将荷兰语 mSQUASH 翻译成英语。对 axSpA（n=13）、干燥综合征（n=10）、系统性红斑狼疮（n=10）和巨细胞动脉炎/多发性肌痛（n=10）的代表性患者样本进行半结构化访谈，以验证相关性、全面性和可理解性。对于结构有效性（n=95），使用临床结果评估与 Spearman 相关性。对于测试-重测信度（n=82），计算了组内相关系数（ICC）。对于反应性（n=80），根据锚定方法计算了标准化反应均值（SRM）。
成功地将 mSQUASH 翻译成英语，可以作为其他翻译的基础。只进行了一些小的调整和澄清。mSQUASH 与 Axial Spondyloarthritis Disease Activity Score（ρ=-0.31）、Bath Ankylosing Spondylitis Functional Index（ρ=-0.37）和 Assessment of SpondyloArthritis International Society-Health Index（ρ=-0.30）之间存在良好的相关性。测试-重测信度非常好（ICC：0.87）。反应性与自我报告的体力活动变化方向相对应（改善时的 SRM：0.72，稳定时的 SRM：0.06，恶化时的 SRM：-0.74）。
根据不同风湿性疾病的现场测试，mSQUASH 表现出良好的语言和表面有效性。临床验证证实了 axSpA 患者的良好结构有效性、测试-重测信度和反应性，这支持了 mSQUASH 在临床实践和研究中的应用。
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