Cultural validation and language translation of the scientific SCI exercise guidelines for use in Indonesia, Japan, Korea, and Thailand

Dissonance in views between healthcare professionals and adults with a spinal cord injury with their understanding and interpretation of exercise intensity for exercise prescription

Objectives

To evaluate the difference between healthcare professionals (HCPs) and adults with spinal cord injury (SCI) in Asia regarding knowledge and interpretation of 'exercise intensity' for aerobic exercise prescription.

Methods and study design

A survey was distributed to practising HCP and adults with SCI. It was completed in participants' local language on topics related to the importance of exercise frequency, intensity, time and type; methods for monitoring and terms related to exercise intensity prescription. χ² analysis was used to detect differences in HCP or those with SCI.

Results

121 HCP and 107 adults with an SCI ≥1 years (C1-L4) participated. Responses revealed 61% of all HCP ranked 'intensity' being most important whereas only 38% respondents from the SCI group ranked it as high importance (p=0.008). For those with SCI, 'frequency' was most important (61%) which was significantly higher than the 45% selected by HCPs (p=0.030). Of the 228 respondents on average only 34% believed that the terms, 'moderate' and 'vigorous' provided enough information for aerobic exercise intensity prescription. HCP most often used HR methods compared with the SCI group (90% vs 54%; p<0.01). Both groups frequently used the subjective measures of exercise intensity, for example, Ratings of Perceived Exertion (8%3 vs 76% for HCP and SCI), HCP also frequently used speed (81%) and SCI also frequently relied on 'the affect' or feelings while exercising (69%).

Conclusions

These differences must be considered when developing clinical-practice exercise guidelines and health referral educational pathways for adults with SCI in Asia.

Validity and reliability of the loco-check questionnaire after cross-cultural adaptation for Indonesia

BACKGROUND

A large number of the elderly in Indonesia are affected by an increasing number of disabilities, with reduced mobility being one of the causes. Locomotive syndrome may cause decreased mobility, and its progression can impair the activities of daily living. Early screening is essential to halt its progression. The loco-check, a screening tool for locomotive syndrome, is available in English. A cross-cultural adaptation of this tool for an Indonesian version is important to maintain the validity of the questionnaire for its implementation in Indonesia. The aim of this study was to obtain a valid Indonesian version of the loco-check questionnaire that has been adapted as per Indonesian language and cultural conventions (through a cross-cultural adaptation process).

METHODS

The subjects in the study were community-dwelling geriatrics over 65 years of age who were recruited using consecutive non-probability judgment sampling according to the inclusion criteria. This study, conducted from February to October 2019, was divided into two stages consisting of: (1) language and cultural adaptation; (2) validity and reliability testing. The seven items on the loco-check were translated using forward-backward translation. The final questionnaire was generated through an expert panel discussion. The validity and reliability were evaluated using concurrent validity and Cronbach's alpha using SPSS Version 23.0.

RESULTS

In the first stage, the first and second trials showed a strong correlation between the English and Indonesian versions of the questionnaire with r = 0.997 (p < 0.001) and r = 0.825 (p = 0.003), respectively. The final Indonesian version of the loco-check had a good validity and reliability with r = 0.981 (p < 0.001) and Cronbach's alpha of 0.768, respectively.

CONCLUSION

The Indonesian cross-cultural adaptation of the loco-check questionnaire is a valid and reliable general questionnaire that could enable screening for locomotive syndrome in Indonesia.