Validity and reliability of the adapted Dutch version of the Brace Questionnaire (BrQ)
Keywords:brace, quality of life, questionnaire, Scoliosis, Spine, validation and reliabilty study
Background and purpose: The Brace Questionnaire (BrQ) is a disease-specific health-related quality of life (HRQOL) instrument for measuring perceived health status of scoliosis patients undergoing brace treatment. The purpose of this study is to evaluate the validity and reliability of a translated and culturally adapted Dutch version of the BrQ.
Patients and methods: The original Greek BrQ was translated into Dutch and a cross-cultural adaptation and validation processes were conducted. Subsequently, 80 adolescent idiopathic scoliosis (AIS) patients undergoing active brace treatment were included from 4 scoliosis centers to evaluate the validity and reliability of the Dutch version of the BrQ. The questionnaire’s floor and ceiling effects, internal consistency, and test–retest reliability were assessed. Concurrent validity was evaluated by comparing the BrQ with the revised Scoliosis Research Society 22-item questionnaire (SRS-22r) scores.
Results: The mean total BrQ score was 75.9 (standard deviation [SD] 11.3) and the mean domain scores varied between 3.4 (SD 0.9) and 4.2 (SD 0.7) for the domains “vitality” and “bodily pain,” respectively. There were no floor and ceiling effects for the total BrQ score. The BrQ showed satisfactory internal consistency in most subdomains with a Cronbach’s α ranging between 0.35 for the domain “general health perception” and 0.89 for the domain “self-esteem and aesthetics.” Excellent test–retest reproducibility was observed for the total BrQ score (ICC 0.91), and the BrQ was successfully validated against the SRS-22r.
Conclusion: The translated and culturally adapted Dutch version of the BrQ is a valid and reliable HRQOL instrument for AIS patients undergoing brace treatment.
Weinstein S L, Dolan L A, Wright J G, Dobbs M B. Effects of bracing in adolescents with idiopathic scoliosis. N Engl J Med 2013; 369: 1512-21. doi: 10.1056/NEJMoa1307337. DOI: https://doi.org/10.1056/NEJMoa1307337
Katz D E, Herring J A, Browne R H, Kelly D M, Birch J G. Brace wear control of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg Am 2010; 92: 1343-52. doi: 10.2106/JBJS.I.01142. DOI: https://doi.org/10.2106/JBJS.I.01142
Karol L A, Virostek D, Felton K, Wheeler L. Effect of compliance counseling on brace use and success in patients with adolescent idiopathic scoliosis. J Bone Joint Surg 2016; Am 98: 9-14. doi: 10.2106/JBJS.O.00359. DOI: https://doi.org/10.2106/JBJS.O.00359
Sanders J O, Newton P O, Browne R H, Katz D E, Birch J G, Herring J A. Bracing for idiopathic scoliosis: how many patients require treatment to prevent one surgery? J Bone Joint Surg Am 2014; 96: 649-53. doi: 10.2106/JBJS.M.00290. DOI: https://doi.org/10.2106/JBJS.M.00290
Wang H, Tetteroo D, Arts J J C, Markopoulos P, Ito K. Quality of life of adolescent idiopathic scoliosis patients under brace treatment: a brief communication of literature review. Qual Life Res 2021; 30: 703-11. doi: 10.1007/s11136-020-02671-7. DOI: https://doi.org/10.1007/s11136-020-02671-7
Schlosser T P, Stadhouder A, Schimmel J J, Lehr A M, van der Heijden G J, Castelein R M. Reliability and validity of the adapted Dutch version of the revised Scoliosis Research Society 22-item questionnaire. Spine J 2014; 14 :1663-72. doi: 10.1016/j.spinee.2013.09.046. DOI: https://doi.org/10.1016/j.spinee.2013.09.046
Vasiliadis E, Grivas T B, Gkoltsiou K. Development and preliminary validation of Brace Questionnaire (BrQ): a new instrument for measuring quality of life of brace treated scoliotics. Scoliosis 2006; 1: 7. doi: 10.1186/1748-7161-1-7. DOI: https://doi.org/10.1186/1748-7161-1-7
Aulisa A G, Guzzanti V, Galli M, Erra C, Scudieri G, Padua L. Validation of Italian version of Brace Questionnaire (BrQ). Scoliosis 2013; 8: 13. doi: 10.1186/1748-7161-8-13. DOI: https://doi.org/10.1186/1748-7161-8-13
Deceuninck J, Tirat-Herbert A, Rodriguez Martinez N, Bernard J C. French validation of the Brace Questionnaire (BrQ). Scoliosis Spinal Disord 2017; 12: 18. doi: 10.1186/s13013-017-0126-y. DOI: https://doi.org/10.1186/s13013-017-0126-y
Gur G, Yakut Y, Grivas T. The Turkish version of the Brace Questionnaire in brace-treated adolescents with idiopathic scoliosis. Prosthet Orthot Int 2018; 42: 129-35. doi: 10.1177/0309364617690393. DOI: https://doi.org/10.1177/0309364617690393
Kinel E, Kotwicki T, Podolska A, Bialek M, Stryla W. Polish validation of Brace Questionnaire. Eur Spine J 2012; 21:1603-1608. doi: 10.1007/s00586-012-2188-0 DOI: https://doi.org/10.1007/s00586-012-2188-0
Lim J M, Goh T S, Shin J K, Kim D S, Lee C S, Lee J S. Validation of the Korean version of the Brace Questionnaire. Br J Neurosurg 2018; 32: 678-81. doi: 10.1080/02688697.2018.1501464. DOI: https://doi.org/10.1080/02688697.2018.1501464
Rezaee S, Jalali M, Babaee T, Kamali M. Reliability and concurrent validity of a culturally adapted Persian version of the Brace Questionnaire in adolescents with idiopathic scoliosis. Spine Deform 2019; 7: 553-8. doi: 10.1016/j.jspd.2018.10.001. DOI: https://doi.org/10.1016/j.jspd.2018.10.001
Yi H, Chen H, Wang X, Xia H. Cross-cultural adaptation and validation of the Chinese version of the Brace Questionnaire. Front Pediatr 2021; 9: 763811. doi: 10.3389/fped.2021.763811. DOI: https://doi.org/10.3389/fped.2021.763811
Liu S, Zhou G, Xu N, Mai S, Wang Q, Zeng L, et al. Translation and validation of the Chinese version of Brace Questionnaire (BrQ). Transl Pediatr 2021; 10: 598-603. doi: 10.21037/tp-20-377. DOI: https://doi.org/10.21037/tp-20-377
Beaton D E, Bombardier C, Guillemin F, Ferraz M B. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000; 25: 3186-91. doi: 10.1097/00007632-200012150-00014. DOI: https://doi.org/10.1097/00007632-200012150-00014
Scoliosis Research Society outcomes; 2013. Available from: http://www.srs.org/professionals/SRS_outcomes/
Bland J M, Altman D G. Cronbach’s alpha. BMJ 1997; 314: 572. doi: 10.1136/bmj.314.7080.572. DOI: https://doi.org/10.1136/bmj.314.7080.572
Koo T K, Li M Y. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15: 155-63. doi: 10.1016/j.jcm.2016.02.012. DOI: https://doi.org/10.1016/j.jcm.2016.02.012
Portney L G, Watkins M P, editors. Statistical measures of reliability. In: Foundations of clinical research: applications to practice, 3rd ed. London: Pearson Education; 2009. Ch. 26.
Rivett L, Rothberg A, Stewart A, Berkowitz R. The relationship between quality of life and compliance to a brace protocol in adolescents with idiopathic scoliosis: a comparative study. BMC Musculoskelet Disord 2009; 10: 5. doi: 10.1186/1471-2474-10-5. DOI: https://doi.org/10.1186/1471-2474-10-5
Risser J C. The iliac apophysis; an invaluable sign in the management of scoliosis. Clin Orthop 1958; 11: 111-19.
Lenke L G, Betz R R, Harms J, Bridwell K H, Clements D H, Lowe T G, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am 2001; 83: 1169-81. DOI: https://doi.org/10.2106/00004623-200108000-00006
How to Cite
Copyright (c) 2023 Charles M M Peeters, Joshua M Bonsel, Roelina Munnik-Hagewoud, Adriaan K Mostert, Guido B van Solinge, Joost P H J Rutges, Mark C Altena, Paul F M Krabbe, G J F Joyce Bos, Chris Faber, Frits-Hein Wapstra, Diederik H R Kempen
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.