Physical activity recall assessment for people with spinal cord injury: Thai translation and cross-cultural adaptation

Abstract

Purpose

This research sought to translate and culturally adapt the content of the original Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) into the Thai language and to assess its inter- and intra-rater reliability.

Methods

This study was divided into two parts; (i) translation and cross-cultural adaptation, using a six-step guideline-based translation-validation process and (ii) reliability assessment of the translated survey tool using intraclass correlation coefficients (ICCs), Bland–Altman plots and one-way ANOVA analyses.

Results

The Thai-PARA-SCI was successfully developed. The results revealed an excellent inter-rater reliability (ICC = 0.99, 95% CI range from 0.959–0.999) and the Bland-Altman plots showed little difference in times spent engaged physical activity. Intra-rater reliability results were affected inadvertently by testing across an unusual period, demonstrating poor to moderate scores (ICC ranged from 0.05–0.69, 95% CI ranged from −0.067–0.830) with the Bland-Altman plots showing very different ranges of time spent on physical activity.

Conclusion

This study achieved its aims of culturally and systematically translating the English PARA-SCI interview script into the Thai version with excellent scores for inter-rater reliability and was proven to be understandable by prospective users (Thai-PT) and participants (Thai-SCI).

Implications for Rehabilitation

• A robust cross-cultural translation and adaptation of the Physical Activity Recall Assessment for people with Spinal Cord Injury (PARA-SCI) into the Thai context has been undertaken, providing an effective exemplar for converting patient reported health outcome measures between languages of different root origins.

• When using the PARA-SCI as a pre- and post-intervention outcomes survey, clinicians should ensure that the timing of interview administration does not coincide with any unintended alterations in work-life balance, to ensure that the data are representative of the habitual physical activity levels performed by participants in their daily lives.

• Due to the possibility that physical activity levels could vary day-by-day or week-to-week, using the same day measurement findings may be a more reliable way to deploy the PARA-SCI than repeated assessments week(s) apart.

Keywords:

• Activities of daily living
• exercise
• leisure activity
• PARA-SCI
• spinal cord injuries
• Thai

Acknowledgments

The authors express their thanks to Dr.Nophanan Chaikittisilpa, Mr.Kritapon Sirikanchana, and Mr.Sirapol Kwangtongpanich for assisting with translation and being available for additional discussion in this study. Special thanks is expressed to Dr.Piyachat Leelasilapasart and Dr.Yutthapong Tongpob for assisting with recruiting bilingual participants. Finally, the authors express their appreciation to Dr.Wanchana Tongkhampao, and Mr.Kantawat Choksanguansak for proofreading the final version of the Thai PARA-SCI interview script.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

This research was approved by the Human Research Ethics Committee, The University of Sydney, Australia (Project numbers: 2017/1006 and 2018/588).