Cross cultural adaptation, validity, and reliability of Central Sensitization Inventory in Arabic language

Abstract

Purpose

The Central Sensitization Inventory (CSI) is a tool that aid in identifying symptoms associated with nociplastic pain. The aim of this study is to adapt CSI to Arabic language, and to examine its psychometric properties.

Methods

Adaptation process followed recommended guidelines. Participants with self-reported chronic pain completed a web-based survey. The internal consistency was calculated. Test–retest reliability was examined by allowing 7–9 day gap between two rounds of measurements. Convergent validity was examined by measuring the correlation with Pain Catastrophizing Scale (PCS), EQ-VAS, and EQ-5D-3L. Discriminant validity was examined by testing four priori hypotheses. Factor analysis with principal components extraction was conducted.

Results

CSI-Arabic (CSI-Ar) was successfully produced. Its internal consistency and test–retest reliability were excellent (Cronbach's α = 0.88 and ICC_2,1=0.94). The standard error of measurement and minimal detectable change 95% were 3.45 and 9.57, respectively. CSI total score correlation with PCS, EQ-5D-3L, and EQ-VAS was moderate. The results lend support to the four hypothesis related to discriminant validity. Factor analysis revealed a four-factor structure of CSI-Ar.

Conclusions

CSI-Ar showed an internal consistency, test–retest reliability, and validity that are comparable to similar studies. The results support the use of CSI-Ar in assessing chronic pain in Arabic-speaking population.

Implications for rehabilitation

• Central sensitization (CS) mechanisms are thought to contribute to chronic pain.

• Identifying the presence of CS would personalize management.

• The Central Sensitization Inventory (CSI) is a valid and reliable tool to aid in identifying symptoms associated with CS.

• The Arabic version of the CSI is valid and reliable to use in Arabic speaking patients suffering from chronic pain.

Keywords:

• Nervous system physiological phenomena
• reproducibility of results
• patient reported outcomes
• nociplastic pain
• CSI

Acknowledgements

We would like to acknowledge Dr. Neblett, R. for the feedback provided on the back-translated version. We would like to acknowledge the copyright holder of EQ-5D and PCS for their permission to use these tools. We would like to acknowledge Dr Jaafar Chemli for assistance in interpreting EQ-5D-3L values. We would like to acknowledge the contribution of the translators, the panel, and all participants.

Author contributions

Mohammad Madi: conceptualization, methodology, investigation, formal analysis, data curation, writing-original draft preparation. Hayat Hamzeh: conceptualization, methodology, investigation, writing-original draft preparation. Sumayeh Abujaber: methodology, investigation, writing-original draft preparation. Ibrahim Altubasi: methodology, investigation, writing-original draft preparation.

Disclosure statement

All authors declare no conflict of interest.