Background & Aims

Joint pain can be assessed using several questionnaires, and one of the most complete is the Intermittent and Constant Osteoarthritis Pain (ICOAP), developed in focus groups to assess the severity of pain and its impact on the quality of life of individuals with knee osteoarthritis/hip. Furthermore, it is the only instrument to assess constant and intermittent osteoarthritis-related pain. Additionally, it can be used to monitor disease progression, response to treatment, and the need for joint replacements. As the ICOAP has a high level of reliability for evaluating the condition of an individual with osteoarthritis, it has been translated into several languages. It is used in many studies in different populations. Thus, the objective of this study was to carry out the translation, cross-cultural adaptation, and validation of the ICOAP into Brazilian Portuguese in individuals with knee osteoarthritis.

Methods

One hundred and thirty-three volunteers of both genders with knee Osteoarthritis, complaint of pain, and/or change in function in the knee(s). lower limb(s),lasting greater than or equal to 12 weeks,morning stiffness, pain intensity verified by the numerical pain scale (NPS) greater than or equal to 3, and those with the mother tongue – Brazilian Portuguese.The process of translating and cross-cultural adaptation of ICOAP followed: translation, synthesis of translations,back-translation, analysis by a committee of experts, testing of the pre-final version, and definition of the final version.The psychometric properties evaluated were structural validity through factor analysis, test-retest reliability through the intraclass correlation coefficient (ICC), internal consistency through Cronbach’s alpha; construct validity through correlations between the NPS, International Knee Documentation Committee (IKDC) and Medical Outcome Study 36 – Item Short-Form Health Survey (SF-36).

Results

Thirty volunteers participated in the ICOAP translation and cross-cultural process. They tested the final version of the ICOAP Brazilian Portuguese for individuals with knee osteoarthritis.Fifty individuals with knee osteoarthritis were included for validity analyses, and a subsample of 53 individuals was used for test-retest reliability. For structural validity, the original structure of the ICOAP Portuguese knee in Brazil presented all adequate fit indices: chi-square/GL = 1.48;CFI = 1.00;TLI = 1.00;RMSEA (90% CI) = 0.068 (0.027 to 0.102);SRMR = 0.045. The reliability analysis presents excellent test-retest reliability and internal consistency values, with an ICC value = 0.95 and Cronbach’s alpha = 0.945 for the constant pain domain. And ICC = 0.92 and Cronbach’s alpha = 0.920 for the intermittent pain domain. Regarding construct validity, there was a greater emphasis on the constant pain domain with correlations greater than 0.50 between the ICOAP knee and IKDC, SF-36, and the END.

Conclusions

The Brazilian version of the ICOAP knee, with two domains and 11 items, presents adequate psychometric properties with an emphasis on the constant pain domain, which presented, in its entirety, an adequate magnitude of correlation with the reference instruments used to evaluate knee osteoarthritis.

References

15. MAILLEFERT, J.F.; KLOPPENBURG, M.; FERNANDES, L.; PUNZI, L.; GÜNTHER, K.P.; MARTIN MOLA, E. et al. Tradução multilíngue e adaptação transcultural da medida OARSI/ OMERACT de dor intermitente e constante da osteoartrite (ICOAP). Osteoartrite Cartilagem 2009; 17: 1293–1296.
16. HAWKER, G.A.; DAVIS, A.M.; FRENCH, M.R.; CIBERE, J.; JORDAN, J.M.; MARCH, L. et al. Desenvolvimento e testes psicométricos preliminares de uma nova medida de dor da OA – uma iniciativa OARSI/OMERACT. Osteoartrite Cartilagem 2008; 16: 409-414.
17. ZHANG, C.; LIU, D.H.; QU, Y.L.; JIA, Z.Y.; WANG, W.; LI, J. et al. Transcultural adaptação e validação da versão chinesa da medida de dor da osteoartrite intermitente e constante (ICOAP) em pacientes com osteoartrite de joelho. Osteoartrite Cartilagem 2017; 25: 506-512.

Presenting Author

Gabriela Nascimento de Santana

Poster Authors

Gabriela Nascimento Santana, Ph.D. Candidate in Rehab.

Nove de Julho University

Lead Author

E-mail

Aron Charles Barbosa da Silva

PhD Candidate in Rehab.

Nove de Julho University

Lead Author

E-mail

Patricia Santos

Msc student of Rehab. Sciences

Nove de Julho University

Lead Author

E-mail

Inaê Silva Santos

Msc student of Rehab. Sciences

Nove de Julho University

Lead Author

E-mail

Topics

  • Assessment and Diagnosis