Translation into Brazilian Portuguese, cross-cultural adaptation, reliability and validation of the Functional Ambulation Classification for the categorization of ambulation following a stroke in a clinical setting
*Corresponding author: Cíntia Elord Júlio MD. University Nove de Julho. Rua Vergueiro, 235/249. Liberdade. CP 01504-001. São Paulo, SP, Brazil.
E-mail: cintia_elord@hotmail.com
Introduction: The Functional Ambulation Classification (FAC) is the only scale that classifies the gait of individuals with multiple sclerosis and stroke victims into ambulation categories. However, the FAC is only available in English and studies conducted in Brazil have used the FAC without an adequate translation and analysis of its measurement properties.
Aim: To translate, cross-culturally adapt the FAC to Brazilian Portuguese, test its reliability and concurrent validity on stroke survivors.
Patients and methods: The translation and cross-cultural adaptation involved six steps. Inter-observer reliability was tested with five physiotherapists who watched videos of the gait of the stroke survivors and watched a second time after at least one week for the determination of intra-observer reliability. Concurrent validity was determined by correlating the FAC with the result of the 10-meter Walk Test (10mWT).
Results: Intra-observer reliability ranged from kappa 0.680 to 0.952 (p = 0.001) and inter-observer reliability ranged from kappa 0.517 to 0.794 (p = 0.001). The correlation between the FAC and 10mWT was rs = 0.771 (p = 0.001).
Conclusion: The translation, cross-cultural adaptation and measurement properties demonstrated that the FAC is a valid, reliable clinical measure for the categorization of ambulation in the Brazilian population of stroke survivors in a clinical setting.
Objetivo Traducir y adaptar culturalmente la FAC para el portugués brasileño y probar su fiabilidad y validez concurrente en individuos afectados por ictus.
Pacientes y métodos La traducción y la adaptación transcultural implicaron seis pasos. La fiabilidad interevaluador se probó con cinco fisioterapeutas que vieron vídeos de la marcha de las personas afectadas por ictus y, después de un intervalo mínimo de una semana, los vieron por segunda vez para determinar la fiabilidad intraevaluador. La validez concurrente se determinó correlacionando la FAC con el resultado de la prueba de marcha de 10 metros (PM10m).
Resultados La fiabilidad intraevaluador varió entre un valor kappa de 0,68-0,95 (p = 0,001), y la fiabilidad interevaluador, un valor kappa de 0,517-0,794 (p = 0,001). La correlación entre la FAC y la PM10m fue rs = 0,771 (p = 0,001).
Conclusión La traducción, la adaptación transcultural y el análisis de las propiedades psicométricas demostraron que la FAC es una medida clínica válida y fiable para clasificar la deambulación de los individuos brasileños afectados por ictus en un entorno clínico.