Cross-cultural adaptation, reliability, and validity of a Chinese version of the pelvic girdle questionnaire

Hui Cong, Heng Liu, Yin Sun, Jinsong Gao, Juntao Liu, Liangkun Ma, Britt Stuge, Lixia Chen, Hui Cong, Heng Liu, Yin Sun, Jinsong Gao, Juntao Liu, Liangkun Ma, Britt Stuge, Lixia Chen

Abstract

Background: The Pelvic Girdle Questionnaire (PGQ) is the only specific instrument designed to evaluate pain and activity limitations in pregnant or postpartum women with pelvic girdle pain (PGP). This study aimed to translate and culturally adapt the PGQ for Chinese patients and to verify the validation of the psychometric items of the PGQ in the Chinese population.

Methods: First, the translation and cultural adaptation process of the PGQ was conducted on the basis of international guidelines. Eighteen women suffering from PGP (11 pregnant women and 7 postpartum women) were enrolled in the pilot tests. Second, a total of 130 pregnant and postpartum women with PGP were enrolled to evaluate the validation of the psychometric items of the Chinese version.

Results: The calculated Cronbach's alphas demonstrated a high level of internal consistency for the Chinese version of the PGQ, ranging from 0.77 to 0.93. The convergent validity showed a high positive correlation between the PGQ total score and the Oswestry Disability Index (0.84) and Numeric Rating Scale (0.73) for pain intensity. Furthermore, a good discriminatory ability was found for the Chinese version of the PGQ for distinguishing women who needed treatment from those not (area under the curve [AUC] = 0.843, p < 0.001), but not for discriminating the pregnant and postpartum states (AUC = 0.488, p = 0.824). The results of test-retest showed good reproducibility for the total PGQ (ICC = 0.93), the PGQ activity subscale (ICC = 0.92), and the PGQ symptom subscale (ICC = 0.77).

Conclusion: Our study presents the translation, validation and psychometric features of the Chinese version of the PGQ, showing good construct validity and discriminative power for assessing the consequences of PGP among pregnant or postpartum Chinese women.

Keywords: Pain; Pelvic girdle pain; Pelvic girdle questionnaire; Pregnancy.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of the study design
Fig. 2
Fig. 2
ROC curve analysis was used to evaluate the ability of the Chinese version of the PGQ to discriminate between treated women and non-treated women

References

    1. Cooper T. Top ten tips for women experiencing pelvic pain in pregnancy Tasha Cooper. Essentially Midirs. 2013;4:27–31.
    1. Bertuit J, Van Lint CE, Rooze M, Feipel V. Pregnancy and pelvic girdle pain: analysis of pelvic belt on pain. J Clin Nurs. 2018;27:e129–e137. doi: 10.1111/jocn.13888.
    1. Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Pract. 2010;10:60–71. doi: 10.1111/j.1533-2500.2009.00327.x.
    1. Wu W-H, Meijer OG, Uegaki K, Mens J, Van Dieen J, Wuisman P, et al. Pregnancy-related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence. Eur Spine J. 2004;13:575–589. doi: 10.1007/s00586-003-0615-y.
    1. Elden H, Lundgren I, Robertson E. The pelvic ring of pain: pregnant women’s experiences of severe pelvic girdle pain: an interview study. Clin Nurs Stud. 2014;2:2.
    1. Norén L, Ostgaard S, Nielsen TF, Ostgaard HC. Reduction of sick leave for lumbar back and posterior pelvic pain in pregnancy. Spine. 1997;22:2157–2160. doi: 10.1097/00007632-199709150-00013.
    1. Kuciel N, Sutkowska E, Cienska A, Markowska D, Wrzosek Z. Impact of Kinesio Taping application on pregnant women suffering from pregnancy-related pelvic girdle pain—preliminary study. Ginekol Pol. 2017;88:620–625. doi: 10.5603/GP.a2017.0111.
    1. Gausel AM, Kjærmann I, Malmqvist S, Dalen I, Larsen JP, Økland I. Pelvic girdle pain 3–6 months after delivery in an unselected cohort of Norwegian women. Eur Spine J. 2016;25:1953–1959. doi: 10.1007/s00586-015-3959-1.
    1. Vøllestad NK, Stuge B. Prognostic factors for recovery from postpartum pelvic girdle pain. Eur Spine J. 2009;18:718–726. doi: 10.1007/s00586-009-0911-2.
    1. Gausel AM, Malmqvist S, Andersen K, Kjærmann I, Larsen JP, Dalen I, et al. Subjective recovery from pregnancy-related pelvic girdle pain the first 6 weeks after delivery: a prospective longitudinal cohort study. Eur Spine J. 2020;29:556–563. doi: 10.1007/s00586-020-06288-9.
    1. Franke H, Franke J-D, Belz S, Fryer G. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: a systematic review and meta-analysis. J Bodyw Mov Ther. 2017;21:752–762. doi: 10.1016/j.jbmt.2017.05.014.
    1. Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement properties of visual analogue scale, numeric rating scale, and pain severity subscale of the brief pain inventory in patients with low back pain: a systematic review. J Pain. 2019;20:245–263. doi: 10.1016/j.jpain.2018.07.009.
    1. Yakut E, Düger T, Öksüz Ç, Yörükan S, Üreten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine. 2004;29:581–585. doi: 10.1097/01.BRS.0000113869.13209.03.
    1. Stuge B, Garratt A, Krogstad Jenssen H, Grotle M. The pelvic girdle questionnaire: a condition-specific instrument for assessing activity limitations and symptoms in people with pelvic girdle pain. Phys Ther. 2011;91:1096–1108. doi: 10.2522/ptj.20100357.
    1. Stuge B, Jenssen HK, Grotle M. The pelvic girdle questionnaire: responsiveness and minimal important change in women with pregnancy-related pelvic girdle pain, low back pain, or both. Phys Ther. 2017;97:1103–1113.
    1. Girard M-P, Marchand A-A, Stuge B, Ruchat S-M, Descarreaux M. Cross-cultural adaptation of the pelvic girdle questionnaire for the french-canadian population. J Manipulative Physiol Ther. 2016;39:494–499. doi: 10.1016/j.jmpt.2016.06.002.
    1. Rejano-Campo M, Ferrer-Peña R, Urraca-Gesto MA, Gallego-Izquierdo T, Pecos-Martín D, Stuge B, et al. Transcultural adaptation and psychometric validation of a Spanish-language version of the “pelvic girdle questionnaire”. Health Qual Life Outcomes. 2017;15:1–9. doi: 10.1186/s12955-017-0605-0.
    1. Fakari FR, Kariman N, Ozgoli G, Naz MSG, Ghasemi V, Fakari FR, et al. Iranian version of pelvic girdle questionnaire: psychometric properties and cultural adaptation. J Res Med Sci. 2019;24:43. doi: 10.4103/jrms.JRMS_391_18.
    1. Gutke A, Stuge B, Elden H, Sandell C, Asplin G, Fagevik OM. The Swedish version of the pelvic girdle questionnaire, cross-cultural adaptation and validation. Disabil Rehabil. 2020;42:1013–1020. doi: 10.1080/09638288.2018.1515991.
    1. Acharya RS, Tveter AT, Grotle M, Khadgi B, Koju R, Eberhard-Gran M, et al. Cross-cultural adaptation and validation of the nepali version of the pelvic girdle questionnaire. J Manipulative Physiol Ther. 2020;43:257–265. doi: 10.1016/j.jmpt.2019.04.009.
    1. Gutke A, Boissonnault J, Brook G, Stuge B. The severity and impact of pelvic girdle pain and low-back pain in pregnancy: a multinational study. J Womens Health. 2018;27:510–517. doi: 10.1089/jwh.2017.6342.
    1. Grotle M, Garratt AM, Krogstad Jenssen H, Stuge B. Reliability and construct validity of self-report questionnaires for patients with pelvic girdle pain. Phys Ther. 2012;92:111–123. doi: 10.2522/ptj.20110076.
    1. Wu J-M, Zhuo Y-Y, Qin X-L, Yu X-Y, Hu S, Ning Y. Pelvic-sacral tendon-regulation needling technique of acupuncture combined with manipulative reduction in treatment of postpartum pelvic girdle pain: a randomized controlled trial. Zhongguo Zhen Jiu. 2020;40:262–266.
    1. Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17:794–819. doi: 10.1007/s00586-008-0602-4.
    1. Fairbank JC, Pynsent PB. The Oswestry disability index. Spine. 2000;25:2940–2953. doi: 10.1097/00007632-200011150-00017.
    1. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–3191. doi: 10.1097/00007632-200012150-00014.
    1. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42. doi: 10.1016/j.jclinepi.2006.03.012.
    1. Chaudhuri KR, Martinez-Martin P, Brown RG, Sethi K, Stocchi F, Odin P, et al. The metric properties of a novel non-motor symptoms scale for Parkinson’s disease: results from an international pilot study. Mov Disord. 2007;22:1901–1911. doi: 10.1002/mds.21596.
    1. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63:737–745. doi: 10.1016/j.jclinepi.2010.02.006.
    1. Haley SM, Fragala-Pinkham MA. Interpreting change scores of tests and measures used in physical therapy. Phys Ther. 2006;86:735–743. doi: 10.1093/ptj/86.5.735.
    1. Acharya RS, Tveter AT, Grotle M, Eberhard-Gran M, Stuge B. Prevalence and severity of low back-and pelvic girdle pain in pregnant Nepalese women. BMC Pregnancy Childbirth. 2019;19:247. doi: 10.1186/s12884-019-2398-0.
    1. Close C, Sinclair M, Liddle D, Mc Cullough J, Hughes C. Women’s experience of low back and/or pelvic pain (LBPP) during pregnancy. Midwifery. 2016;37:1–8. doi: 10.1016/j.midw.2016.03.013.
    1. Bjelland EK, Eskild A, Johansen R, Eberhard-Gran M. Pelvic girdle pain in pregnancy: the impact of parity. Am J Obstet Gynecol. 2010;203:146.e1–146.e6. doi: 10.1016/j.ajog.2010.03.040.
    1. Shu X. Education and gender egalitarianism: the case of China. Sociol Educ. 2004;77:311–336. doi: 10.1177/003804070407700403.

Source: PubMed

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