Cross-Cultural Adaptation of the Dance Functional Outcome Survey (DFOS) for Spanish Dancers

Blanca de-la-Cruz-Torres, Irene Barrera-García-Martín, Carlos Romero-Morales, Shaw Bronner, Blanca de-la-Cruz-Torres, Irene Barrera-García-Martín, Carlos Romero-Morales, Shaw Bronner

Abstract

A growing number of research papers regarding Spanish-speaking dancers justifies the need for an adapted Spanish version of the Dance Functional Outcome Survey (DFOS). The objective of this study was to cross-culturally adapt and validate the DFOS for Spanish-speaking dancers. A sample of 127 healthy and injured professional and pre-professional dancers were recruited. Test-retest reliability of DFOS-Sp was examined using intraclass correlation coefficients. Construct validity compared DFOS-Sp to the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) using Pearson correlations. Principal component analysis identified factors and internal-item consistency. Sensitivity was evaluated by generating receiver operating characteristic and area under the curve analyses. A subgroup of 51 injured dancers were followed across three time-points to examine responsiveness using repeated measures analysis of variance. Injured scores were analyzed for floor and ceiling effects. The DFOS-Sp showed high test-retest reliability (ICC2,1 ≥ 0.92). DFOS-Sp scores had moderate construct validity compared with SF-36 physical component summary scores (r ≥ 0.56). Principal component analysis (PCA) supported uni-dimensionality explaining 58% of the variance with high internal consistency (α = 0.91).Area under the curve (AUC) sensitivity values were excellent (AUC ≥ 0.82). There were significant differences across time (p < 0.001), demonstrating responsiveness to change, with no floor or ceiling effects. The DFOS-Sp demonstrated acceptable test-retest reliability and validity in Spanish-speaking dancers, with comparable psychometric performance to the English-language version.

Keywords: cross-cultural adaptation; dance; musculoskeletal injury; patient-reported outcome measure; physical therapy diagnosis; validation.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the steps for translation of the DFOS (English to Spanish). Abbreviations: Sp, Spanish; DFOS, Dance Functional Outcome Survey.
Figure 2
Figure 2
Receiver Operating Characteristic (ROC) curve for DFOS-Sp total, ADL and Technique scores. Abbreviations: ADL, activities of daily living; Tech, Technique; DFOS-Sp total, Spanish Dance Functional Outcome Survey total.
Figure 3
Figure 3
Injuries categorized by diagnosis.
Figure 4
Figure 4
Mean ±SD DFOS-Sp and SF-36 scores across three time-points. Abbreviations: ADL, activities of daily living; DFOS, Dance Functional Outcome Survey; PCS, physical component summary; MCS, mental component summary.

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