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Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish

Gijon-Nogueron, Gabriel; Ndosi, Mwidimi; Luque-Suarez, Alejandro; Alcacer-Pitarch, Begonya; Munuera, Pedro Vicente; Garrow, Adam; Redmond, Anthony C.


Gabriel Gijon-Nogueron

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Dr Mwidimi Ndosi
Associate Professor in Nursing Rheumatology

Alejandro Luque-Suarez

Begonya Alcacer-Pitarch

Pedro Vicente Munuera

Adam Garrow

Anthony C. Redmond


Purpose: The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment 19-item questionnaire developed in the UK to measure foot pain and disability. This study aimed at conducting cross-cultural adaptation and validation of the MFPDI for use in Spain. Methods: Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures were followed in the MFPDI adaptation into Spanish. The cross-cultural validation involved Rasch analysis of pooled data sets from Spain and the UK. Results: Spanish data set comprised 338 patients, five used in the adaptation phase and 333 in the cross-cultural validation phase, mean age (SD) = 55.2 (16.7) and 248 (74.5 %) were female. A UK data set (n = 682) added in the cross-cultural validation phase; mean age (SD) = 51.6 (15.2 %) and 416 (61.0 %) were female. A preliminary analysis of the 17-item MFPDI revealed significant local dependency of items causing significant deviation from the Rasch model. Grouping all items into testlets and re-analysing the MFPDI as a 3-testlet scale resulted in an adequate fit to the Rasch model, χ 2 (df) = 15.945 (12), p = 0.194, excellent reliability and unidimensionality. Lack of cross-cultural invariance was evident on the functional and personal appearance testlets. Splitting the affected testlets discounted the cross-cultural bias and satisfied requirements of the Rasch model. Subsequently, the MFPDI was calibrated into interval-level scales, fully adjusted to allow parametric analyses and cross-cultural data comparisons when required. Conclusions: Rasch analysis has confirmed that the MFPDI is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions. © 2013 Springer Science+Business Media Dordrecht.


Gijon-Nogueron, G., Ndosi, M., Luque-Suarez, A., Alcacer-Pitarch, B., Munuera, P. V., Garrow, A., & Redmond, A. C. (2014). Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish. Quality of Life Research, 23(2), 571-579.

Journal Article Type Article
Acceptance Date Aug 9, 2013
Online Publication Date Aug 23, 2013
Publication Date Mar 1, 2014
Journal Quality of Life Research
Print ISSN 0962-9343
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 23
Issue 2
Pages 571-579
Keywords cross-cultural validation, patient outcome measures, foot pain, Rasch Analysis
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