An Outcome Measure of Functionality and Quality of Life in Patients With Cervical Myelopathy

Background: Cervical spondylotic myelopathy (CSM) is a common cause of significant clinical morbidity. The Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) is a measure of health-related quality of life in these patients. Objectives: This study aimed to cross-culturally translate and validate the JOACMEQ in Iran. Patients and Methods: This study was a prospective clinical validation one. Forward-backward procedure was applied to translate the questionnaire from English into Persian. The translation and cross-cultural adaptation were performed in accordance with the published guidelines. A sample of patients with CSM was asked to respond to the questionnaire at two times: providing preoperative and postoperative assessments (6 months follow-up). To test the reliability, the internal consistency was assessed by Cronbach alpha coefficient and the validity was assessed by convergent validity. Responsiveness to change was also assessed comparing patients' preoperative and postoperative scores. Results: All 87 patients completed the questionnaire. The Cronbach alpha coefficient for the JOACMEQ at preoperative and postoperative assessments ranged from 0.71 to 0.82 indicating a good internal consistency for the questionnaire. In addition, the correlation of each item with its hypothesized subscale of the JOACMEQ showed satisfactory results suggesting that the items had a substantial association with their own subscales. Further analysis also indicated that the questionnaire was responsive to change (P < 0.001). Conclusions: In general, the findings suggest that the Persian version of the JOACMEQ is a reliable and valid measure of functionality and quality of life evaluation among Iranian patients suffered from CSM.