Cross-cultural adaptation, reliability, validity and responsiveness of Urdu version of hip disability and osteoarthritis outcome score

Purpose: To linguistically and cross-culturally translate Hip Disability and Osteoarthritis Outcome Score into Urdu language (HOOS-U), and test its psychometric properties among patients with hip pain. Materials and methods: Translation and cross-cultural adaptation of English version of HOOS were carried out following international guidelines. Psychometric testing included reliability (internal consistency and test-retest reliability), validity (content and construct validity) and responsiveness. Baseline assessments included self-structured questionnaire, HOOS-U, SF-36, VAS-pain, and VAS-disability. After three weeks of advised physiotherapy intervention, patients fulfilled the aforementioned questionnaires along with Global Rating of Change (GROC) scale. Results: HOOS-U exhibited satisfactory internal consistency (Cronbach's alpha: 0.86 to 0.96) and excellent test-retest reliability (Intraclass correlation coefficient [ICC]: 0.97 to 0.99). No floor or ceiling effects were observed. Discriminant validity was confirmed by significant differences in HOOS-U scores between patients and controls (p-value <0.001). For convergent validity, HOOS-U subscales showed strong Pearson Correlation Coefficient with PF and BP subscale of SF-36, specifically the ADL subscale of HOOS-U (PF = 0.82 and BP = 0.74). HOOS-U also demonstrated strong correlations with VAS pain (-0.70 to -0.83) and VAS disability (-0.69 to 0.82). For responsiveness, all subscales improved significantly after treatment (p-value < 0.001). Conclusion: HOOS-U demonstrated good psychometric properties, making it a suitable tool for assessing outcomes in Urdu-speaking individuals.