Cross-cultural adaptation and validation of the Neck Bournemouth Questionnaire into Urdu language

Background: The Neck Bournemouth Questionnaire (NBQ) has been translated and validated in a number of languages and has good psychometric properties for assessing neck pain. However, an Urdu translation is currently unavailable.Purpose: To translate, cross-culturally adapt, and validate the NBQ into Urdu language (NBQ-U) in patients with nonspecific neck pain (NSNP).Methods: The NBQ was translated and cross-culturally adapted into Urdu using previously described guidelines. The study included 150 Urdu-speaking patients with NSNP and 50 healthy participants. All participants completed the NBQ-U, Urdu version of neck disability index (NDI-U), neck pain and disability scale (NPDS), and numerical pain rating scale (NPRS). After three weeks of physical therapy treatment, the patients completed all of the above-mentioned questionnaires, along with the global rating of change scale. Reliability, validity, and responsiveness were all tested.Results: The NBQ-U demonstrated excellent test-retest reliability (intra-class correlation coefficient = 0.92) and high internal consistency (Cronbach's alpha = 0.89). The NBQ-U showed moderate to strong correlations with NDI-U, NPDS, and NPRS (r = 0.67-0.73, P < .001). The results revealed a significant difference between patients and healthy controls in the NBQ-U total scores (P < .001). The NBQ-U has a single factor structure with no floor or ceiling effects for individual item scores or total scores. A significant difference in the NBQ-U change scores between the stable and the improved groups (P < .001) confirmed its responsiveness. Furthermore, the NBQ-U change score showed moderate correlations with NDI-U, NPDS, and NPRS change scores (r = 0.52-0.62, P < .001).Conclusion: In Urdu-speaking patients with NSNP, the NBQ-U demonstrated good reliability, validity, and responsiveness.