Oral Communication

Cross-cultural adaptation and validation of the Amputation Body Image Scale (ABIS®) and its shortened version (ABIS-R®)for French speaking patients with lower limb amputation..

Dr Aurélie VOUILLOZa, Mr Philippe VUISTINERa, Dr Isabelle LOIRETb, Dr Noël MARTINETb, Prof Jean PAYSANTb, Dr Yvan ARLETTAZc, Dr Mathieu ASSALd, Dr Olivier BORENSe, Dr Laure HUCHONb, Dr François LUTHIa

a Clinique romande de réadaptation, 1950 Sion, b Institut régional de Médecine Physique et Réadaptation, 54042 Nancy, c Hôpital de Martigny, Réseau Santé Valais, 1920 Martigny, d Clinique de la Colline, 1206 Genève, e Centre Hospitalier Universitaire Vaudois, 1011 Lausanne

Aim. The Amputation Body Image Scale (ABIS®) and its shortened version (ABIS-R®) are self-administered questionnaires addressing the patient’s perspective, only available in English [1] and Turkish. The aim of this study was the French cross cultural adaptation and validation of the ABIS (ABIS-F) and its shortened version ABIS-R (ABIS-R-F). Psychometrics properties: internal consistency, test-retest reliability, construct validity.

Method. 129 patients (23% women), with a mean age of 62 years, with lower limb amputation for at least 1 year (vascular 75%, traumatic 25%) were recruited in 5 clinical centers. Translation and cross-cultural adaptation (ABIS 20 items; ratings of 1-5; high score indicating high body disturbance, and ABIS-R 14 items, ratings of 0-2) were made according to international guidelines. Internal consistency was calculated by the coefficient of Cronbach. Test-retest reliability was assessed by intraclass correlation in a subgroup who completed the ABIS on 2 occasions with an interval of 5 to 7 days. Construct validity was estimated through correlations with SF-36 mental component summary (MCS) and SF-36 physical component summary (PCS). Correlations with some scales of the Brief Pain Inventory (BPI): pain severity, highest pain and pain interference with activities.

Results. High internal consistency(ABIS-F:α=0.91, ABIS-R-F: α=0.90).Test-retest reliability (24 patients) was good: ABIS-F 0.87 [95% CI 0.69-0.95] and for ABIS-R at 0.86 [95% CI 0.66-0.94]. Correlations with SF-36 were negative: ABIS-F/ SF-36 CM: -0.40 [-0.54 to -0.21], ABIS-R-F/SF-36 CM: -0.42 [-0.56 to -0.24]; ABIS-F/ SF-36 CP: -0.40 [-0.54 to -0.21], ABIS-R-F/SF-36 CP: -0.44 [-0.58 to -0.26]. Correlations with pain were positive for both ABIS questionnaires: respectively for ABIS-F and for ABIS-R-F: pain severity, 0.39 [0.20-0.54] and 0.38 [0.19-0.53]: highest pain, 0.39 [0.20-0.54] and 0.39 [0.20-0.54]: interference with activities, 0.53 [0.36-0.65] for both. No floor or ceiling effects.

Discussion/Conclusion. The ABIS-F and the ABIS-R-F have the same good psychometric properties as the original ABIS® and ABIS-R®. They could be applied with confidence in patients with lower limb amputation. The ABIS-R-F (the shortened version) is as reliable as the ABIS-F (the longer version).

[1]Gallagher P,Horgan O,Franchignoni F,Giordano A,MacLachlan M. Body image in people with lower-limb amputation: a Rasch analysis of the Amputee Body Image Scale.Am J Phys Med Rehabil.2007; 86:205-15.

Keywords : amputation, body image scale, French cross cultural adaptation