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

AimThe 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.MethodOne hundred and twenty-nine 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.ResultsHigh 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/conclusionThe 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)