Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish

Gabriel Gijon-Nogueron, Mwidimi Ndosi, Alejandro Luque-Suarez, Begonya Alcacer-Pitarch, Pedro Vicente Munuera, Adam Garrow, Anthony C Redmond

    Research output: Contribution to journalArticlepeer-review


    PURPOSE: The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment 19-item questionnaire developed in the UK to measure foot pain and disability. This study aimed at conducting cross-cultural adaptation and validation of the MFPDI for use in Spain.

    METHODS: Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures were followed in the MFPDI adaptation into Spanish. The cross-cultural validation involved Rasch analysis of pooled data sets from Spain and the UK.

    RESULTS: Spanish data set comprised 338 patients, five used in the adaptation phase and 333 in the cross-cultural validation phase, mean age (SD) = 55.2 (16.7) and 248 (74.5 %) were female. A UK data set (n = 682) added in the cross-cultural validation phase; mean age (SD) = 51.6 (15.2 %) and 416 (61.0 %) were female. A preliminary analysis of the 17-item MFPDI revealed significant local dependency of items causing significant deviation from the Rasch model. Grouping all items into testlets and re-analysing the MFPDI as a 3-testlet scale resulted in an adequate fit to the Rasch model, χ (2) (df) = 15.945 (12), p = 0.194, excellent reliability and unidimensionality. Lack of cross-cultural invariance was evident on the functional and personal appearance testlets. Splitting the affected testlets discounted the cross-cultural bias and satisfied requirements of the Rasch model. Subsequently, the MFPDI was calibrated into interval-level scales, fully adjusted to allow parametric analyses and cross-cultural data comparisons when required.

    CONCLUSIONS: Rasch analysis has confirmed that the MFPDI is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions.

    Original languageEnglish
    Pages (from-to)571-9
    Number of pages9
    JournalQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
    Issue number2
    Publication statusPublished - Mar 2014


    • Cross-Cultural Comparison
    • Disabled Persons
    • Female
    • Foot
    • Health Surveys
    • Humans
    • Male
    • Middle Aged
    • Pain Measurement
    • Reproducibility of Results
    • Self-Assessment
    • Spain
    • Surveys and Questionnaires
    • Translations
    • Journal Article


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