Crosscultural adaptation, reliability, and validity of the Japanese version of the neck disability index.

STUDY DESIGN: Translation and psychometric testing.

OBJECTIVE: To translate and culturally adapt the Neck Disability Index (NDI) and to assess the reliability and validity of the Japanese version of the NDI (NDI-J) in Japanese outpatients with neck pain.

SUMMARY OF BACKGROUND DATA: To date, no previous report exists on the translation process and psychometric testing of the NDI-J.

METHODS: The NDI was translated and culturally adapted into Japanese in accordance with published guidelines. A total of 110 outpatients with neck pain participated in the study. Psychometric testing included reliability by internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient), factor analysis, convergent validity by comparing the NDI-J with the short-form health survey (Pearson correlation) and responsiveness (unpaired t tests, standard error of measurement, and minimal detectable change).

RESULTS: The Cronbach α of the NDI-J was 0.88 and the intraclass correlation coefficient for test-retest reliability was 0.91 (95% confidence interval, 0.82-0.95). Factor analysis demonstrated a 2-factor structure, explaining 61.8% of the total variance. The correlation between the NDI-J and the short-form health survey, version 36, subscales ranged from good to fair (-0.25 to -0.51). The analysis of responsiveness was calculated with an unpaired t test after 3 weeks of treatment demonstrating a statistically significant difference between the stable and improved patients (P ≤ 0.05). The standard error of measurement and minimal detectable change were calculated as 2.9 and 6.8, respectively.

CONCLUSION: The NDI-J is a valid, reliable, and responsive tool that can be used to assess neck pain in Japanese outpatients.