Hebrew adaptation and validation of a clinical-quantitative method of low back pain evaluation (the BADIX)

Background: The BackAche Disability Index (BADIX) is a 2-section test: (a) the BackAche Index encompassing 5 active back movements, evaluated on a 4-point Likert-type rating scale; (b) the morning Back Stiffness Score, choosing the most fitting statement out of 6, upon awakening. Objective: To perform a cross-cultural adaptation and evaluate the reliability and validity of the Hebrew version of BADIX. Methods: Translation/retranslation of the English version of the BADIX was conducted, and the cross-cultural adaptation process performed. The Hebrew version BADIX was evaluated at two meetings, two weeks apart, in 51 female nurses (40 reported back pain and 11 reported no back problems). The Rolland Morris Disability Questionnaire (RMQ) and The Modified Oswestry Low Back Pain Disability Questionnaire (MODQ) were also evaluated. Results: The mean age of the subjects was 45.34±11.11 years. Internal consistency calculated by the Cronbach's α coefficient was very high (α>0.9). A high degree of test-retest reliability was found, with an intraclass correlation coefficient (ICC) 95% CI) of 0.933 (0.839 - 0.973), and r=0.908. Concurrent validity of the BADIX domains with the RMQ and MODQ was found statistically significant and high (ρ=0.688, RMQ, and ρ=0.674, MODQ). Conclusions: The adapted and modified Hebrew version of the BADIX is reliable and measures the pain and mobility outcome of physical impairment and morning backache stiffness. It can be employed, in addition to self-reported outcome measures, by clinicians and researchers in quantitatively evaluating the clinical status and progression of patients with lower back pain in Hebrew-speaking populations.