Full Outline of UnResponsiveness (FOUR) scale: Translation and linguistic and cultural adaptation of the Russian language version

Introduction: The assessment of the level of consciousness in patients with acute brain injury is a mandatory first step of neurological examination. There is a need for clinical scales which allow to assess the level of wakefulness and degree of patient non-responsiveness in 2-3 minutes. The Full Outline of UnResponsiveness (FOUR) scale is an optimal tool for such clinical assessment, which focuses on eye response, motor response, brainstem reflexes, and respiratory pattern. The absence of an officially translated and validated version impedes the use of FOUR scale in Russia, while the use of non-validated clinical scales carries a risk of erroneous diagnosis and reduces the quality and information value of research studies. Study aim: to develop an official Russian language version of the FOUR scale, taking into account its linguistic and cultural characteristics as part of the validation st udy. Materials and methods: The first stage of the validation process was completed, consisting of the linguistic and cultural adaptation of the FOUR scale. Medical professionals (Russian and English native speakers) performed forward and back translations of the original scale. The developed version then underwent review by the Expert Commission, which included a linguist, neurologists, anaesthesiologists and intensive care specialists. The next step was a pilot test of the scale. Results: The main difficulties in the translated text of the scale were solved during the first meeting of the Expert Commission. Then, taking into account the inclusion and exclusion criteria, a pilot test was performed by assessing 15 patients with the developed version of the FOUR scale. The statistics of this cohort are presented. Investigators had no difficulties in understanding and interpreting the scale instructions during the pilot test. Based on the results, the final version of the scale was adopted. The Russian version of the scale text with instructions and illustrations is presented in this paper. Conclusion: Translation, linguistic and cultural adaptation of the FOUR scale was conducted at the Research Centre of Neurology (Moscow, Russia). For the first time, the Russian version of the scale is officially presented and recommended for widespread use in clinical and research practice in Russia and other Russian-speaking countries based on the results of pilot testing. The next publication will present the results of the evaluation of psychometric properties (reliability, sensitivity, etc.) of this version of the scale. © 2019 Sovero Press Publishing House. All rights reserved

Validation of the modified rankin scale in Russia

Objective: to develop a Russian version of the modified Rankin Scale (mRS) and to assess its psychometric properties. Patients and methods: The investigation involved 50 patients (25 women, 25 men) over 18 years of age (mean age, 56 years) with an acute cerebrovascular accident diagnosis. During the validation procedure, the authors carried out the linguocultural ratification of mRS, prepared its Russian-language version, and then assessed its psychometric properties (reliability, sensitivity, validity). Results and discussion: Translation and linguistic adaptation of mRS was successfully completed. The results obtained in assessing the psychometric properties of the developed Russian version of the scale reflect its high reliability and the valid and reliable indicators of its sensitivity. A statistical study of constructive and content validity also determined the high significance of differences. Conclusion: The investigation has resulted in the official Russian version of mRS, which is recommended for use by neurologists and rehabilitation specialists in both daily clinical practice and in clinical trials. © 2018 Ima-Press Publishing House. All Rights Reserved

Glasgow coma scale: Linguistic-cultural adaptation of the Russian version [Шкала комы Глазго (Glasgow Coma Scale, GCS): лингвокультурная адаптация русскоязычной версии]

INTRODUCTION Determination of the degree of depression of consciousness in patients with brain damage upon admission to the intensive care unit and intensive therapy is a primary task. In order to carry out a quick and at the same time sufficiently complete assessment of this kind, in 1974 neurosurgeons Graham Teasdale and Bryan Jennett from the University of Glasgow developed an algorithm consisting of a sequential series of tests in the form of eye opening, speech and motor responses, called Glasgow Coma Scale. This scale has received worldwide recognition and for many decades has been the main one for determining the state of consciousness in the most severe patients with brain damage. The absence of a validated version of this scale complicates its application in Russia, and the use of currently available versions that have not passed all the necessary stages of validation distorts the originally intended meaning of the scale and does not allow obtaining reliable clinical results when examining patients with acute impairment of consciousness. AIM OF STUDY Development of the official Russianlanguage version of the Glasgow Coma Scale, taking into account linguistic and cultural characteristics (1st stage of the validation study). MATeRIAL AND MeTHODS The staff of Center for Validation of Health Status Questionnaires and Scales in Russia, Research Center of Neurology obtained consent from G. Teasdale to validate Glasgow Coma Scale in Russia. Two Russianspeaking professional certified translators in the field of medicine performed a direct translation of the original Englishlanguage scale, and a reverse translation was carried out by native speakers with a medical education. Pilot study was performed in 15 patients with acute impairment of consciousness, two meetings of the expert committee were held (before and after pilot study). ReSULTS Based on the results of the first meeting of the expert commission, a linguistic and cultural adaptation of the text of the scale was carried out. During the pilot testing of the researchers did not have difficulties in understanding and interpreting instructions. As a result, the second meeting of the expert commission was held and the final Russianlanguage version was approved, which is presented in this article and is available on the website of Center for Validation of Health Status Questionnaires and Scales in Russia, Research Center of Neurology. CONCLUSION For the first time, the Russian language version of the Glasgow Coma Scale was officially presented and recommended for use both in clinical and research practice in Russia and other Russian speaking countries. The next publication will highlight the result of assessing the psychometric properties (reproducibility, interexpert agreement and sensitivity) of the Russianlanguage version of the scale. © 2021 Sklifosovsky Research Institute for Emergency Medicine. All rights reserved

Validation of the Modified Ashworth scale in Russia

Spasticity after stroke is a factor that causes disability and restricts activities of daily living, and presents a problem for both doctors and patients' relatives. At the present time, the Modified Ashworth scale (MAS) is a useful method of assessing increased muscle tone in patients after a cerebrovascular incident. The aim of the work is the linguistic and cultural adaptation of the MAS, with subsequent evaluation of its psychometric properties. Materials and methods: The study included 50 patients. The validation procedure consisted of linguistic and cultural adaptation and evaluation of the psychometric properties of the Russian language version of the MAS. Test-retest was used to examine reliability (calculating Spearman's rank correlation coefficient) and Cohen's kappa coefficient was used to evaluate inter-rater agreement. Criterion validity was assessed by comparing the MAS results with the Spasticity Scale score of the Research Centre of Neurology. Sensitivity was measured using Wilcoxon nonparametric test, which reflects the statistical significance of intertest differences before and after rehabilitation measures. Results: Test-retest analysis showed a significant correlation (ρ=0.87) between reassessment results. Inter-rater reliability was average (ρ=0.56), which confirms the scale's subjectivity and proves that patient assessment over time should be performed by the same investigator whenever possible. The correlation coefficient between the MAS and the Spasticity Scale of the Research Centre of Neurology was ρ=0.79. Statistically significant differences were found when patients were reassessed after rehabilitation treatment (p<0.0001). Conclusion: The Russian version of the MAS is a valid, reliable and sensitive instrument, which can be recommended for use in clinical practice, both for the initial assessment of spasticity and for monitoring the effect of treatment. © 2020 Sovero Press Publishing House. All rights reserved

Validation of the Russian version of the Fugl-Meyer Assessment of Physical Performance for assessment of patients with post-stroke paresis [Validatsiya russkoyazychnoi versii shkaly Fugl-Meiera dlya otsenki sostoyaniya patsientov s postinsul'tnym parezom]

OBJECTIVE: To perform linguistic and cultural adaptation of the Fugl-Meyer Assessment of Physical Performance. MATERIALS AND METHODS: The study for assessment of psychometric properties included 53 post-stroke patients with neurological deficit presented by hemiparesis of different severity. The patients were assessed twice: at admission and after 14 days of treatment and rehabilitation procedures. The Russian version of the Fugl-Meyer Assessment of Physical Performance was developed with consideration of language and cultural characteristics. RESULTS AND CONCLUSION: Results of assessment of psychometric properties of the Russian-language version show its high validity, reliability and sensitivity. The developed Russian-language version of Fugl-Meyer Assessment of Physical Performance is recommended for using by neurologists and rehabilitation specialists both in everyday clinical practice and in clinical studies of patients with post-stroke paresis. The results obtained in the study show necessity for pre-training of specialists who perform assessment of patients with post-stroke paresis using the Fugl-Meyer Assessment of Physical Performance.ЦЕЛЬ ИССЛЕДОВАНИЯ: Лингвокультурная адаптация шкалы оценки физического состояния Фугл-Мейера (Fugl-Meyer Assessment of Physical Performance). МАТЕРИАЛ И МЕТОДЫ: В исследование по оценке психометрических свойств разработанной русскоязычной версии было включено 53 пациента, перенесших нарушение мозгового кровообращения с развитием гемипареза различной степени выраженности. Все пациенты были осмотрены дважды: в первый день поступления и через 14 дней после лечебно-восстановительных мероприятий. С учетом языковых и культурных особенностей подготовлена русскоязычная версия шкалы оценки физического состояния Фугл-Мейера. РЕЗУЛЬТАТЫ И ЗАКЛЮЧЕНИЕ: Данные, полученные при оценке психометрических свойств русскоязычной шкалы, отражают высокую степень ее содержательной валидности, надежности и чувствительности. Разработанная валидированная русскоязычная версия шкалы Фугл-Мейера является инструментом, рекомендованным к использованию врачами-неврологами и реабилитологами как в повседневной практике, так и при проведении клинических исследований с участием пациентов с постинсультным парезом. В ходе исследования были получены данные, свидетельствующие о необходимости предварительной подготовки (обучения, тренинга) специалистов, проводящих оценку больных с постинсультным гемипарезом с использованием шкалы Фугл-Мейера