Translation and Cross -Cultural Validation of ECOS-16 Questionnaire in Urdu Language

ECOS-16 was developed to evaluate the quality of life in postmenopausal women with osteoporosis. It is a brief, straightforward, self-administered questionnaire containing 16 easy-to-score items, 4 of which are taken from OQLQ and the remaining 12 taken from the Questionnaire of the QUALEFFO-41 . The 16 items are further divided into four subscales: pain (5 items), physical functioning (5 items), illness-related fear (2 items), and psychosocial functioning (4 items). Each question related to these items has five response options, ranging from 1 to 5, where 5 represents the worst quality of life score. ECOS-16 provides both subscale domain scores and an overall score. ECOS-16 questionnaire, originally developed in English, has been translated into many languages to assess for its validity and reliability ever since, but Urdu version is not developed or tested. Previous studies have shown that the translation of the scale would end up giving a standard measure to be utilized in clinical practices and research studies while sanctioning clinicians and specialists to share information and have an insight into patient's health-related concerns of Osteoporosis. The reliability and validity of the ECOS-16 have been well documented by the developers of the instrument Thus, it is imperative to translate this questionnaire into psychometrically tested Urdu version. This may promote an easy understanding of the local population in Pakistan where the Urdu language is spoken and will provide a valid measure of Quality of life to be clinically utilized by practitioners and researchers across the country.

Inclusion criteria

• Postmenopausal women who can speak and understand the Urdu language
• Osteopenic with Lumbar spine or femur T-score between -1 to -2.5
• Osteoporotic with Lumbar spine or femur T-score less than -2.5.

Exclusion criteria

• Impairment of communicative and sensorial functions
• Impaired Cognition
• Unstable angina
• disease requiring oxygen therapy and Symptomatic orthostatic hypotension
• Hypertension in poor pharmacologic control (diastolic >95 mmHg, systolic >160 mmHg)
• Neurological disorders