Cross-Cultural Adaptation and Psychometric Validation of the Turkish Version of the American Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal-Interphalangeal Joint Scale

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dc.authorid0000-0002-2595-9459
dc.contributor.authorKoluman, Ali Can
dc.contributor.authorCiftci, Ebru Aloglu
dc.contributor.authorCiftci, Mehmet Utku
dc.contributor.authorSahbaz, Yasemin
dc.contributor.authorOzturk, Vedat
dc.contributor.authorDuramaz, Altug
dc.contributor.authorBaca, Emre
dc.date.accessioned2026-01-31T15:09:08Z
dc.date.available2026-01-31T15:09:08Z
dc.date.issued2025
dc.departmentİstanbul Beykent Üniversitesi
dc.description.abstractObjective: Lesser toe disorders can cause significant functional impairment and pain, requiring reliable tools for outcome assessment. The American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) joint scale is a clinician-based instrument frequently used in foot and ankle evaluations, yet no validated Turkish version exists. The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Turkish version of the AOFAS lesser MTP-IP scale. Methods: The scale was translated following international cross-cultural adaptation guidelines. A total of 43 patients with various lesser-toe pathologies were assessed using the AOFAS lesser MTP-IP, foot and ankle ability measure (FAAM), visual analogue scale, and short form-12 (SF-12). Test-retest reliability was assessed by calculating intraclass correlation coefficients [ICC (2,1)] using a two-way mixed-effects model with absolute agreement; by assessing internal consistency via Cronbach's alpha; and by evaluating agreement using Bland-Altman analysis. Construct validity was tested by correlating AOFAS scores with FAAM and SF-12 subscales. Floor and ceiling effects were also analyzed. Results: The Turkish version demonstrated excellent test-retest reliability [ICC (2,1)=0.96] and acceptable internal consistency (alpha=0.76). Bland-Altman plots revealed no systematic bias. Strong correlations were observed with FAAM-activities of daily living (r=0.93) and FAAM-sports (r=0.75), whereas correlations with SF-12 physical component summary (r=0.34) and MCS (r=0.45) were weak but significant, which is consistent with the hypothesized convergent and divergent validity. A notable ceiling effect was identified in the AOFAS function and alignment domains, consistent with the high functional status and low pain levels reported by participants. Conclusion: The Turkish adaptation ofthe AOFAS lesser MTP-IP scale is a reliable and valid instrumentfor evaluating pain, function, and alignment in patients with lesser toe disorders. Its strong psychometric performance supports its use in both clinical and research settings, although the observed ceiling effect should be interpreted in the context of patient characteristics.
dc.identifier.doi10.4274/BMJ.galenos.2025.2025.10-5
dc.identifier.endpage467
dc.identifier.issn1305-9319
dc.identifier.issn1305-9327
dc.identifier.issue4
dc.identifier.startpage458
dc.identifier.trdizinid1365734
dc.identifier.urihttps://doi.org./10.4274/BMJ.galenos.2025.2025.10-5
dc.identifier.urihttps://search.trdizin.gov.tr/tr/yayin/detay/1365734
dc.identifier.urihttps://hdl.handle.net/20.500.12662/10835
dc.identifier.volume21
dc.identifier.wosWOS:001644593100001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakTR-Dizin
dc.language.isoen
dc.publisherGalenos Publ House
dc.relation.ispartofMedical Journal of Bakirkoy
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20260128
dc.subjectAOFAS
dc.subjectlesser toe
dc.subjectTurkish validation
dc.subjectreliability
dc.subjectvalidity
dc.subjectpsychometrics
dc.subjectfoot and ankle
dc.titleCross-Cultural Adaptation and Psychometric Validation of the Turkish Version of the American Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal-Interphalangeal Joint Scale
dc.typeArticle

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