Cross-cultural adaptation and validation of the Chinese version of the 25-question Geriatric Locomotive Function Scale in patients undergoing total knee arthroplasty
Bibliographic record
Abstract
Background: Knee osteoarthritis (KOA) is prevalent among the elderly, often necessitating total knee arthroplasty (TKA) for severe cases. However, traditional assessment tools primarily focus on pain and physical function, neglecting the psychosocial aspects that influence postoperative satisfaction. The 25-question Geriatric Locomotive Function Scale (GLFS-25) is a comprehensive measure of locomotor function, however, it has limited validation within populations in Mainland China. Objectives: This study aimed to translate, cross-culturally adapt, and validate the Chinese version of the GLFS-25 (GLFS-25CV) for evaluating postoperative outcomes in TKA patients with KOA. Methods: Following established guidelines, the English GLFS-25 was both forward- and back-translated, subjected to expert review, and pretested in 30 patients. End-stage KOA patients scheduled for primary unilateral TKA were then recruited, with a subset completing the GLFS-25CV twice, one week apart, to assess test-retest reliability. Exploratory factor analysis (EFA) was conducted to evaluate structural validity, while convergent validity was assessed through Pearson correlations with the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the 5-Level EuroQol Five-Dimensional Questionnaire (EQ-5D-5L). Internal consistency was evaluated using Cronbach's α, and standard deviations (SD) were calculated. Additionally, floor and ceiling effects were analyzed based on score distributions. Results: A total of 295 participants completed the study. Both the four-factor model identified by EFA, which explained 58% of the total variance, and the strong correlations with the OKS (rho = 0.85), the WOMAC (rho = 0.77), and the EQ-5D-5L (rho = 0.66) collectively confirm the excellent validity of the GLFS-25CV. Internal consistency was excellent (Cronbach's α = 0.94, SD > 0.85), and test-retest reliability (ICC = 0.94-0.97) was also strong, confirming its overall reliability. Neither floor nor ceiling effects were significant, and no participants reported difficulty completing the instrument. Conclusion: The GLFS-25CV is a reliable, valid, and user-friendly tool for assessing knee function in individuals in mainland China undergoing TKA for KOA. By incorporating both physical and psychosocial domains, it offers a comprehensive evaluation that is well-suited for both clinical practice and research applications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".