ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1613589
GLFS-25CV adaptation for TKA
Provisionally accepted
- 1Department of Knee Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- 2The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, China, xianyang, China
- 3Guangxi University of Chinese Medicine, Nanning, Guangx, China
- 4Department of Orthopedics, Dali County Hospital, Weinan, China, Weinan, China
- 5Student Brigade of Basic Medical College, Air Force Military Medical University, Xi’an, China
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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.Objective: 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 backtranslated, 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 GLFS-25CV adaptation for TKA 2 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.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.
Keywords: Geriatric Locomotive Function Scale, Cross-cultural adaptation, Total knee arthroplasty, knee osteoarthritis, Psychometrics, Chinese
Received: 17 Apr 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Tai, Wan, Yao, Miao, Zan, Tan, Ma and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianbing Ma, Department of Knee Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
Chao Xu, Department of Knee Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
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