Translation, cross-cultural adaptation and validation of the 'Musculoskeletal Pain Intensity and Interference Questionnaire for Professional Orchestra Musicians' for Brazilian musicians

Abstract

Introduction: Researches have shown that the career of a professional musician has a high prevalence of playing-related musculoskeletal disorders. However, despite the evident scientific growth in the musician's health area, several studies are still conducted without defined methodological criteria, especially regarding the use of non-validated and inconsistent data collection instruments. Objective: This study aimed to translate into the Portuguese language and adapt to the Brazilian cultural context, the "Musculoskeletal Pain Intensity and Interference Questionnaire for Professional Orchestra Musicians" (MPIIQM). Also, a validation study analyzed its psychometric properties. Methods: The MPIIQM consists of 22 items that evaluate the presence of musculoskeletal pain related to musical performance, its location, intensity, and interference in the social and working life of professional orchestra musicians. The translation and adaptation processes were divided into nine steps until the final questionnaire was elaborated (MPIIQM-Br). Additionally, a committee of five experts was responsible for evaluating the conceptual, idiomatic, and semantic equivalences, moreover, the Content Validity Ratio (CVR). For the validation stage, the dimensional structure and component items (factor analysis), reliability (internal consistency and temporal stability), and construct validity were verified. Convergent validity was analyzed by comparing the results obtained by the MPIIQM-Br, the Brief Pain Inventory (BPI), and the optional module of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). Results: According to the expert's committee, a good equivalence was found between all versions, and the general CVR reached 0.99. In the validation stage, 273 professional orchestral musicians (137 male) living and performing in eight cities of the State of Rio de Janeiro participated. Their average age was 38 years (± 6.19), and the average time of musical experience was 25.9 years (± 6.12). Exploratory factor analysis showed that MPIIQM-Br had two factors (dimensions) with eigenvalues higher than 1.0 and these explained 70% of the total variance. However, the partial confirmatory analysis suggested that this was not the most adjusted model for the instrument. Regarding reliability, both internal consistency (Cronbach's α = 0.905) and temporal stability (Intraclass Correlation Coefficient = 0.849) obtained high values in all analyzes. Finally, construct validity confirmed a good correlation between MPIIQM-Br results with BPI and the DASH optional module. Conclusion: All steps of translation and cross-cultural adaptation were achieved and demonstrated that MPIIQM-Br contained the characteristics of the original instrument. Moreover, the analysis of its psychometric property presented adequate reliability and construct validity indices. Future studies should extend into a more robust confirmatory factor analysis and consider validating the tool for other non-orchestral contexts.