title: Translation and Cross-Cultural Adaptation of the 6-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale Questionnaire Into Brazilian Portuguese.
abstract: BACKGROUND
  There are several medical questionnaires to evaluate the quality of life of carpal tunnel syndrome patients. However, most measures are only available in English. We chose to translate and culturally adapt to Portuguese the Six-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale (CTS-6) questionnaire because it provides objective assessment using a small number of questions.
  
  
  METHODS
  The translation and cultural adaptation were carried out according to the medical literature and consisted of five steps: (1) initial translation by two translators fluent in both languages, (2) association of initial translations, (3) back translation to Portuguese by two native speakers of English, (4) association of back translation and (5) comparison with the original version.
  
  
  RESULTS
  The Portuguese version was administered to patients with carpal tunnel syndrome and difficulties were noted concerning the comprehension and completion of the translated questionnaire. Patients had difficulty in understanding the horizontal layout of the response choices. Without altering the content, we changed the response choices to a vertical layout and re-administered the questionnaire to a new sample of patients followed up in the same ambulatory care service. We noted a substantial improvement in comprehension and completion of the questionnaire after the modifications.
  
  
  CONCLUSIONS
  Availability of a Portuguese version of the Six-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale (CTS-6) questionnaire will allow an objective evaluation of the treatment of a syndrome that is very prominent in medical practice.
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Brazil.
authors.forename: Rodrigo Pires
authors.initials: RP
authors.lastname: Matsuo
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Fernandes
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Brazil.
authors.forename: Lia Miyamoto
authors.initials: LM
authors.lastname: Meirelles
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Brazil.
authors.forename: Jorge
authors.initials: J
authors.lastname: Raduan Neto
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Brazil.
authors.forename: João Baptista Gomes
authors.initials: JB
authors.lastname: Dos Santos
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Universidade Federal de São Paulo, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Fallopa
keywords: 6-Item Carpal Tunnel Syndrome scale; carpal tunnel syndrome; questionnaire