# Development, Urdu translation, and validation of a lifestyle modification manual for patients post-total knee replacement

## TL;DR

This study created and validated a lifestyle manual in Urdu to help patients recover after knee replacement surgery at home.

## Contribution

The novel contribution is the development and validation of a culturally adapted lifestyle manual for post-knee replacement patients in Pakistan.

## Key findings

- A 34-item manual was developed and validated for relevance and clarity in both English and Urdu.
- The Urdu version achieved high content validity scores (0.864 and 0.900) for relevance and clarity.
- The manual is tailored for home-based rehabilitation of knee replacement patients in Pakistan.

## Abstract

Development, Urdu translation, and content validation of a manual on lifestyle modifications for individuals post-total knee replacement.

A methodological study design was utilized in which a thorough literature review and a group interview with eight subjects were conducted, which led to the identification of domains and generation of items. The group consisted of 10 patients who had undergone total knee arthroplasty and five caregivers. A focal group discussion was conducted to evaluate the overlay and repetition among variable items. Two series of content validation were conducted by four content experts and four untrained individuals in English and Urdu. A revision was conducted for items with scores between 0.70 and 0.79 and retention was conducted for items that scored more than 0.79. Items with a content validity index score of less than 0.70 were omitted from the final set of items.

The initial review and focus group interview finalized 53 items in the exercise, education, and diet sections. After the discussion phase, the manual was tailored to 34 items. Content validation reported that the English version of the manual received validation scores of 0.864 and 0.858 for relevance and clarity, respectively. Likewise, the Urdu version of the manual attained Scale-Content Validity Index/Average scores of 0.864 and 0.900, respectively, for these metrics.

A 34-item lifestyle modification manual was generated and its content was thoroughly validated to provide detailed guidance and instructions, enabling patients to continue their rehabilitation exercises and lifestyle modifications in the comfort of their own homes. The manual shows strong content validity, particularly for our target population in Pakistan.