Cross-cultural adaptation and psychometric properties of the Arabic version of the Central Sensitization Inventory in people with chronic musculoskeletal pain

Abstract

Background The Central Sensitization Inventory (CSI) is a patient-reported screening instrument that can be used to identify and assess central sensitization (CS)/Central Sensitization Syndrome (CSS)-related symptoms. Objective The aim was to translate the CSI into Arabic (CSI-Ar) and to subsequently validate its psychometric properties. Design Cross-sectional. Methods The CSI was translated and cross-culturally adapted into Arabic, and validated following international standardized guidelines. This study included patients with chronic musculoskeletal pain (n = 264) and healthy control participants (n = 56). Patients completed the CSI-Ar, Pain Catastrophizing Scale (PCS), Depression, Anxiety, and Stress scale (DASS-21), Tampa Scale of Kinesiophobia (TSK), and 5-level EuroQol-5D (EQ-5D). Patients completed the CSI-Ar twice to assess test–retest reliability. To evaluate discriminative validity, healthy controls participants completed the CSI-Ar. Statistical analyses were conducted to test the internal consistency, reliability, and structural, construct and discriminant validity of CSI-Ar. Results The CSI-Ar showed acceptable internal consistency (Cronbach’s alpha = 0.919) and excellent test–retest reliability (intraclass correlation coefficient = 0.874). The CSI-Ar scale had significant correlations (P < 0.001) with all PCS subscales and total score (Spearman’s rho = 0.459–0.563, P < 0.001), all DASS-21 subscales and total score (Spearman’s rho = 0.599–0.685, P < 0.001), the TSK (Spearman’s rho = 0.395, P < 0.001), and the EQ-5D (Spearman’s rho = −0.396, P < 0.001). The Mann-Whitney U-test showed a statistically significant difference between the patient group and the healthy control group (P < 0.001), with the healthy controls displaying a lower average CSI-Ar score (12.27 ± 11.50) when compared to the patient group (27.97 ± 16.08). Factor analysis indicated that the CSI-Ar is a unidimensional tool. Conclusion The CSI-Ar is a reliable and valid screening tool that can be used to assess CS/CSS-related symptoms in Arabic-speaking people with chronic musculoskeletal pain.

Keywords

• Central Sensitization Inventory
• CSI
• CSI-Ar
• Pain
• Cross-cultural adaptation
• Psychometric validation