ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2022 June;58(3):342-51

DOI: 10.23736/S1973-9087.21.07029-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Cross-cultural adaptation into Italian and validation of the Frenchay dysarthria assessment - 2

Valentina RIOLO ¹, Nicole PIZZORNI ² ✉, Eleonora GUANZIROLI ¹, Bruna AGOSTINIS ³, Megghi CONFORTOLA ⁴, Nicolò SCHETTINO ⁵, Giulia GILARDONE ⁶, Antonio SCHINDLER ², Franco MOLTENI ¹

¹ Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy; ² Department of Biomedical and Clinical Sciences “Luigi Sacco,” University of Milan, Milan, Italy; ³ Renato Piatti Foundation, Varese, Italy; ⁴ Unit of Childhood and Adolescent Neuropsychiatry, ASST Valtellina e Alto Lario, Sondrio, Italy; ⁵ ASST Lecco, Lecco, Italy; ⁶ Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy

BACKGROUND: A comprehensive evaluation of dysarthria is required to make an accurate differential diagnosis with other communication disorders and plan effective rehabilitation programs. The Frenchay Dysarthria Assessment-2 (FDA-2) is a valid, reliable and widely used protocol for the assessment of dysarthria. An Italian version of the FDA-2 is currently lacking.
AIM: To perform a cross-cultural adaptation of the FDA-2 in Italian and to validate the Italian version of the FDA-2.
DESIGN: Validation study.
SETTING: Inpatient rehabilitation center.
POPULATION: 69 patients with dysarthria and 112 healthy controls.
METHODS: The FDA-2 was translated and cross-culturally adapted to Italian. The validation study was carried out in 4 steps: (1) 42 audio-recorded samples of FDA-2 items from 11 patients with dysarthria were independently assessed by 7 speech and language pathologists for interrater reliability and re-assessed after 6 weeks for intrarater reliability; (2) 11 patients were simultaneously assessed by 3 speech and language therapists for interrater reliability of the whole Italian version of the FDA-2 and re-assessed within 24 hours for test-retest reliability; (3) the Italian version of the FDA-2 was administered to 112 healthy volunteers to gain normative data; (4) 49 patients with different types of dysarthria were assessed using the Italian version of the FDA-2, the Therapy Outcome Measure impairment scale and the Robertson Profile for the validity analysis.
RESULTS: Interrater and intrarater reliability ranged from good to excellent (ICC >0.75) except for 3 audio-recorded items. The overall protocol demonstrated excellent (ICC >0.9) inter-rater and test-retest reliability for all the sections and the total score. Normative data were gained for 6 age groups. For the validity analysis, a statistically significant difference was found between dysarthric patients and healthy subjects for all sections and the total score. The FDA-2 significantly correlated to the therapy outcome measure (r=0.75) and the Robertson Profile (r=0.81).
CONCLUSIONS: The Italian version of the FDA-2 yield satisfactory reliability and validity, comparable to the psychometric properties of the original version.
CLINICAL REHABILITATION IMPACT: Speech and language pathologists can rely on a valid and reliable tool in Italian for the assessment of dysarthria in both clinical and research practice.

KEY WORDS: Dysarthria; Speech-language pathology; Validation study