Translation, Cross-cultural Adaptation, and Study of the Validity and Reliability of the Persian Version of Sport Concussion Assessment Tool 5 (SCAT5)

Background and Objectives: This study was done to translate and evaluate the validity and reliability of the Persian version of the Sport Concussion Assessment Tool 5 (SCAT5) among Iranian martial arts athletes. Methods: Translation and adaptation were performed in several stages with the instructions provided by Beaton et al. A total of 86 Persian-speaking martial arts athletes (42 males and 44 females) participated in this study. Descriptive statistics were reported for all items of SCAT5. For determining construct validity, the correlations between items of the Persian version of the SCAT5 and the Beck Depression Inventory (BDI) were all reviewed. The reliability of the questionnaire was determined from two different aspects of test-retest reliability and internal consistency. Results: The processes of translation and cultural adaptation were done by maintaining cultural adaptation through replacing appropriate words and terms, and finding semantic and perceptual equivalents. There was a significant difference between the results of male and female participants. For components of the SCAT5 in comparison with BDI, Spearman rank-order correlation coefficient (rho) was moderate with the Persian version of BDI 0.57 (p<0.001) in terms of the number of symptoms and severity of symptoms 0.50 (p<0.001). Regarding the test-retest reliability, the Persian version of the SCAT5 questionnaire showed excellent reliability for all items (ICC>0.75) and moderate reliability for the number of symptoms (ICC=0.48) and severity of symptoms (ICC=0.49). The coefficient of Cronbach’s alpha was more than 0.70 for all items of the Persian version of the SCAT5. Conclusion: The Persian version of the SCAT5 is a valid and moderate reliable instrument for medical professionals and health care providers in concussion assessment. The ceiling effect was observed in three components, including orientation and two parts of concentration (backward recalling of digits+recalling of months in reverse order).