Validity of the Turkish Translation of the Modified JOA
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorIzmir Democracy University
About this trial
Degenerative cervical myelopathy (DCM) is the most common cause of non-traumatic spinal cord dysfunction in adults and may lead to progressive motor, sensory, and autonomic impairment. Accurate and standardized assessment of neurological function is essential for clinical decision-making, prognostic evaluation, and comparison of treatment outcomes. The Modified Japanese Orthopaedic Association (mJOA) score is one of the most widely used clinician-based outcome measures for evaluating neurological status in patients with DCM. Although the mJOA has been translated and validated in several languages, no validated Turkish version currently exists.
This prospective, cross-sectional validation study aims to culturally adapt the mJOA score into Turkish and evaluate its validity, reliability, and clinical correlation in Turkish-speaking patients diagnosed with DCM. Adult patients (≥18 years) with clinically and radiologically confirmed DCM presenting to the outpatient clinics of Physical Medicine and Rehabilitation and Neurosurgery will be included. Previously obtained cervical magnetic resonance imaging will be reviewed retrospectively to determine myelomalacia levels, while clinical scales will be administered prospectively.
Construct validity will be assessed by examining correlations between the Turkish mJOA scores and the Neck Disability Index, as well as the Nurick grading system. Inter-rater reliability will be evaluated using the Intraclass Correlation Coefficient (ICC \[2,1\]) between two independent evaluators, and test-retest reliability will be assessed in clinically stable patients after 7-14 days. Feasibility will be evaluated by recording the administration time and potential difficulties during application.
This study is expected to provide a valid and reliable Turkish version of the mJOA score, facilitating standardized assessment of DCM in Turkish clinical practice and enabling comparability with international research.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adults aged 18 years and older
Patients diagnosed with degenerative cervical myelopathy using clinical or magnetic resonance imaging
Able to provide written informed consent to participate in the study
Cognitive competence to understand Turkish forms and scales
Disqualifiers
Spinal cord injury due to trauma, tumor, infection, inflammatory diseases, etc., pathologies
Previous cervical surgery
Severe cognitive impairment or communication problems that would prevent participation in the study
Subjects who were informed about the study but refused to participate
Trial population
This study will include patients aged 18 years and older who have been diagnosed with degenerative cervical myelopathy based on clinical and radiological evaluation and who have applied to the Physical Medicine and Rehabilitation Outpatient Clinic and Neurosurgery Outpatient Clinic at İzmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital.
Trial design
Design model
Case-only
Time perspective
Prospective
Treatments tested in this trial
Not listed
Trial groups
70 Participants
are grouped into 1 trial groupGroup A: degenerative cervical miyelopathy
Trial outcomes
Primary outcomes
1
Modified Japanese Orthopedic Association Score
The Modified Japanese Orthopedic Association Score is a clinician-based functional assessment scale used to evaluate neurological function in patients with DSM. The scale covers four main areas: upper extremity motor function, lower extremity motor function, sensory function, and bladder (sphincter) function. Upper extremity motor function is scored from 0 to 5 points, lower extremity motor function from 0 to 7 points, sensory function from 0 to 3 points, and sphincter function from 0 to 3 points. The total score ranges from 0 to 18. Lower scores indicate more severe neurological dysfunction and poorer clinical status, while higher scores indicate better neurological function and clinical improvement. The scale is applied based on clinical examination findings and is a practical assessment tool that can be completed in a short time.
Time frame
Day 12
Neck Disability Index
The Neck Disability Index is an adaptation of the Oswestry Disability Index for the cervical region and is a widely used 10-item questionnaire for assessing cervical dysfunction and neck pain. Each item is scored between 0 (no disability) and 5 (complete disability). The total score ranges from 0 to 50; a higher score indicates greater functional limitation. The questionnaire has established validity and reliability in Turkish.
Time frame
Day 1Secondary outcomes
1
Nurick Grading System
The Nurick grading system is a clinician-based classification system developed specifically to assess walking function and the level of independence in activities of daily living in patients with degenerative cervical myelopathy. The scale consists of six grades and is scored from 0 to 5. Grade 0 indicates the presence of root symptoms without myelopathy findings; Grades 1 and 2 indicate mild walking difficulties; Grade 3 indicates limited work capacity despite being able to walk independently; Grade 4 indicates inability to walk without assistance; and Grade 5 indicates dependence on a bed or chair. Lower grades indicate a milder clinical picture, while higher grades indicate more advanced neurological function loss.
Time frame
Day 1Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Source ClinicalTrials.gov