Translation of SCIM IV into Gujarati: Improving Accessibility for Gujarati-Speaking Individuals with Spinal Cord Injury

Abstract

Introduction: Spinal cord injury (SCI) is a severe neurological condition with profound effects on physical, psychological, and socioeconomic well-being. In Gujarat, SCI disproportionately affects young males in rural areas due to road traffic accidents and occupational hazards [3]. The Spinal Cord Independence Measure IV (SCIM IV) is a globally recognized tool for assessing functional independence in SCI patients. However, the absence of a validated Gujarati version limits its utility in regions where English proficiency is low. Given that Gujarati is spoken by over 60 million people worldwide, this study aimed to translate and linguistically validate SCIM IV into Gujarati to improve accessibility and clinical use.

Methods: The study followed MAPI Research Trust's standardized linguistic validation protocol. Steps included forward translation by two independent translators, reconciliation into Version 1 by an expert panel, backward translation for conceptual equivalence, cognitive debriefing with 10 Gujarati-speaking SCI patients and caregivers, and final proofreading by bilingual experts. Cultural and linguistic adaptations were made based on participant feedback and expert review.

Results: The forward translation addressed challenges related to complex medical terms, cultural context, and readability. Cognitive debriefing confirmed the clarity and relatability of items, leading to minor refinements. Backward translation showed strong conceptual consistency with the original SCIM IV. The final Gujarati version retained the intent of the original, using familiar terms such as “ગતિશીલતા સાધનો” (mobility aids) and “સ્વ-કાળજી પ્રવૃત્તિઓ” (self-care activities). Proofreading ensured grammatical correctness, terminology consistency, and formatting accuracy. The final version was confirmed to be culturally appropriate and linguistically accurate for clinical use.

Conclusion: This study successfully produced a linguistically validated Gujarati version of the SCIM IV. It bridges a crucial gap in SCI assessment among Gujarati-speaking populations, enabling more accurate evaluation, better clinician-patient communication, and improved rehabilitation outcomes. Given the high burden of SCI in Gujarat [3], this tool is poised to enhance clinical practice, especially in rural and underserved areas. Future studies should focus on psychometric testing and large-scale field validation.