Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Persian Version of the Patient-Rated Ulnar Nerve Evaluation (PRUNE)

Articles in Press

Document Type : RESEARCH PAPER

Authors

1 Joint Reconstruction Research Center, Department of Orthopedic Surgery, Tehran University of Medical Sciences

2 Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

4 1. Joint Reconstruction Research Center, Department of Orthopedic Surgery, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran

10.22038/abjs.2025.89398.4054

Abstract

Abstract

Objective: The Patient-Rated Ulnar Nerve Evaluation (PRUNE) is a validated, condition-specific instrument used to assess symptoms and functional limitations in patients with ulnar nerve pathologies. However, no Persian version has been available to date. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Persian version of the PRUNE in patients with Cubital Tunnel Syndrome (CuTS).

Methods: Following international guidelines, the PRUNE was translated and culturally adapted into Persian. A total of 106 patients with clinically diagnosed CuTS participated. Internal consistency was assessed using Cronbach’s alpha. Test-retest reliability was measured using the Intraclass Correlation Coefficient (ICC) over a two-week interval. Construct validity was examined through exploratory factor analysis (EFA) using principal component analysis with Varimax rotation. Convergent validity was assessed by examining correlations between PRUNE scores and established instruments: QuickDASH, DASH, and the Visual Analog Scale (VAS).

Results: The Persian PRUNE showed excellent internal consistency (Cronbach’s alpha = 0.889) and strong test-retest reliability (ICC = 0.886). EFA confirmed a multi-dimensional factor structure, consistent with the original version. Significant positive correlations were found between PRUNE and QuickDASH (r = 0.768), DASH (r = 0.699), and VAS (r = 0.664), supporting convergent validity.

Conclusion: The Persian version of the PRUNE is a reliable and valid instrument for assessing symptoms and functional limitations in Persian-speaking patients with Cubital Tunnel Syndrome. It can be confidently used in both clinical and research settings.

Keywords: PRUNE, Cubital Tunnel Syndrome, Cross-Cultural Adaptation, Persian Translation, Psychometric Validation, Upper Limb Assessment

Level of Evidence: II

Keywords

Main Subjects

The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 19 January 2026

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History

  • Receive Date: 08 July 2025
  • Revise Date: 24 September 2025
  • Accept Date: 02 November 2025

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