Development of Multidimensional Nil Hallux Valgus Scale: a reliability and validity study

Abstract

Objective: The aim of this study was to develop a disease-specific multidimensional hallux valgus
(HV) scale, as well as to establish the validity and reliability thereof.
Methods: The 14-item Multidimensional Nil Hallux Valgus Scale was developed. The scale has a
score range of 0–60, with higher score indicating increased HV symptoms, complaints, and functional
disorder. Among the patients referred to our clinic with HV diagnosis based on anterior-posterior
non-weight-bearing radiography of the affected foot, 129 feet of 66 patients (63 bilateral, 3 unilateral)
were included in the study. In clinical evaluations of these HV patients, American Orthopaedic
Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal Joints Scale (AOFAS-MTFIF),
Manchester Scale, and Short Form 36 Health Survey (SF-36) were used to test the validity and
reliability of the new scale.
Results: From factor analyses, it was observed that the items clustered in 5 factors, which explained
73.2% of the variance. Floor and ceiling effects were observed to be within normal limits (floor effect:
3.1%; ceiling effect: 0.8%). The Cronbach’s alpha level related with the overall internal consistency of
the scale was estimated as 83.3%, and the Cronbach’s alpha for the subheadings of the scale varied
between 33.9% and 74.2%. High correlation was observed regarding test-retest reliability of the scale.
Conclusion: This newly developed scale allows for the holistic evaluation of HV including the condition-
specific parameters and is a valid and reliable scale that can be conveniently used by health care
professionals.

Keywords

• Deformities; Hallux Valgus; reliability; scales; validity.