{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T01:00:35Z","timestamp":1778547635950,"version":"3.51.4"},"reference-count":52,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy, often impairing daily function and quality of life. This study aimed to translate, cross-culturally adapt, and assess the validity of the Boston Carpal Tunnel Questionnaire (BCTQ) in a Romanian cohort. Methods: We conducted a cross-sectional study to translate, culturally adapt, and validate the Romanian version of the BCTQ. A total of 190 participants were recruited, representing 380 wrists, including 130 patients with suspected or confirmed CTS and 60 healthy controls. The adaptation process followed international standards, with forward and backward translation, expert committee review, and pilot testing. Participants completed the Romanian BCTQ and performed standardized nerve conduction studies. The internal consistency and validity, including convergent and discriminant validity, exploratory factor analysis, and test\u2013retest assessments, were performed. Results: The Romanian BCTQ exhibited exceptional internal consistency (Cronbach\u2019s \u03b1 = 0.96), significant inter-item correlations, and robust factor loadings confirming a one-factor structure. Convergent validity was evidenced by strong correlations with electrodiagnostic measurements. The test\u2013retest reliability was high, with intraclass correlation coefficients above 0,99. Conclusions: The Romanian adaptation of the BCTQ is a valid, reliable, and culturally appropriate patient-reported instrument to assess symptom severity and functional status in CTS, improving clinical decision-making and cross-cultural research.<\/jats:p>","DOI":"10.3390\/diagnostics15233036","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"3036","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Translation, Cross-Cultural Adaptation and Psychometric Validation of the Romanian Version of the Boston Carpal Tunnel Questionnaire"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7811-8277","authenticated-orcid":false,"given":"Nicu Catalin","family":"Draghici","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"IMOGEN Institute, Centre of Advanced Research Studies, 400347 Cluj-Napoca, Romania"},{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4218-8622","authenticated-orcid":false,"given":"Daniel-Corneliu","family":"Leucu\u021ba","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Gianina","family":"Balea","sequence":"additional","affiliation":[{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Toader","sequence":"additional","affiliation":[{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Livint-Popa","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Tecar","sequence":"additional","affiliation":[{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Sipos-Lascu","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1115-9650","authenticated-orcid":false,"given":"Oliviu Florentiu","family":"Sarb","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor Dimitrie","family":"Lupescu","sequence":"additional","affiliation":[{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dafin Fior","family":"Mure\u0219anu","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"RoNeuro Institute, Centre for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1007\/s10571-022-01297-2","article-title":"Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review","volume":"43","author":"Malakootian","year":"2023","journal-title":"Cell Mol. Neurobiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"851","DOI":"10.5603\/FM.a2021.0121","article-title":"Carpal tunnel syndrome: State-of-the-art review","volume":"81","author":"Osiak","year":"2022","journal-title":"Folia Morphol."},{"key":"ref_3","first-page":"e49385","article-title":"Reported Symptoms and Associated Factors of Carpal Tunnel Syndrome in Qassim Region: A Cross-Sectional Study","volume":"15","author":"Alduraibi","year":"2023","journal-title":"Cureus"},{"key":"ref_4","first-page":"35","article-title":"Carpal Tunnel syndrome surgery. A 10-year retrospective analysis of 442 cases","volume":"39","author":"Lucaciu","year":"2025","journal-title":"Rom. Neurosurg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.2478\/rjom-2024-0002","article-title":"Occupational carpal tunnel syndrome: Clinical insights from a case report","volume":"75","author":"Dinescu","year":"2024","journal-title":"Rom. J. Occup. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vulpoi, G.A., Bistriceanu, C.E., B\u00eersanu, L., Palade, C.M., and Cuciureanu, D.I. (2025). Computer Use and Compressive Neuropathies of the Upper Limbs: A Hidden Risk?. J. Clin. Med., 14.","DOI":"10.3390\/jcm14155237"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rotaru-Zavaleanu, A.D., Lungulescu, C.V., Bunescu, M.G., Vasile, R.C., Gheorman, V., Gresita, A., and Dinescu, V.C. (2024). Occupational Carpal Tunnel Syndrome: A scoping review of causes, mechanisms, diagnosis, and intervention strategies. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1407302"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Dr\u0103ghici, N., Magdalena, M., Corneliu, D., Lupescu, T.D., Strilciuc, \u0218., Rednic, S., and Mure\u0219anu, D.F. (2020). Diagnosis Accuracy of Carpal Tunnel Syndrome in Diabetic Neuropathy. Medicina, 56.","DOI":"10.3390\/medicina56060279"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"C\u00eempeanu, M.C., Roman, N., Grigorescu, S., Grigorescu, O.D., and Micl\u0103u\u0219, R.S. (2024). Management of \u201cDe Novo\u201d Carpal Tunnel Syndrome in Pregnancy: A Narrative Review. J. Pers. Med., 14.","DOI":"10.3390\/jpm14030240"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2646","DOI":"10.3390\/cimb44060181","article-title":"The Pathological Links between Adiposity and the Carpal Tunnel Syndrome","volume":"44","author":"Otelea","year":"2022","journal-title":"Curr. Issues Mol. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Draghici, N.C., Balea, M.G., Toader, R., Fior, D., Dragos, H.M., and Livint, L. (2025). Validation of the Romanian Version of the 6-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale Questionnaire. J. Clin. Med., 14.","DOI":"10.3390\/jcm14093059"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Dr\u0103ghici, N.C., Leucuta, D.C., Ciobanu, D.M., Adina Dora Stan Lupescu, T.D., and Mures, D.F. (2023). Clinical Utility of Boston-CTS and Six-Item CTS Questionnaires in Carpal Tunnel Syndrome Associated with Diabetic Polyneuropathy. Diagnostics, 13.","DOI":"10.3390\/diagnostics13010004"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/S1474-4422(16)30231-9","article-title":"Carpal tunnel syndrome: Clinical features, diagnosis, and management","volume":"15","author":"Padua","year":"2016","journal-title":"Lancet Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2519\/jospt.2019.0501","article-title":"Carpal Tunnel Syndrome: A Summary of Clinical Practice Guideline Recommendations-Using the Evidence to Guide Physical Therapist Practice","volume":"49","author":"Erickson","year":"2019","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"751","DOI":"10.12680\/balneo.2024.751","article-title":"Romanian validation study of the Boston questionare in patients with carpal tunnel syndrome","volume":"15","author":"Covali","year":"2024","journal-title":"Balneo PRM Res. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1111\/hex.12186","article-title":"Patient participation in clinical encounters: A systematic review to identify self-report measures","volume":"18","author":"Mavis","year":"2015","journal-title":"Health Expect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/0895-4356(93)90142-N","article-title":"Cross-cultural adaptation of health-related quality of life measures: Literature review and and proposed guidelines","volume":"46","author":"Guillemin","year":"1993","journal-title":"J. Clin. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1023\/A:1026410721664","article-title":"\u201cEquivalence\u201d and the translation and adaptation of health-related quality of life questionnaires","volume":"6","author":"Herdman","year":"1997","journal-title":"Qual. Life Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.2106\/00004623-199311000-00002","article-title":"A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome","volume":"75","author":"Levine","year":"1993","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1080\/09638288.2019.1629651","article-title":"Cross cultural adaptation, reliability and construct validity of the Boston Carpal Tunnel Questionnaire in standard Arabic language","volume":"43","author":"Hamzeh","year":"2021","journal-title":"Disabil. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1002\/mus.10185","article-title":"Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: Summary statement","volume":"25","author":"Jablecki","year":"2002","journal-title":"Muscle Nerve."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S1474-4422(22)00432-X","article-title":"Carpal tunnel syndrome: Updated evidence and new questions","volume":"22","author":"Padua","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_24","unstructured":"Fournier, E. (2013). Atlas D\u2019\u00e9lectromyographie, Lavoisier."},{"key":"ref_25","unstructured":"Nunnally, J.C. (1994). Psychometric Theory, Tata McGraw-Hill Education. [3rd ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1177\/17531934231191685","article-title":"Use of nerve conduction studies in carpal tunnel syndrome","volume":"48","author":"Bland","year":"2023","journal-title":"J. Hand Surg."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"De Kleermaeker, F.G.C.M., Levels, M., Verhagen, W.I.M., and Meulstee, J. (2019). Validation of the Dutch Version of the Boston Carpal Tunnel Questionnaire. Front. Neurol., 10.","DOI":"10.3389\/fneur.2019.01154"},{"key":"ref_28","first-page":"346","article-title":"Erratum to \u201cA Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research\u201d","volume":"16","author":"Koo","year":"2017","journal-title":"J. Chiropr. Med."},{"key":"ref_29","unstructured":"Revelle, W. (2025, September 01). Psych: Procedures for Psychological, Psychometric, and Personality Research, Version 2.5.3, pp. 1\u2013445. Available online: https:\/\/personality-project.org\/r\/psych\/."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"296","DOI":"10.17712\/nsj.2019.4.20190014","article-title":"Translation and validation of the Arabic version of the boston carpal tunnel syndrome questionnaire","volume":"24","author":"Alanazy","year":"2019","journal-title":"Neurosciences"},{"key":"ref_31","first-page":"e10901","article-title":"Translation and Validation of the Bulgarian Version of the Boston Carpal Tunnel Questionnaire","volume":"12","author":"Karabinov","year":"2020","journal-title":"Cureus"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s10926-013-9438-9","article-title":"Validation of the Chinese version of the boston carpal tunnel questionnaire","volume":"24","author":"Lue","year":"2014","journal-title":"J. Occup. Rehabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s10072-019-03756-z","article-title":"The controversy of the normal values of ultrasonography in carpal tunnel syndrome: Diagnostic accuracy of wrist-dependent CSA revisited","volume":"40","author":"Meulstee","year":"2019","journal-title":"Neurol. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1177\/1457496919851607","article-title":"Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients","volume":"109","author":"Multanen","year":"2020","journal-title":"Scand. J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Multanen, J., Ylinen, J., Karjalainen, T., Ikonen, J., H\u00e4kkinen, A., and Repo, J.P. (2020). Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale: A Rasch analysis one year after surgery. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03626-2"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1177\/1558944717725379","article-title":"Reliability and validation of the greek version of the boston carpal tunnel questionnaire","volume":"13","author":"Bougea","year":"2018","journal-title":"Hand"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/1558944715627271","article-title":"Translation and Cross-Cultural Adaptation of the 6-Item Carpal Tunnel Syndrome Symptoms Scale and Palmar Pain Scale Questionnaire Into Brazilian Portuguese","volume":"11","author":"Matsuo","year":"2016","journal-title":"Hand"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1590\/S0004-282X2003000100009","article-title":"Tradu\u00e7\u00e3o e valida\u00e7\u00e3o do question\u00e1rio de avalia\u00e7\u00e3o de gravidade dos sintomas e do estado funcional na s\u00edndrome do t\u00fanel do carpo","volume":"61","author":"Manzano","year":"2003","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.bjps.2018.12.032","article-title":"The Polish version of the Boston Carpal Tunnel Questionnaire: Associations between patient-rated outcome measures and nerve conduction studies","volume":"72","author":"Trybus","year":"2019","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1177\/1753193414540083","article-title":"The Korean version of the Carpal Tunnel Questionnaire. Cross cultural adaptation, reliability, validity and responsiveness","volume":"40","author":"Kim","year":"2015","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.3346\/jkms.2013.28.7.1095","article-title":"Cross-cultural adaptation of the korean version of the bostoncarpal tunnel questionnaire: Its clinical evaluation in patients with carpal tunnel syndrome following local corticosteroid Injection","volume":"28","author":"Park","year":"2013","journal-title":"J. Korean Med. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Bulatovic, D., Nikolic, D., Hrkovic, M., Filipovic, T., Cirovic, D., Radosavljevic, N., and Lazovic, M. (2022). Reliability, Validity and Temporal Stability of the Serbian Version of the Boston Carpal Tunnel Questionnaire. Medicina, 58.","DOI":"10.3390\/medicina58111531"},{"key":"ref_43","first-page":"105","article-title":"Validation of the Slovakian version of Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ)","volume":"62","year":"2019","journal-title":"Acta Medica Hradec Kral."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.medcli.2015.10.013","article-title":"Validaci\u00f3n al castellano de la escala Boston Carpal Tunnel Questionnaire","volume":"146","author":"Matas","year":"2016","journal-title":"Med. Clin."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"326","DOI":"10.4274\/haseki.galenos.2023.9573","article-title":"Reliability and Validity of the Turkish Version of the 6-item Carpal Tunnel Syndrome Symptoms Scale","volume":"61","author":"Salbas","year":"2023","journal-title":"Haseki Tip. Bulteni"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1080\/09638280600621469","article-title":"Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: Reliability and validity of the Turkish version of the Boston questionnaire","volume":"28","author":"Sezgin","year":"2006","journal-title":"Disabil. Rehabil."},{"key":"ref_47","unstructured":"(2025, September 01). Metro North HHS (2016)\u2014Functional Status Scale.pdf, Available online: https:\/\/www.parliament.qld.gov.au\/Work-of-the-Assembly\/Tabled-Papers\/docs\/5516t1687\/5516t1687.pdf."},{"key":"ref_48","unstructured":"(2025, September 01). Metro North HHS (2016)\u2014Symptom Severity Scale.pdf, Available online: https:\/\/www.parliament.qld.gov.au\/Work-of-the-Assembly\/Tabled-Papers\/docs\/5516t1687\/5516t1687.pdf."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Atthakomol, P., Nudchapong, J., Sangseekaew, K., Manosroi, W., Tongprasert, S., Wongpakaran, T., and Wongpakaran, N. (2023). Field testing and psychometric properties of Thai version of the Boston carpal tunnel questionnaire. Front. Neurol., 14.","DOI":"10.3389\/fneur.2023.1132218"},{"key":"ref_50","first-page":"1","article-title":"Validation of the Polish version of the Boston Carpal Tunnel Questionnaire, and the influence of treatment for disordered sleep and daytime sleepiness in carpal tunnel syndrome","volume":"33","author":"Budnicka","year":"2024","journal-title":"Postep. Psychiatr. i Neurol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S0140-6736(14)61682-2","article-title":"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"385","author":"Naghavi","year":"2015","journal-title":"Lancet"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"277","DOI":"10.5606\/tftrd.2018.1685","article-title":"Reliability and validity of Duruoz Hand Index in carpal tunnel syndrome","volume":"64","author":"Paker","year":"2018","journal-title":"Turkish J. Phys. Med. Rehabil."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/23\/3036\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:35:14Z","timestamp":1764329714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/23\/3036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":52,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["diagnostics15233036"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15233036","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]}}}