Open Access Research article

Cross-cultural adaptation and validation of a Bengali version of the modified fibromyalgia impact questionnaire

Mohammed A Muquith1, Md Nazrul Islam1*, Syed A Haq1, Peter M ten Klooster2, Johannes J Rasker2 and Muhammad B Yunus3

Author Affiliations

1 Rheumatology Wing, Department of Medicine, Bangabandhu Sheikh Mujib, Medical University, Shahbagh, Dhaka, Bangladesh

2 Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands

3 Section of Rheumatology, The University of Illinois College of Medicine, Peoria, IL, USA

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BMC Musculoskeletal Disorders 2012, 13:157  doi:10.1186/1471-2474-13-157

Published: 27 August 2012



Currently, no validated instruments are available to measure the health status of Bangladeshi patients with fibromyalgia (FM). The aims of this study were to cross-culturally adapt the modified Fibromyalgia Impact Questionnaire (FIQ) into Bengali (B-FIQ) and to test its validity and reliability in Bangladeshi patients with FM.


The FIQ was translated following cross-cultural adaptation guidelines and pretested in 30 female patients with FM. Next, the adapted B-FIQ was physician-administered to 102 consecutive female FM patients together with the Health Assessment Questionnaire (HAQ), selected subscales of the SF-36, and visual analog scales for current clinical symptoms. A tender point count (TPC) was performed by an experienced rheumatologist. Forty randomly selected patients completed the B-FIQ again after 7 days. Two control groups of 50 healthy people and 50 rheumatoid arthritis (RA) patients also completed the B-FIQ.


For the final B-FIQ, five physical function sub-items were replaced with culturally appropriate equivalents. Internal consistency was adequate for both the 11-item physical function subscale (α = 0.73) and the total scale (α = 0.83). With exception of the physical function subscale, expected correlations were generally observed between the B-FIQ items and selected subscales of the SF-36, HAQ, clinical symptoms, and TPC. The B-FIQ was able to discriminate between FM patients and healthy controls and between FM patients and RA patients. Test-retest reliability was adequate for the physical function subscale (r = 0.86) and individual items (r = 0.73-0.86), except anxiety (r = 0.27) and morning tiredness (r = 0.64).


This study supports the reliability and validity of the B-FIQ as a measure of functional disability and health status in Bangladeshi women with FM.

FIQ; Validation; Fibromyalgia; Reliability; Bengali; Questionnaire