Open Access Research

Cross-cultural adaptation, reliability and validity of the Spanish version of the upper limb functional index

Antonio I Cuesta-Vargas12* and Philip C Gabel3

Author Affiliations

1 Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain

2 School of Clinical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia

3 Centre for Healthy Activities, Sport and Exercise, Faculty of Science, University of the Sunshine Coast Queensland, Sippy Downs, Australia

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Health and Quality of Life Outcomes 2013, 11:126  doi:10.1186/1477-7525-11-126

Published: 26 July 2013



The Upper Limb Functional Index (ULFI) is an internationally widely used outcome measure with robust, valid psychometric properties. The purpose of study is to develop and validate a ULFI Spanish-version (ULFI-Sp).


A two stage observational study was conducted. The ULFI was cross-culturally adapted to Spanish through double forward and backward translations, the psychometric properties were then validated. Participants (n = 126) with various upper limb conditions of >12 weeks duration completed the ULFI-Sp, QuickDASH and the Euroqol Health Questionnaire 5 Dimensions (EQ-5D-3 L). The full sample determined internal consistency, concurrent criterion validity, construct validity and factor structure; a subgroup (n = 35) determined reliability at seven days.


The ULFI-Sp demonstrated high internal consistency (α = 0.94) and reliability (r = 0.93). Factor structure was one-dimensional and supported construct validity. Criterion validity with the EQ-5D-3 L was fair and inversely correlated (r = −0.59). The QuickDASH data was unavailable for analysis due to excessive missing responses.


The ULFI-Sp is a valid upper limb outcome measure with similar psychometric properties to the English language version.

Upper limb; Psychometrics; Outcome measure; Spanish