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



Naghizadeh H ; Arabi H ; Salkhori O ; Ayati Firoozabadi M ; Khabiri S S ; Kalantar S H ; Poorghasem E ; Arabzadeh A
Source: Archives of Bone and Joint Surgery Published:2026

Abstract

Objectives: The Patient-Rated Ulnar Nerve Evaluation (PRUNE) is a validated, condition-specific instrument designed to assess symptoms and functional limitations in individuals with ulnar nerve disorders. However, no Persian adaptation has been developed to date. The present study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Persian version of the PRUNE among 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 Cubital Tunnel Syndrome (CuTS) were enrolled in the study. Internal consistency was evaluated using Cronbach’s alpha, and test–retest reliability was determined with the Intraclass Correlation Coefficient (ICC) over a two-week interval. Construct validity was examined through an exploratory factor analysis (EFA) using principal component extraction and Varimax rotation. Convergent validity was examined by assessing the correlations between PRUNE scores and those of established instruments, including the QuickDASH, DASH, and Visual Analog Scale (VAS). Results: The Persian version of the PRUNE demonstrated excellent internal consistency (Cronbach’s α = 0.889) and strong test–retest reliability (ICC = 0.886). Exploratory factor analysis confirmed a multidimensional factor structure consistent with that of the original instrument. Significant positive correlations were observed between the PRUNE and the QuickDASH (r = 0.768), DASH (r = 0.699), and VAS (r = 0.664), supporting its convergent validity. Conclusion: The Persian version of the PRUNE proved to be a reliable and valid instrument for assessing symptoms and functional limitations in Persian-speaking patients with Cubital Tunnel Syndrome. It can be confidently applied in both clinical practice and research contexts. Level of evidence: II. © 2026BY THE ARCHIVES OF BONE AND JOINT SURGERY and 2026 Mashhad University of Medical Sciences.