Validity of the Turkish Translation of the Modified JOA

NCT07448883 | Recruiting DMC

• 1 other identifier: 2025 549
• Study Type: observational
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

Degenerative cervical myelopathy (DCM) is the most common cause of non-traumatic spinal cord dysfunction in adults and may lead to progressive motor, sensory, and autonomic impairment. Accurate and standardized assessment of neurological function is essential for clinical decision-making, prognostic evaluation, and comparison of treatment outcomes. The Modified Japanese Orthopaedic Association (mJOA) score is one of the most widely used clinician-based outcome measures for evaluating neurological status in patients with DCM. Although the mJOA has been translated and validated in several languages, no validated Turkish version currently exists. This prospective, cross-sectional validation study aims to culturally adapt the mJOA score into Turkish and evaluate its validity, reliability, and clinical correlation in Turkish-speaking patients diagnosed with DCM. Adult patients (≥18 years) with clinically and radiologically confirmed DCM presenting to the outpatient clinics of Physical Medicine and Rehabilitation and Neurosurgery will be included. Previously obtained cervical magnetic resonance imaging will be reviewed retrospectively to determine myelomalacia levels, while clinical scales will be administered prospectively. Construct validity will be assessed by examining correlations between the Turkish mJOA scores and the Neck Disability Index, as well as the Nurick grading system. Inter-rater reliability will be evaluated using the Intraclass Correlation Coefficient (ICC \[2,1\]) between two independent evaluators, and test-retest reliability will be assessed in clinically stable patients after 7-14 days. Feasibility will be evaluated by recording the administration time and potential difficulties during application. This study is expected to provide a valid and reliable Turkish version of the mJOA score, facilitating standardized assessment of DCM in Turkish clinical practice and enabling comparability with international research.

Conditions

Spondylosis, Cervical; Spinal Cord Compression

Keywords

Degenerative Cervical Myelopathy; Cervical Spondylotic Myelopathy; Modified Japanese Orthopaedic Association Score; mJOA; Reliability; Neck Disability Index

Outcome Measures

Primary Outcomes (2)

• Modified Japanese Orthopedic Association Score

  The Modified Japanese Orthopedic Association Score is a clinician-based functional assessment scale used to evaluate neurological function in patients with DSM. The scale covers four main areas: upper extremity motor function, lower extremity motor function, sensory function, and bladder (sphincter) function. Upper extremity motor function is scored from 0 to 5 points, lower extremity motor function from 0 to 7 points, sensory function from 0 to 3 points, and sphincter function from 0 to 3 points. The total score ranges from 0 to 18. Lower scores indicate more severe neurological dysfunction and poorer clinical status, while higher scores indicate better neurological function and clinical improvement. The scale is applied based on clinical examination findings and is a practical assessment tool that can be completed in a short time.

  Day 1

• Neck Disability Index

  The Neck Disability Index is an adaptation of the Oswestry Disability Index for the cervical region and is a widely used 10-item questionnaire for assessing cervical dysfunction and neck pain. Each item is scored between 0 (no disability) and 5 (complete disability). The total score ranges from 0 to 50; a higher score indicates greater functional limitation. The questionnaire has established validity and reliability in Turkish.

  Day 1

Secondary Outcomes (1)

• Nurick Grading System

  Day 1

Study Arms (1)

degenerative cervical miyelopathy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study will include patients aged 18 years and older who have been diagnosed with degenerative cervical myelopathy based on clinical and radiological evaluation and who have applied to the Physical Medicine and Rehabilitation Outpatient Clinic and Neurosurgery Outpatient Clinic at İzmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital.

You may qualify if:

• Adults aged 18 years and older
• Patients diagnosed with degenerative cervical myelopathy using clinical or magnetic resonance imaging
• Able to provide written informed consent to participate in the study
• Cognitive competence to understand Turkish forms and scales

You may not qualify if:

• Spinal cord injury due to trauma, tumor, infection, inflammatory diseases, etc., pathologies
• Previous cervical surgery
• Severe cognitive impairment or communication problems that would prevent participation in the study
• Subjects who were informed about the study but refused to participate

Sponsors & Collaborators

• Izmir Democracy University: lead

Study Sites (1)

Izmir Democracy University

Buca, İzmir, 35570, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Spondylosis; Spinal Cord Compression

Condition Hierarchy (Ancestors)

Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Spinal Cord Diseases; Central Nervous System Diseases; Nervous System Diseases; Spinal Cord Injuries; Wounds and Injuries

Central Study Contacts

Kadir Songür, Assoc. Prof.

CONTACT

+905054529231; kadir.93@gmail.com

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Month
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr. Lecturer

Study Record Dates

• First Submitted: February 27, 2026
• First Posted: March 4, 2026
• Study Start: May 10, 2026
• Primary Completion (Estimated): April 30, 2027
• Study Completion (Estimated): May 30, 2027
• Last Updated: May 13, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)