Cross-cultural adaptation and psychometric testing of the Hausa version of the London Handicap Scale among stroke survivors in Nigeria

Introduction
Stroke is a leading cause of long-term disability worldwide, often resulting in persistent limitations in activity and participation. Measuring the degree of handicap experienced by stroke survivors is essential for guiding rehabilitation, monitoring progress, and evaluating outcomes. The London Handicap Scale (LHS) is a widely used tool for assessing participation restrictions; however, its application requires cultural and linguistic adaptation to ensure validity in non-English-speaking populations. Given the large Hausa-speaking population in West Africa, a culturally adapted version of the LHS is needed to support clinical practice and research.

Aims
To cross-culturally adapt the London Handicap Scale (LHS) into the Hausa language and to evaluate its psychometric properties among stroke survivors.

Material and methods
The cross-cultural adaptation of the LHS was performed in accordance with the American Association of Orthopaedic Surgeons (AAOS) guidelines. The psychometric properties of the final Hausa version (LHS-H)—including test–retest reliability, criterion validity, internal consistency, and construct validity—were assessed among stroke survivors. Socio-demographic characteristics were summarized using descriptive statistics. Reliability and validity analyses were conducted using Spearman rank-order correlation, Cronbach’s alpha, and confirmatory factor analysis, with statistical significance set at α = 0.05.