Cross-cultural validation and responsiveness of the French version of the lymphedema functioning, disability and health questionnaire for lower limb lymphedema (Lymph-ICF-LL)

Heroes, An-Kathleen;Fourgeaud, Caroline;Fourneau, Inge;De Vrieze, Tessa;Devoogdt, Nele;et.al.
(2026) Disability and Rehabilitation — p. 1-20 (2026)

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  • Heroes, An-Kathleenorcid-logoResearch Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven - University of Leuven
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  • Fourgeaud, Carolineorcid-logoReference center for primary lymphedema, Hospital Cognacq-Jay
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  • Fourneau, Ingeorcid-logoResearch Unit Vascular Surgery, Department of Cardiovascular Sciences, KU Leuven-University of Leuven
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  • De Vrieze, Tessaorcid-logoResearch Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven - University of Leuven
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  • Devoogdt, Neleorcid-logoResearch Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven - University of Leuven
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Abstract
To investigate reliability, validity and responsiveness of the French Lymph-ICF-LL questionnaire for lower limb lymphedema (LLL). In this observational study, patients with stable LLL completed the Lymph-ICF-LL twice with an interval of 1-2 days. Test-retest reliability was determined with Intraclass Correlation Coefficients (ICC), standard error of measurement and smallest real difference. Internal consistency was analyzed with Cronbach's alpha (α). To assess construct validity, Spearman rank correlation coefficients between the Lymph-ICF-LL and SF-36 were calculated. For responsiveness, the Global Perceived Effect scale (GPE) and Lymph-ICF-LL were completed after 2 months. Other patients completed the Lymph-ICF-LL at start of an intensive treatment and 1 month later together with the GPE. Wilcoxon signed rank test, Standardized Response Mean, Minimal Clinically Important Difference and correlations between the change on Lymph-ICF and GPE were determined. (NCT07075549). For the total score, excellent reliability (ICC = .94) and good internal consistency (α = .86) were found. Convergent validity was confirmed with significant moderate correlations with SF-36 (r = -0.48--0.72; <.001). A significant change in total score was found after intensive treatment (=.017). Significant correlations between change scores and GPE were obtained ( < .05). The French Lymph-ICF-LL is a reliable, valid and responsive questionnaire to evaluate lymphedema-specific quality of life in patients with LLL. The French Lymphedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphedema (Lymph-ICF-LL) is a reliable and valid questionnaire to evaluate lymphedema-specific quality of life in patients with lymphedema at the leg and/or foot.The French Lymph-ICF-LL can be used to determine improvement in the lymphedema-specific quality of life after treatment in patients with lower limb lymphedema (LLL).A decrease of 14 points on the total score equals a real minimal clinically important improvement in lymphedema-specific quality of life.
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Heroes, A.-K., Fourgeaud, C., Fourneau, I., De Vrieze, T., Frippiat, J., Deltombe, T., Thomis, S., Abba, S., Vignes, S., & Devoogdt, N. (2026). Cross-cultural validation and responsiveness of the French version of the lymphedema functioning, disability and health questionnaire for lower limb lymphedema (Lymph-ICF-LL). Disability and Rehabilitation, 1-20. https://doi.org/10.1080/09638288.2026.2704565 (Original work published 2026)