Dutch normative values for the LIMB-Q: A step toward international standardization of patient-reported outcomes after lower extremity trauma

BACKGROUND: The LIMB-Q is a patient-reported outcome measure (PROM) developed to assess multiple key health-related domains after lower extremity trauma. This study aimed to translate the LIMB-Q into Dutch and establish normative data for the Dutch population. METHODS: The LIMB-Q was translated and culturally adapted in line with established international guidelines using forward and backward translation. A representative general population sample was recruited via an online research panel. Participants completed the Dutch LIMB-Q (33 items) and reported sociodemographic and health information. Poststratification weights were applied based on the 2025 Statistics Netherlands [Centraal Bureau voor de Statistiek (CBS)] age-sex distribution. Descriptive statistics and multivariable regression analyses were performed for all domains. RESULTS: A total of 1188 respondents were included in the analyses. The sample reflected the Dutch adult population (55.7% women; mean age, 49.6 years). On a 0 to 100 scale, the mean (standard deviation) scores were 87.3 (17.3) for appearance, 81.6 (19.8) for function, and 85.3 (18.0) for symptoms. The ceiling effects were modest (≤11%). The scores were stable across age groups, with slight declines in older adults. In multivariable regression, comorbidity was significantly associated with lower scores in all domains (p0.27). Weighted and unweighted results were nearly identical, confirming demographic representativeness. CONCLUSIONS: This study provided the first Dutch translation and normative reference values for the LIMB-Q. It aimed to support clinicians and researchers in interpreting patient-reported outcomes after lower extremity trauma by offering population-based reference data.