Validation and cross-cultural adaptation of the Bedside Language test for Brazilian patients

Aphasia is a neurological condition characterized by partial or total loss of verbal communication, most commonly caused by stroke. In hospital settings, brief and reliable tools are essential to identify and quantify aphasia early, enabling prompt diagnosis and appropriate rehabilitation planning. However, Brazil lacks language assessment instruments adapted for bedside use.

To perform the cross-cultural adaptation and validation of the Bedside Language test for Brazilian Portuguese.

The BL underwent translation, back-translation, expert review, and cultural adaptation. The final version was administered to 70 participants. Two evaluators applied the instrument on the same day to assess inter-rater reliability, and the same examiner reapplied it within two days to assess test-retest reliability. The Bedside Evaluation Screening Test (BEST-2) language test was also used for concurrent validity.

The Brazilian version of the BL demonstrated high internal consistency (Cronbach's alpha: spontaneous reading - LE=0.80; comprehension - CO=0.86; repetition - RE=0.95; writing - ES=0.73; overall=0.87), as well as satisfactory intra-rater (p=0.22) and inter-rater (p=0.77) reliability. It showed a strong correlation with the BEST-2 across all linguistic domains except writing.

The Brazilian Portuguese version of the BL is a brief, valid, and reliable bedside screening tool for identifying aphasia in patients with ischemic stroke, supporting high-quality care in specialized stroke centers.