The "International Classification of Functioning, Disability and Health" (ICF) is a model that classifies health and health-related function. Of the ICF domains, least is known about participation. Although a few measures have been developed in English that tap the construct "Participation", none exist in Spanish. The Reintegration to Normal Living (RNL)-Index is the measure of reference to evaluate participation. The general objective of the present study was to translate, culturally adapt, and assess the psychometric properties the RNL-Index in Spanish for use in Spain. The translation and the cultural adaptation of the RNL-Index consisted of a five-step process, leading to the Spanish version of the RNL-Index (SRNL-Index). Psychometric evaluation consisted of a cross-sectional study design, with a longitudinal design used for test-retest evaluation. Thirty-two subjects with stroke and 36 with total knee arthroplasty completed the SRNL-Index twice, as well as the Six Minute Walk Test (6MWT), the Short-Form 36 Health Survey (SF-36), and for stroke subjects, the Barthel Index (BI). Descriptive statistics, one-way analysis of variance and post-hoc t tests were calculated, as well as Cronbach's alpha, Pearson's, and Intraclass correlation coefficients. The SRNL-Index was found to be internally consistent. Test-retest reliability was quite poor, being moderately low for the TKA sample and moderate for the stroke sample. Discriminant validity was demonstrated by the correlations between the SRNL-Index's Perception of Self and Daily Activity subscales with the Mental and Physical Component Summary scores of the SF-36. The SRNL-Index has convergent validity as shown by the high correlations between of the SRNL-Index and the 6MWT. Known-groups validity was shown in people with stroke grouped by Barthel Index scores, and in both samples when grouped according to gait speed. The SRNL-Index demonstrated acceptable validity and internal reliability for subjects with stroke and total knee arthroplasty. However, further studies are needed to reassess external validity, reliability, and responsiveness in other populations and other Spanish-speaking countries.

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