Cross-cultural adaptation and validation of the VISA-A questionnaire for Portuguese-speaking (Portugal) patients with Achilles tendinopathy

Abstract

Abstract Introduction Achilles tendinopathy is considered one of the most frequent injuries in individuals who practice regular physical activity, thus the existence of an instrument that allows the evaluation of the degree of severity of the lesion is important. The VISA-A was developed for English-speaking population to evaluate patients with this condition, and there is a need to adapt this tool to Portuguese (Portugal). Objectives To cross-cultural adapt and validate the VISA-A questionnaire for Portuguese-speaking (Portugal) Achilles tendinopathy patients. Methodology The VISA-A questionnaire was translated and cross-culturally adapted into Portuguese (VISA-A-Por) according to specific guidelines, using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 10), and appraisal of the adaptation process. The resulting VISA-A-Por was then subjected to an analysis of the psychometric properties (construct validity, reproducibility [agreement and reliability], internal consistency and floor and ceiling effects) in 57 Achilles tendinopathy patients and 58 asymptomatic people. Participants completed the questionnaire at baseline and after a minimum interval of 48 hours. Results The Visa-A-Por semantic and content validity was considered good by the expert committee and has construct validity shown by the differences between groups (p < 0,001). The questionnaire presented good internal consistency, with a Cronbach α of 0,88. Concerning reproducibility, agreement levels were considered optimal which can be verified in the Bland Altman graph, the standard error measurement (6,49) and the minimally important change (17,99 points), as well as the excellent ICC value (0,88). No ceiling-floor effect was found. Conclusion The VISA-A-Por questionnaire has been shown to be equivalent to the original questionnaire, which indicates that it is a valid and reliable measure for the evaluation of the severity and functional impact of patellar tendinopathy in Portuguese-speaking (Portugal) patients.