Abstract
BackgroundThere is a need for a patient-relevant instrument to evaluate outcome after treatment in patients with a total Achilles tendon rupture. The purpose of this study was to undertake a cross-cultural adaptation of the Achilles Tendon Total Rupture Score (ATRS) into Brazilian Portuguese, determining the test-retest reliability and construct validity of the instrument.MethodsA five-step approach was used in the cross-cultural adaptation process: initial translation (two bilingual Brazilian translators), synthesis of translation, back-translation (two native English language translators), consensus version and evaluation (expert committee), and testing phase. A total of 46 patients were recruited to evaluate the test-retest reproducibility and construct validity of the Brazilian Portuguese version of the ATRS. Test-retest reproducibility was performed by assessing each participant on two separate occasions. The construct validity was determined by the correlation index between the ATRS and the Orthopedic American Foot and Ankle Society (AOFAS) questionnaires.ResultsThe final version of the Brazilian Portuguese ATRS had the same number of questions as the original ATRS. For the reliability analysis, an ICC(2,1) of 0.93 (95 % CI: 0.88 to 0.96) with SEM of 1.56 points and MDC of 4.32 was observed, indicating excellent reliability. The construct validity showed excellent correlation with R = 0.76 (95 % CI: 0.52 to 0.89, P < 0.001).ConclusionThe ATRS was successfully cross-culturally validated into Brazilian Portuguese. This version was a reliable and valid measure of function in patients who suffered complete rupture of the Achilles Tendon.Electronic supplementary materialThe online version of this article (doi:10.1186/s13102-016-0034-0) contains supplementary material, which is available to authorized users.
Highlights
There is a need for a patient-relevant instrument to evaluate outcome after treatment in patients with a total Achilles tendon rupture
No question was modified after the formal testing of the questionnaire, and the T1-2 version was considered the final version in Brazilian Portuguese of Achilles Tendon Total Rupture Score (ATRS) (Additional file 2)
A study investigating the psychometric properties of the Brazilian Portuguese version of the Foot Health Status Questionnaire (FHSQ) found that five out of eight domains on the FHSQ were significantly correlated with Health Assessment Questionnaire and Numeric Rating Scale [19]
Summary
There is a need for a patient-relevant instrument to evaluate outcome after treatment in patients with a total Achilles tendon rupture. The recent increase in incidence has been associated with increased participation in high demand competitive and recreational sports, aging population, lack of fitness and performing strenuous physical activities [10,11,12]. Another explanation may be the increasing incidence of metabolic and other chronic diseases, which are associated with acute Achilles tendon ruptures [13]
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