Abstract
PurposePatient-reported outcome measures (PROMs) have become a cornerstone for the evaluation of the effectiveness of treatment. The Achilles tendon Total Rupture Score (ATRS) is a PROM for outcome and assessment of an Achilles tendon rupture. The aim of this study was to translate the ATRS to Dutch and evaluate its reliability and validity in the Dutch population.MethodsA forward–backward translation procedure was performed according to the guidelines of cross-cultural adaptation process. The Dutch ATRS was evaluated for reliability and validity in patients treated for a total Achilles tendon rupture from 1 January 2012 to 31 December 2014 in one teaching hospital and one academic hospital. Reliability was assessed by the intraclass correlation coefficients (ICC), Cronbach’s alpha and minimal detectable change (MDC). We assessed construct validity by calculation of Spearman’s rho correlation coefficient with domains of the Foot and Ankle Outcome Score (FAOS), Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) and Numeric Rating Scale (NRS) for pain in rest and during running.ResultsThe Dutch ATRS had a good test–retest reliability (ICC = 0.852) and a high internal consistency (Cronbach’s alpha = 0.96). MDC was 30.2 at individual level and 3.5 at group level. Construct validity was supported by 75 % of the hypothesized correlations. The Dutch ATRS had a strong correlation with NRS for pain during running (r = −0.746) and all the five subscales of the Dutch FAOS (r = 0.724–0.867). There was a moderate correlation with the VISA-A-NL (r = 0.691) and NRS for pain in rest (r = −0.580).ConclusionThe Dutch ATRS shows an adequate reliability and validity and can be used in the Dutch population for measuring the outcome of treatment of a total Achilles tendon rupture and for research purposes.Level of evidenceDiagnostic study, Level I.
Highlights
The Achilles tendon is the most frequently ruptured tendon in the human body with an increasing incidence from 4.7/100,000 in 1981 to 32.6/100,000 in 2002 [10]
The Dutch Achilles tendon Total Rupture Score (ATRS) had a strong correlation with Numeric Rating Scale (NRS) for pain during running (r = −0.746) and all the five subscales of the Dutch Foot and Ankle Outcome Score (FAOS) (r = 0.724–0.867)
There was a moderate correlation with the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A)-NL (r = 0.691) and NRS for pain in rest (r = −0.580)
Summary
The Achilles tendon is the most frequently ruptured tendon in the human body with an increasing incidence from 4.7/100,000 in 1981 to 32.6/100,000 in 2002 [10]. Optimal treatment of Achilles tendon ruptures remains controversial. Patient-reported outcome measures (PROMs) are an addition in the evaluation of the treatment of patients in the clinical practice and contribute to research purposes [9]. No Dutch PROM is validated for Achilles tendon ruptures . For the Dutch population, several ankle-specific PROMs are available, such as the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM) [16, 17, 21]. There is one Dutch PROM for patients with Achilles tendinopathy the VISA-A-NL [20]. The advantage of a disease-specific PROM is that it is more sensitive to change compared to a generic health-related quality of life instrument and can measure the outcome after treatment more specific [14, 22]
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