Abstract
PurposePatient reported outcome measures (PROMs) are increasingly being used in clinical research. The Achilles tendon Total Rupture Score (ATRS) is a PROM designed to assess outcomes in patients with ruptures of the Achilles tendon. The aim of this study was to develop a Norwegian adaption of the ATRS and evaluate its validity and reliability.MethodsThe ATRS was translated into Norwegian in accordance with recommended guidelines. The study included 94 patients treated for Achilles tendon ruptures from January 2010 until February 2013, and the web-based questionnaires were administered twice. Reliability was assessed by Cronbach’s alpha, the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). Construct validity was evaluated by calculating the Spearman’s correlation coefficient with the five subclasses of the Foot and Ankle Outcome Score (FAOS), the SF-36 subclass physical function and the SF-36 physical and mental summary scores.ResultsBoth internal consistency (Cronbach’s alpha = 0.96) and test–retest reliability (ICC = 0.90) were excellent, and the MDC was 2.12 at the group level and 16.98 at the individual level. Construct validity was supported by Spearman’s correlation coefficients above 0.7 with the SF-36 subclass physical function and the SF-36 physical summary score as well as the FAOS subclasses Sport/Rec and quality of life. There was no floor effect, and 6 patients (6.4%) achieved a maximum score of 100.ConclusionsThe Norwegian adaption of the ATRS demonstrates acceptable validity and reliability for use in the Norwegian population to assess clinical outcomes in patients with Achilles tendon ruptures.
Highlights
An acute rupture of the Achilles tendon represents a common injury [8], but the best choice of treatment remains controversial [6]
Patient reported outcome measures (PROMs) are questionnaires answered by the patients themselves, and they are becoming increasingly popular when evaluating treatment results and patients satisfaction in clinical studies
The acute Achilles tendon Rupture Score (ATRS) is a PROM developed to assess outcomes in patients who have undergone treatment for acute Achilles tendon ruptures [13], and it has been validated in Swedish, English, Danish, Turkish, Persian, Dutch, Brazilian Portuguese and Italian [1, 4, 7, 9, 13, 15, 19, 21]
Summary
An acute rupture of the Achilles tendon represents a common injury [8], but the best choice of treatment remains controversial [6]. Recent studies emphasizing early mobilization have reported improved results after non-operative treatment [17], underlining the need to evaluate outcomes beyond occurrences of common complications such as reruptures, wound healing problems, infections and nerve injuries. Patient reported outcome measures (PROMs) are questionnaires answered by the patients themselves, and they are becoming increasingly popular when evaluating treatment results and patients satisfaction in clinical studies. There are presently no PROMs in Norwegian validated for assessing outcomes after Achilles tendon injuries, and the purpose of this study was to translate and validate a Norwegian version of the ATRS. This will facilitate future research on the treatment of Achilles tendon ruptures in the Norwegian population
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