1
|
Larsson E, Brandt Knutsson S, Brorsson A, Johansson C, Nilsson Helander K. Establishment of the Patient Acceptable Symptom State (PASS) for the Achilles Tendon Total Rupture Score in a Swedish Population. Orthop J Sports Med 2024; 12:23259671241253280. [PMID: 39070900 PMCID: PMC11273557 DOI: 10.1177/23259671241253280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 07/30/2024] Open
Abstract
Background As the use of patient-reported outcome measures (PROMs) is increasing in orthopaedic research, there is also a growing need for a standardized interpretation of these scores, such as the Patient Acceptable Symptom State (PASS), defined as the value beyond which patients consider themselves well. The Achilles tendon Total Rupture Score (ATRS) is the only PROM specific for Achilles tendon ruptures. Purpose To establish the PASS for the ATRS in a Swedish population. Study Design Cross-sectional study; Level of evidence, 3. Methods Patients treated for an acute Achilles tendon rupture at a single institution in Sweden (injured between July 1, 2018, and December 31, 2020) were asked to participate in this study. The patients completed a questionnaire consisting of the ATRS and an anchor question: "How satisfied are you with the result of your treatment?" Receiver operating characteristic curve analysis was performed to calculate the PASS threshold for a positive response to the anchor question. Results Of 516 eligible patients, 316 (61%) were included. The time from injury to completion of the questionnaire ranged from 12 to 27 months. The PASS threshold for the ATRS was found to be 75. The median ATRS of all patients was 80; 66% of patients reached an ATRS ≥75. Overall, 79% of patients were satisfied with the results of their treatment. Conclusion The estimated PASS for the ATRS was 75 in the general Swedish population at 12 to 27 months after an acute Achilles tendon rupture.
Collapse
Affiliation(s)
- Elin Larsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Sara Brandt Knutsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Annelie Brorsson
- IFK Kliniken Rehab, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Sweden
| | - Christer Johansson
- Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Sweden
| | - Katarina Nilsson Helander
- Department of Orthopaedics, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
2
|
Arbab D, Lichte P, Gutteck N, Bouillon B, Arbab D. Reliability and validation of the German Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2024; 32:454-460. [PMID: 38270292 DOI: 10.1002/ksa.12059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Patient-related outcome measures (PROMs) are important instruments to evaluate efficacy of orthopaedic procedures. The Achilles tendon Total Rupture Score (ATRS) is a PROM developed to evaluate outcomes after treatment of Achilles tendon ruptures (ATRs). Purpose of this study is to develop and culturally adapt the German version of the ATRS and to evaluate reliability and validity. METHODS The ATRS was translated by forward-backward translation based on common guidelines. In this retrospective study, 48 patients with a surgical intervention after ATR were recruited. Reliability was evaluated by intraclass correlation coefficient (ICC) and Cronbach's alpha. Construct validity was valued by determining Pearson correlation coefficient with the German version of the Foot and Ankle Outcome Score (FAOS) and the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A). RESULTS The German Version of the ATRS has an excellent internal consistency (Cronbach's alpha 0.96) as well as an excellent test-retest-reliability (ICC 0.98). It has a moderately strong correlation with the VISA-A (r = 0.73) as well as with the FAOS subclasses (r = 0.6-0.79). CONCLUSION The German version of the ATRS demonstrated good psychometric properties. It proofed to be a valid and reliable instrument for use in patients with Achilles tendon Rupture. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- Dorothe Arbab
- Department of Orthopaedic and Trauma Surgery, Aachen University Hospital, Aachen, Germany
| | - Philip Lichte
- Department of Orthopaedic and Trauma Surgery, Aachen University Hospital, Aachen, Germany
| | - Natalia Gutteck
- Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Bertil Bouillon
- Department of Traumatology and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany
| | - Dariusch Arbab
- Department of Orthopedic and Trauma Surgery, St. Elisabeth-Hospital Herten, Member Faculty of Health Witten/Herdecke University, Herten, Germany
| |
Collapse
|
3
|
Maffulli N, Bartoli A, Sammaria G, Migliorini F, Karlsson J, Oliva F. Free tendon grafts for surgical management of chronic tears of the main body of the Achilles tendon: a systematic review. Knee Surg Sports Traumatol Arthrosc 2023; 31:4526-4538. [PMID: 37193823 PMCID: PMC10471519 DOI: 10.1007/s00167-023-07446-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE After four weeks from injury, tears of the Achilles tendon are considered chronic. Their management is challenging, and the use of a graft is suggested when the gap between proximal and distal stumps is greater than 6 cm. The present study systematically reviews the outcome of free tendon grafts in chronic ruptures of the Achilles tendon, evaluating clinical outcomes, complications and return to sport. METHODS The present study was conducted according to the PRISMA 2020 guidelines. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in February 2023. All the published clinical studies reporting clinical outcome, return to sport and complications of free tendon grafts used the treatment of chronic rupture of the midportion of the Achilles Tendon were accessed. The mean CMS (Coleman Methodology Score) of 65.7 suggested an overall good quality of the available published articles, attesting to the low risk of bias. RESULTS Data from 22 articles (368 patients with a mean age of 47 years) were retrieved. The average time from rupture to surgery was 25.1 week. At last follow-up, the AOFAS (American Orthopaedic Foot and Ankle Surgery) and ATRS (Achilles Tendon Total Rupture Score) scores improved of 33.8 (P = 0.0004), and 45.1 points (P = 0.0001) respectively. Return to activity was reported in 105 patients, and 82 (78.1%) had no activity limitations, while 19 (18.1%) had limited recreational but not daily activity limitations, and 4 (3.8%) reported limitations in daily activities. Return to sport data was reported in six studies, and 45 of 93 (48.4%) patients returned to sport at an average of 22.6 weeks. CONCLUSION In chronic tears of the Achilles tendon, with a gap of at least 6 cm, free tendon grafts allow predictable return to sport and acceptable recovery function. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London, E1 4DG UK
- School of Pharmacy and Bioengineering, Faculty of Medicine, Keele University, Thornburrow Drive, Stoke on Trent, ST4 7QB UK
| | - Alessandro Bartoli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Giuliano Sammaria
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, Germany
| | - Jon Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80 Gothenburg, Sweden
| | - Francesco Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| |
Collapse
|
4
|
Zhang Y, Ren J, Zang Y, Guo W, Disantis A, Martin RL. Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity. Int J Sports Phys Ther 2023; V18:653-686. [PMID: 37425110 PMCID: PMC10324371 DOI: 10.26603/001c.74528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown. Purpose The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization. Study design Literature Review. Methods PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data. Results Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use. Conclusion Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use. Level of evidence 3a.
Collapse
Affiliation(s)
- Yongni Zhang
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Jiayi Ren
- Shuguang Hospital of Shanghai University of Traditional Chinese Medicine
| | - Yaning Zang
- Department of Kinesiology Shanghai University of Sport
| | - Wenhao Guo
- Rangos School of Health Sciences Duquesne- China Health Institute
| | - Ashley Disantis
- Department of Physical Therapy Duquesne University
- UPMC Children's Hospital of Pittsburgh
| | - Robroy L Martin
- Department of Physical Therapy Duquesne University
- UPMC Center for Sports Medicine
| |
Collapse
|
5
|
Suphinnapong P, Teeranon N, Teerakidpisan S, Tansuthunluck S, Apinun J. Validity and reliability of the Thai version of the Achilles tendon total rupture score. Knee Surg Sports Traumatol Arthrosc 2023; 31:2228-2235. [PMID: 36651942 DOI: 10.1007/s00167-023-07319-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose of this study was to translate and cross-culturally adapt the Achilles Tendon Total Rupture Score (ATRS), a patient-reported outcome measurement (PROM) designed specifically to assess outcomes in patients with Achilles tendon rupture, into the Thai language and then determine its validity and reliability. METHODS The ATRS was translated into the Thai version (Thai-ATRS) according to internationally recognized guidelines. The study included 50 patients with Achilles tendon rupture from 2003 to 2017. The web-based online assessments were conducted two weeks apart. Construction validity was determined by assessing the correlation between the Thai-ATRS and the Thai version of the Foot and Ankle Outcome Score (Thai-FAOS). Reliability was determined with Cronbach's alpha and intraclass correlation coefficients (ICC). RESULTS The validity test displayed a strong correlation between the Thai-ATRS and the Thai-FAOS (r = 0.87). The reliability test showed good internal consistency with a Cronbach's alpha of 0.95 and excellent internal consistency with an ICC of 0.95, which represented excellent test-retest reliability. The MDC was 10.7 at the individual level and 1.5 at the group level. CONCLUSION The Thai-ATRS was demonstrated to be valid and reliable for assessing functional outcomes in Thai patients with Achilles tendon rupture. LEVEL OF EVIDENCE II.
Collapse
Affiliation(s)
- Pawichaya Suphinnapong
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand
| | - Niphon Teeranon
- Rehabilitation Center, Siriraj-Piyamaharajkarun Hospital, Bangkok, Thailand
| | | | | | - Jirun Apinun
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
| |
Collapse
|
6
|
de Oliveira PR, Arrebola LS, Stéfani KC, Pinfildi CE. Photobiomodulation Associated With Conservative Treatment for Achilles Tendon Rupture: A Double-Blind, Superiority, Randomized Controlled Trial. Arch Rehabil Res Clin Transl 2022; 4:100219. [PMID: 36545533 PMCID: PMC9761261 DOI: 10.1016/j.arrct.2022.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate the effects of photobiomodulation on Achilles tendon rupture (ATR) treated conservatively. Design Prospective, patient- and assessor-blinded, parallel, randomized controlled trial. Setting Patients with acute ATR treated conservatively. Participants Thirty-four male individuals with acute unilateral ATR treated conservatively (N=34), equally divided in 2 groups: photobiomodulation group (PBMG) and sham group, with mean age of 45.5±9.47 and 48.7±8.38 years, respectively. Intervention All participants underwent through an immobilization period, followed by rehabilitation sessions (2 d/wk for 12 weeks) comprising strengthening, range of motion, and balance/weightbearing exercises. In PBMG, the tendon was irradiated with a photobiomodulation cluster (1 904 nm/50 mW infrared laser, 4 858 nm/50 mW infrared diodes, and 4 658 nm/40 mW red diodes; power density of 105 mW/cm2 per cluster area) during the immobilization period (2 d/wk for 8 weeks) and the sham group received a simulation of the procedure with no irradiation. Outcomes were assessed at the removal of the immobilization 12 and 16 weeks after tendon rupture. Main Outcome Measures Primary outcome was the Achilles Tendon Rupture Score. Secondary outcomes included Numerical Pain Rating Scale at rest and during effort, plantar flexor strength, and ankle range of motion. Results Both groups demonstrated an increase in the Achilles Tendon Rupture Score and improvements in range of motion, plantar flexor strength, and pain. There were no significant differences in outcomes between the 2 groups (P>.05) except in pain during walking, which was significantly lower in the PBMG in week 12 (P<.01, effect size=0.56) and week 16 (P<.01, effect size=0.55). Conclusion Photobiomodulation associated with conservative treatment is not superior to conservative treatment alone for improving function in patients with acute ATR.
Collapse
Key Words
- ATR, Achilles tendon rupture
- ATRS, Achilles Tendon Rupture Score
- Achilles tendon
- CI, confidence interval
- ES, effect size
- IAMSPE, Institute of Medical Assistance to the State Public Servant
- Low-level light therapy
- NPRS, Numerical Pain Rating Scale
- PBM, photobiomodulation
- PBMG, photobiomodulation group
- ROM, range of motion
- Rehabilitation
- SG, sham group
- WALT, World Association for Photobiomodulation Therapy
Collapse
Affiliation(s)
- Pedro Rizzi de Oliveira
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo,Physical Therapy Department, Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo,Corresponding author Pedro Rizzi de Oliveira, PT, MSc, Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Rua Silva Jardim, 136 Vila Matias, Santos, São Paulo 11015-020.
| | - Lucas Simões Arrebola
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo,Physical Therapy Department, Institute of Medical Assistance to the State Public Servant (IAMSPE), São Paulo
| | - Kelly Cristina Stéfani
- Center of Technological Innovation, University of Sao Paulo Hospital of Clinics (HC-FMUSP), São Paulo, Brazil
| | - Carlos Eduardo Pinfildi
- Department of Human Movement Sciences, Federal University of São Paulo (UNIFESP), Baixada Santista Campus, São Paulo
| |
Collapse
|
7
|
Khan S, Faulkner S, Algarni FS, Almalki A, Almansour A, Altowaijri AM. Foot Function Index for Arabic-speaking patients (FFI-Ar): translation, cross-cultural adaptation and validation study. J Orthop Surg Res 2022; 17:212. [PMID: 35392981 PMCID: PMC8991848 DOI: 10.1186/s13018-022-03092-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Foot Function Index (FFI) is a valid and reliable outcome measure, which is widely used to measure the foot and ankle functional level and disorders. Until now, no validated Arabic version of the FFI is available. This study was conducted at a tertiary care hospital in Riyadh, Saudi Arabia. The purpose of this project was to translate and adapt the FFI into Arabic and to evaluate its psychometric properties of validity and reliability. METHODS The study consisted of two phases. The first phase was the translation and cultural adaptation of the FFI to Arabic. The next phase involved, testing the psychometric properties of the Arabic version of the FFI on a sample of 50 consecutive participants which included internal consistency, test-retest reliability, floor and ceiling effects and construct validity. RESULTS The mean age of the study participants was 38 ± 12.94 years. Both the genders were evenly enrolled with 50% of the participants as male and 50% as female. Majority of them complained of plantar fasciopathy (32%) followed by pes planus (22%) and ankle sprain (18%). The scores of FFI-Ar were normally distributed, confirmed by a significant Shapiro-Wilk test. The mean value of FFI-Ar total score was 47.73 ± 19.85. There were no floor or ceiling effects seen in any of the subscales and total score. The internal consistency was good with the Cronbach's alpha value of 0.882, 0.936 and 0.850 for the pain, disability and activity limitation subscales, respectively. The reproducibility of the FFI-Ar was analysed by intra-class correlation coefficient which revealed good to excellent test-retest reliability. A significant correlation was found between FFI-Ar and SF-36 and numeric rating scale (NRS) confirming its construct validity. CONCLUSION The FFI-Arabic version showed good validity and reliability in patients with foot and ankle problems. This tool can be used in usual practice and research for analysing foot and ankle disorders in Arabic-speaking people.
Collapse
Affiliation(s)
- Shershah Khan
- Medical Rehabilitation Department, King Saud University Medical City, King Saud University, Riyadh, 11461, Saudi Arabia.
| | - Suzanne Faulkner
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, Wolfson Building, University of Strathclyde, Glasgow, UK
| | - Fahad S Algarni
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Abdulaziz Almalki
- Medical Rehabilitation Department, King Saud University Medical City, King Saud University, Riyadh, 11461, Saudi Arabia
| | - Ahmed Almansour
- Department of Physical Therapy, College of Applied Medical Science, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Abdulrahman M Altowaijri
- Medical Rehabilitation Department, King Saud University Medical City, King Saud University, Riyadh, 11461, Saudi Arabia
| |
Collapse
|
8
|
Park YH, Cho HW, Choi JW, Kim HJ. Validation and cross-cultural adaptation of the Korean translation of the Achilles tendon Total Rupture Score. BMC Musculoskelet Disord 2021; 22:876. [PMID: 34649549 PMCID: PMC8518316 DOI: 10.1186/s12891-021-04765-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
Background The Achilles tendon Total Rupture Score (ATRS) is a widely used patient-reported outcome measure to assess clinical outcomes of Achilles tendon rupture, but it has not been validated in Korean yet. The purpose of this study was to translate the ATRS into Korean and evaluate its reliability and validity in a Korean population. Methods The ATRS was translated into Korean according to recommended guidelines for forward-backward translation. Thirty-eight patients who underwent surgical treatment for Achilles tendon rupture from 2017 to 2019 were enrolled. Reliability was evaluated by the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). Construct validity was assessed with Spearman rank correlations with the Korean version of the Foot and Ankle Outcome Score (FAOS) and Numeric Rating Scale (NRS) for pain in daily activity. Results The Korean translation of the ATRS had excellent test-retest reliability (ICC = 0.84) and acceptable internal consistency (Cronbach’s alpha = 0.84). The SEM was 6.61, and the MDC was 18.32 at the individual level and 2.97 at the group level. The Korean translation of the ATRS was strongly correlated with the FASO (r = 0.88). Correlation with the NRS in daily activity (r = − 0.66) was moderate. Conclusion The Korean translation of the ATRS showed sufficient reliability and validity for use in the Korean population. Level of evidence II. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04765-w.
Collapse
Affiliation(s)
- Young Hwan Park
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hyun Woo Cho
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Jung Woo Choi
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hak Jun Kim
- Department of Orthopaedic Surgery, Korea University Medical Center, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
| |
Collapse
|
9
|
Buckinx F, Lecoq G, Bornheim S, Van Beveren J, Valcu A, Daniel C, Bruyère O, Reginster JY, D'Hooghe P, Kaux JF. French translation and validation of the Achilles Tendon Total Rupture Score "ATRS". Foot Ankle Surg 2020; 26:662-668. [PMID: 31492520 DOI: 10.1016/j.fas.2019.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/05/2019] [Accepted: 08/19/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND To provide a cross-cultural French adaptation of the Achille's Tendon Total Rupture Score (ATRS) and to assess its psychometric performances. METHOD The ATRS questionnaire was first translated and inter-culturally adapted into French according to international guidelines. Then, 95 subjects were recruited to complete the French version of the ATRS twice (2 weeks of interval). The SF-36 and VISA-A were used as comparative questionnaires. The psychometric properties of the questionnaire were evaluated (test-retest reliability, internal consistency, construct validity, floor/ceiling effects). RESULTS Thetest-retest reliability was excellent (ICC of 0,966 (95% CI:0.644-0.879)) and the internal consistency very high (Cronbach's alpha of 0,98). The convergent and divergent construct validity were also confirmed. Finally, none of the subjects obtained the lowest score (0) or the maximal score (100) to the questionnaire. CONCLUSION A valid and reliable French version of the ATRS is now available.
Collapse
Affiliation(s)
- F Buckinx
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Belgium.
| | - G Lecoq
- Department of Sport Rehabilitation Sciences, University of Liège, Belgium
| | - S Bornheim
- Department of Sport Rehabilitation Sciences, University of Liège, Belgium; Department of Physical Medicine and Rehabilitation, SportS, FIFA Medical Center of Excellence Liege University Hospital Center, Liege, Belgium
| | | | - A Valcu
- Orthopaedic Surgery Department, University Hospital of Liège, Liege, Belgium
| | - C Daniel
- Orthopaedic Surgery Department, University Hospital of Liège, Liege, Belgium
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Belgium
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Belgium; Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - P D'Hooghe
- Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - J F Kaux
- Department of Sport Rehabilitation Sciences, University of Liège, Belgium; Department of Physical Medicine and Rehabilitation, SportS, FIFA Medical Center of Excellence Liege University Hospital Center, Liege, Belgium
| |
Collapse
|
10
|
Hansen MS, Nilsson Helander K, Karlsson J, Barfod KW. Performance of the Achilles Tendon Total Rupture Score Over Time in a Large National Database: Development of an Instruction Manual for Accurate Use. Am J Sports Med 2020; 48:1423-1429. [PMID: 32255669 DOI: 10.1177/0363546520912222] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The Achilles tendon Total Rupture Score (ATRS) is a commonly used patient-reported outcome measure for patients with an acute Achilles tendon rupture. The score consists of 10 questions, the last 3 of which include activities that some patients cannot or do not do. No instruction manual has been developed for the ATRS. HYPOTHESIS/PURPOSE The purpose was to evaluate the ATRS at 4, 12, and 24 months after a rupture. The hypothesis was that the results at 4 months would be inconsistent when compared with the results at 1 year and 2 years. We also aimed to develop a manual that explains how to use the ATRS. STUDY DESIGN Cohort study (Diagnosis); Level of evidence, 3. METHODS This was a mixed-methods study. The first section was a registry study, where prospectively collected data were analyzed. Data were collected 4, 12, and 24 months after rupture. The original score based on 10 items was compared with a score based on the first 7 items adjusted to the same scale as the original score. Density plots and scatterplots were made and differences between the scores were tested using the Mann-Whitney U test. The second section of the study consisted of discussions among the authors, which resulted in a manual for the ATRS. RESULTS In total, 2790 complete ATRSs were included. The 7-item score significantly overestimated the value of the 10-item score at all time points (P < .001), but only at 4 months was the difference clinically relevant (9.7 points). CONCLUSION When the ATRS is used for short-term evaluation, there is a risk of results being inconsistent because of the last 3 questions. A manual explaining how to use the ATRS was therefore developed. We recommend that the full ATRS together with the manual should be used in future research rather than eliminating the 3 last questions.
Collapse
Affiliation(s)
- Maria Swennergren Hansen
- Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.,Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark
| | | | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristoffer Weisskirchner Barfod
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark
| |
Collapse
|
11
|
Dams OC, Reininga IHF, Zwerver J, Diercks RL, van den Akker-Scheek I. The Achilles tendon Total Rupture Score is a responsive primary outcome measure: an evaluation of the Dutch version including minimally important change. Knee Surg Sports Traumatol Arthrosc 2020; 28:3330-3338. [PMID: 32146524 PMCID: PMC7511458 DOI: 10.1007/s00167-020-05924-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/25/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Aim of this study was to evaluate the responsiveness of the Dutch version of the Achilles tendon Total Rupture Score (ATRS-NL). METHODS Patients (N = 47) completed the ATRS-NL at 3 and 6 months after Achilles tendon rupture (ATR). Additionally, they filled out the Euroqol-5D-5L (EQ-5D-5L) and Global Rating of Change Score (GRoC). Effect sizes (ES) and standardized response means (SRM) were calculated. The anchor-based method for determining the minimally important change (MIC) was used. GRoC and improvement on the items mobility and usual activities on the EQ-5D-5L served as external criteria. The scores on these anchors were used to categorize patients' physical functioning as improved or unchanged between 3 and 6 months after ATR. Receiver operating curve (ROC) analysis was performed, with the calculation of the area under the ROC curve (AUC) and the estimation of MIC values using the optimal cut-off points. RESULTS There was a large change (ES: 1.58) and good responsiveness (SRM: 1.19) of the ATRS-NL between 3 and 6 months after ATR. Using ROC analysis, the MIC values ranged from 13.5 to 28.5 for reporting improvement on EQ-5D-5L mobility and GRoC, respectively. The AUC of improvement on mobility and improvement on GRoC were > 0.70. CONCLUSION The ATRS-NL showed good responsiveness in ATR patients between 3 and 6 months after injury. Use of this questionnaire is recommended in clinical follow-up and longitudinal research of ATR patients. MIC values of 13.5 and 28.5 are recommended to consider ATR patients as improved and greatly improved between 3 and 6 months after ATR. LEVEL OF EVIDENCE II.
Collapse
Affiliation(s)
- Olivier C. Dams
- Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Inge H. F. Reininga
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Johannes Zwerver
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands ,Sports Valley, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP Ede, The Netherlands
| | - Ronald L. Diercks
- Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- Department of Orthopaedic Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| |
Collapse
|
12
|
Bąkowski P, Rubczak S, Wolff-Stefaniak M, Grygorowicz M, Piontek T. Reliability and validity of the Polish version of the Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2018; 26:2074-2079. [PMID: 29094171 PMCID: PMC6061432 DOI: 10.1007/s00167-017-4764-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 10/23/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to perform the translation and cross-cultural adaptation of the Achilles tendon Total Rupture Score (ATRS) into Polish version, and to evaluate its reliability and validity. METHODS The ATRS was translated into Polish language according to the Beaton recommendations. A total number of 71 patients previously treated surgically (from 2011 to 2015), due to the Achilles tendon rupture, were enrolled in this study. ATRS-Polish was performed twice within a period of 5-10 days. To evaluate test-retest reliability, intra-rater coefficient (ICC) was calculated. Construct validity was determined by the Spearman's rank coefficient correlation between the ATRS-Polish and a Polish version of EQ-5D-5L questionnaire. RESULTS Test-retest reliability was found to be excellent (ICC 0.9). The mean and standard deviation of the first and second assessment amounted 87.4 ± 14.0 and 88.4 ± 13.2, respectively. Construct validity analysis showed a strong correlation between the ATRS and the EQ-5D-5L score (r = - 0.69.) and moderate correlation between ATRS and actual comfort (r = 0.47). CONCLUSIONS AND PERSPECTIVES Polish version of the Achilles tendon Total Rupture Score was found to be reliable and valid. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- Paweł Bąkowski
- Orthopedic Department, Rehasport Clinic, Górecka 30, 60-201, Poznan, Poland.
| | - Szymon Rubczak
- Orthopedic Department, Rehasport Clinic, Górecka 30, 60-201, Poznan, Poland
| | | | | | - Tomasz Piontek
- Orthopedic Department, Rehasport Clinic, Górecka 30, 60-201, Poznan, Poland.,Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences Poznań, Poznan, Poland
| |
Collapse
|
13
|
Myhrvold SB, Sandnes Ø, Hoelsbrekken SE. Validity and reliability of the Norwegian translation of the Achilles tendon Total Rupture Score. Knee Surg Sports Traumatol Arthrosc 2018; 26:2045-2050. [PMID: 28823061 PMCID: PMC6061451 DOI: 10.1007/s00167-017-4689-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/16/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Patient 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. METHODS The 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. RESULTS Both 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. CONCLUSIONS The 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.
Collapse
Affiliation(s)
| | - Øystein Sandnes
- Department of Orthopedics, Ringerike Hospital, 3511 Hønefoss, Norway
| | - Sigurd Erik Hoelsbrekken
- Department of Orthopedic and Rheumatic Surgery, Kongsvinger Hospital, P.O. Box 901, 2226 Kongsvinger, Norway
| |
Collapse
|
14
|
Baumfeld D, Baumfeld T, Figueiredo AR, de Araujo Junior LF, Macedo B, Silva TAA, Raduan F, Nery C. Endoscopic Flexor Halluces Longus transfer for Chronic Achilles Tendon rupture - technique description and early post-operative results. Muscles Ligaments Tendons J 2017; 7:341-346. [PMID: 29264347 DOI: 10.11138/mltj/2017.7.2.341] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Achilles tendon ruptures may lead to proximal retraction of the stump if not treated acutely, increasing the chances of poorer functional outcomes. The flexor halluces longus transfer is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report the preliminary results and describe the technique of endoscopic flexor halluces longus transfer. Material and methods Six patients with chronic Achilles tendon injuries or re-ruptures were treated with endoscopic FHL transfer. The Achilles Tendon Rupture Score was used to clinically evaluate the patients. Single leg heel rise ability, functional hallux weakness, complications and procedure length were also checked. Results On average, we took 56 minutes to perform the surgery. All patients had a major increase in the ATRS score value postoperatively. Single leg heel rise was possible for all patients without limitation. None of the patients noticed functional weakness of the hallux during daily life activity and no wound or soft tissue complications were seen. Conclusion Endoscopic FLH transfer is a reliable option for patients with high skin risk and soft tissue complications. Other studies are needed to compare this technique with the open procedure, gold standard by now, to ensure its safety and efficacy. Level of evidence 4.
Collapse
Affiliation(s)
- Daniel Baumfeld
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Tiago Baumfeld
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | | | | | | | | | - Caio Nery
- UNIFESP - Escola Paulista de Medicina - SP, Brazil
| |
Collapse
|