Cross-Cultural Adaptation and Validation of the Oslo Sports Trauma Research Center Questionnaires on Overuse Injury and Health Problems (2nd Version) in Spanish Youth Sports

Abstract

Background: The Oslo Sports Trauma Research Center Questionnaires on Health Problems (OSTRC-H) and Overuse Injury (OSTRC-O) have shown a greater ability to identify athletes with health problems and to estimate the severity of those problems compared with traditional surveillance methods. Despite the numerous language adaptations of these questionnaires and their extended use, some of their measurement properties remain unknown. Moreover, these questionnaires are not available for Spanish-speaking athletes, and the validity and reliability of these questionnaires in youth athletes are unknown. Purpose: To cross-culturally adapt and investigate the measurement properties of the second version of the OSTRC-H (OSTRC-H2) and OSTRC-O (OSTRC-O2) questionnaires in Spanish youth athletes. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Following international guidelines, we developed Spanish cross-cultural adaptations of the questionnaires, including a comprehensibility analysis with 30 participants from the target population. In the second phase, 73 athletes (age range, 12-18 years) were invited to participate in an 11-week prospective study. The reliability (internal consistency and test-retest reliability) of both questionnaires was assessed through use of Consensus-Based Standards for the Selection of Health Measurement Instruments recommendations. The construct validity and responsiveness of the OSTRC-H2 were evaluated using the convergence of the OSTRC-H2 severity score and the number of days of time loss. The response rate after 11 weeks was calculated as a feasibility indicator. Results: Equivalent Spanish versions were developed. A total of 63 athletes (age range, 12-17 years) participated in the prospective study. The Cronbach alpha was 0.93 (95% CI, 0.92-0.94) for OSTRC-H2 and 0.88 (95% CI, 0.86-0.90) for OSTRC-O2. The intraclass correlation coefficient was 0.87 (95% CI, 0.79-0.92) and 0.85 (95% CI, 0.81-0.89), and the Cohen kappa was 0.80 (95% CI, 0.71-0.89) and 0.87 (95% CI, 0.78-0.96), respectively, for OSTRC-H2 and OSTRC-02. Correlations between the severity score and time loss (Spearman rho = 0.61) and between the changes in both scores over time (Spearman rho = 0.78) were within our expected range. The response rate was 95.5% for the OSTRC-O2 and 99.6% for the OSTRC-H2. Conclusion: These results present equivalent, reliable, and feasible Spanish versions of both questionnaires as well as evidence of the validity and responsiveness of the OSTRC-H2.

Methodological implications of adapting and applying a web-based questionnaire on health problems to adolescent football players

“…Although previous studies have demonstrated that the questionnaire is a valid and reliable tool [ 7 , 8 , 11 – 13 ], when adapting the questionnaire to contexts beyond adult sports, such as adolescent football, the wording needs to be adjusted and new psychometric testing and validation should be performed [ 15 ]. In alignment with other studies [ 10 – 12 ], we ensured feasibility through our pretest and the final questions about comprehensibility.…”

“…The questionnaires have been developed to identify and record different types of health complaints including illness and injuries, and to quantify the effect these have on sport participation [ 8 , 9 ]. Several studies have explored the psychometric properties of the questionnaires across different contexts and populations [ 7 , 10 – 14 ], confirming that the questionnaires are valid and reliable tools. Additionally, a range of elite sport organizations have employed the tools in their sport injury research and clinical health monitoring programmes [ 15 ].…”

“…To better understand and prevent injury development among adolescent athletes, monitoring their health status has in recent years gained importance [ 1 – 3 ]. For health monitoring to be successful, both the International Olympic Committee (IOC) and researchers have called for a more unified and evidence-informed approach toward the health of young athletes [ 4 – 7 ]. Two increasingly popular monitoring tools are the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H) and the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O).…”

“…Additionally, a range of elite sport organizations have employed the tools in their sport injury research and clinical health monitoring programmes [ 15 ]. In recent years, the two questionnaires have also been applied to children and adolescents of different sport contexts [ 1 , 2 , 6 , 7 , 16 – 18 ]. Most of these studies, however, applied the questionnaires without reporting any consideration regarding methodological suitability and implications for application.…”

“…With regard to the OSTRC-H questionnaire, Clarsen et al [ 15 ] have in their latest revision of the tool emphasized the importance of adjusting the questionnaire when applying it to adolescents. Some of the studies that have applied the OSTRC-O/H to younger athletes have reported adaptions, such as language adaption [ 7 ] and supplemental interviews [ 2 ]. However, these studies did not report on the application process, hence did not focus on the study context (i.e.…”