Reliability and validation of the Dutch Achilles tendon Total Rupture Score

Abstract

Purpose Patient-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.Electronic supplementary materialThe online version of this article (doi:10.1007/s00167-016-4242-7) contains supplementary material, which is available to authorized users.

Validity and reliability of the Norwegian translation of the Achilles tendon Total Rupture Score

“…The observed internal consistency was comparable to previous reports from other cross-cultural adaptations of the ATRS ranging from 0.89 to 0.97 [1, 4, 7, 9, 13, 15, 19]. The SEM was also in agreement with previously reported results ranging from 3.2 to 10.91 [1, 4, 7, 9, 15].…”

“…Based on the MDC values, the Norwegian translation of the ATRS is well suited to compare groups of patients as a difference above 2.12 points reflects a real change, but the individual MDC of 16.98 restricts its usefulness in the follow-up of individual patients. The ICC was similar to 0.908 attained in the Danish validation and well within what has previously been reported (0.852–0.986) [1, 7, 13, 15, 19]. …”

“…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]. 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.…”

Reliability and validity of the Polish version of the Achilles tendon Total Rupture Score

“…Additionally, it showed moderate correlation between ATRS and actual comfort ( r  = 0.47). These validation findings are in a good accordance with other studies concerning cross-national ATRS adaptations [2, 5, 9, 14, 18, 21, 26, 27]. It has been commonly accepted that such moderate strong correlation is desirable [6, 25], because quality of life EQ-5D-5L score is not specifically designed for Achilles tendon ruptures [10].…”

“…The incompatibilities of socio-cultural and economic conditions among different countries make the regular translation insufficient for proper estimation of the ATR score. For these reasons, the ATRS scale has been already translated and culturally adapted for English [5], Danish [9], Italian [26], Turkish [14], Portuguese [27], Dutch [9, 21] Persian [2] and recently also Chinese [8] and Norvegian [18]. Up to date, there is no Polish version of ATRS available, for that authors decided to translate and adapt this score into Polish.…”