Tendinopathy VISAs have expired—is it time for outcome renewals?

Korakakis, Vasileios; Whiteley, Rod; Kotsifaki, Argyro; Thorborg, Kristian

doi:10.1007/s00167-021-06596-7

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…The TENDINS-A demonstrated moderate correlations to both the VISA-A and FAOS, which is expected given they are proposed to measure the same overall health domain of disability. 15 We did not expect strong correlations to the VISA-A or FAOS given the limitations of the VISA-A, 10 11 14 which we theorised would extend to the FAOS as it is also lacking content validity. We expected the TENDINS-A was likely to be superior as it adhered to the guidelines set out by COSMIN for the development of an outcome measure.…”

Section: Discussionmentioning

confidence: 84%

“…12 13 However, the value of a PROM is not in its availability but in its quality, reflected by its clinometric properties. 14 Valid and reliable PROMs should be used and recommended, but this is not currently possible in Achilles tendinopathy research of the disability domain. 15 Existing PROMs, such as the Victorian Institute of Sport Assessment – Achilles (VISA-A), are recommended in the absence of other tools, 16 but do not satisfy the guidelines set out by COSMIN for the assessment of Achilles tendinopathy, largely because of inadequate content and structural validity.…”

Section: Introductionmentioning

confidence: 99%

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TENDINopathy Severity assessment – Achilles (TENDINS-A): Evaluation of reliability and validity in accordance with COSMIN recommendations

Murphy,

McCleary,

Hince

et al. 2023

Preprint

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ObjectivesEvaluate the construct validity (structural validity and hypothesis-testing), reliability (test-retest reliability, measurement error and internal consistency) and minimal detectable change (MDC) of the 13-item TENDINopathy Severity assessment–Achilles (TENDINS-A).MethodsParticipants with Achilles pain completed an online survey: demographics, TENDINS-A, Foot and Ankle Outcome Score (FAOS) and Victorian Institute of Sport Assessment-Achilles (VISA-A). Exploratory factor analysis (EFA) assessed dimensionality. Confirmatory Factor Analysis (CFA) assessed structural validity [root-mean-squared error of approximation (RMSEA); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); Standardised Root Measure Square (SRMS)]. Correlations between TENDINS-A and the FAOS/ VISA-A assessed hypothesis-testing. Intraclass correlation (ICC) assessed test-retest reliability. Cronbach’s α assessed internal consistency. Standard error of the measurement (SEM) assessed measurement error. A distribution-based approach assessed MDC.ResultsSeventy-nine participants (51% female) with a mean (SD) age=42.6 (13.0)years, height=175.0 (11.7)cm and body mass=82.0 (19.1)kg were included. EFA identified three meaningful factors, proposed to be pain, symptoms and function. The best model identified using CFA had adequate structural validity (CFI= 0.959, TLI= 0.947, RMSEA= 0.101, SRMS=0.068) excluded three items from the original TENDINS-A, included three factors (Pain, Symptoms, and Function). TENDINS-A exhibited moderate positive correlation with FAOS (rho=0.598,p<0.001), moderate, negative correlation with VISA-A (r=-0.639,p<0.001). Reliability of the TENDINS-A is excellent (ICC=0.930; Cronbach’s α=0.808; SEM=6.54 units) and has an MDC of 12 units.ConclusionsOur evaluation of the revised 10-item TENDINS-A has determined it has adequate validity and reliability. Thus, the TENDINS-A can be recommended for immediate use, being the preferred tool over other PROMs to assess disability in Achilles tendinopathy.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

TENDINopathy Severity assessment – Achilles (TENDINS-A): Evaluation of reliability and validity in accordance with COSMIN recommendations

Murphy,

McCleary,

Hince

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Additionally, recent studies showed limited evidence for the clinimetric properties of the frequently utilized Victorian Institute of Sport Assessment-Patella questionnaire, affecting its validity in diagnosing PT. 45 The phases of a sports season could change the PT prevalence. Studies that reported a higher mean monthly prevalence of PT during the preseason compared with the competitive season, 24 highlighted methodological issues in capturing these injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, recent studies showed limited evidence for the clinimetric properties of the frequently utilized Victorian Institute of Sport Assessment–Patella questionnaire, affecting its validity in diagnosing PT. 45 …”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Patellar Tendinopathy in Athletes and the General Population: A Systematic Review and Meta-analysis

Nutarelli

Lodi²,

Cook

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Patellar tendinopathy (PT) mainly affects athletes who use the tendon for repeated energy storage and release activities. It can have a striking impact on athletes’ careers, although data on its real prevalence and incidence are sparse. Research efforts should start from the results of reliable and updated epidemiological research to help better understand the impact of PT and underpin preventative measures. Purpose: To determine the prevalence and incidence of PT in athletes and the general population. Design: Systematic review; Level of evidence, 3. Methods: A systematic review of the literature was performed on January 17, 2022, and conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Web of Science, and Wiley Cochrane Library databases were searched for epidemiological reports of any evidence level and clinical studies reporting data on the incidence or prevalence of PT for the 11,488 retrieved records. The primary endpoint was the prevalence and incidence of PT in sport-active patients. The secondary endpoints were PT prevalence and incidence in subgroups of athletes based on sex, age, sport type, and sport level played, as well as the same epidemiological measures in the general population. Results: A total of 28 studies, with 28,171 participants, were selected and used for the qualitative and quantitative analysis. The general and athletes’ populations reported an overall PT prevalence of 0.1% and 18.3%, respectively. In athletes, the prevalence of PT was 11.2% in women and 17% in men ( P = .070). The prevalence of PT in athletes <18 years was 10.1%, while it was 21.3% in athletes ≥18 years ( P = .004). The prevalence of PT was 6.1% in soccer players, 20.8% in basketball players, and 24.8% in volleyball players. Heterogeneous PT diagnostic approaches were observed. Higher prevalence values were found when PT diagnoses were made using patient-reported outcomes versus clinical evaluations ( P = .004). Conclusion: This review demonstrated that PT is a common problem in the male and female sport-active populations. There are twice as many athletes aged ≥18 years than there are <18 years. Volleyball and basketball players are most affected by PT.

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“…The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines represent international best practice for the design and appraisal of patient-reported outcome measures (PROMs) 13 14. However, the value of a PROM is not in its availability but in its quality, reflected by its clinometric properties 15. Valid and reliable PROMs should be used and recommended, but this is not currently possible in Achilles tendinopathy research of the disability domain 16.…”

Section: Introductionmentioning

confidence: 99%

TENDINopathy Severity assessment–Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations

Murphy,

McCleary,

Hince

et al. 2024

Br J Sports Med

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ObjectiveTo evaluate the construct validity (structural validity and hypothesis testing), reliability (test–retest reliability, measurement error and internal consistency) and minimal important change (MIC) of the 13-item TENDINopathy Severity assessment–Achilles (TENDINS-A).MethodsParticipants with Achilles pain completed an online survey including: demographics, TENDINS-A, Foot and Ankle Outcome Score (FAOS) and Victorian Institute of Sport Assessment–Achilles (VISA-A). Exploratory factor analysis (EFA) assessed dimensionality. Confirmatory factor analysis (CFA) assessed structural validity (root mean square error of approximation (RMSEA); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); standardised root measure square (SRMS)). Correlations between TENDINS-A and the FAOS or VISA-A assessed hypothesis testing. Intraclass correlation (ICC) assessed test–retest reliability. Cronbach’s alpha assessed internal consistency. SE of the measurement (SEM) assessed measurement error. A distribution-based approach assessed MIC.Results79 participants (51% female) with a mean (SD) age=42.6 (13.0) years, height=175.0 (11.7) cm and body mass=82.0 (19.1) kg were included. EFA identified three meaningful factors, proposed as pain, symptoms and function. The best model identified using CFA for TENDINS-A had structural validity (RMSEA=0.101, CFI=0.959, TLI=0.947, SRMS=0.068), which included three factors (pain, symptoms and function), but excluded three items from the original TENDINS-A. TENDINS-A exhibited moderate positive correlation with FAOS (r=0.598, p<0.001) and a moderate negative correlation with VISA-A (r=−0.639, p<0.001). Reliability of the TENDINS-A was excellent (ICC=0.930; Cronbach’s α=0.808; SEM=6.54 units), with an MIC of 12 units.ConclusionsOur evaluation of the revised 10-item TENDINS-A determined it has construct validity and excellent reliability, compared with the VISA-A and FAOS which lack content and construct validity. The TENDINS-A is recommended as the preferred patient-reported outcome measure to assess disability in people with Achilles tendinopathy.

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Tendinopathy VISAs have expired—is it time for outcome renewals?

Cited by 8 publications

References 20 publications

TENDINopathy Severity assessment – Achilles (TENDINS-A): Evaluation of reliability and validity in accordance with COSMIN recommendations

TENDINopathy Severity assessment – Achilles (TENDINS-A): Evaluation of reliability and validity in accordance with COSMIN recommendations

Epidemiology of Patellar Tendinopathy in Athletes and the General Population: A Systematic Review and Meta-analysis

TENDINopathy Severity assessment–Achilles (TENDINS-A): evaluation of reliability and validity in accordance with COSMIN recommendations

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