Cross-cultural adaptation and measurement properties of the VISA-A questionnaire for Chinese patients with Achilles Tendinopathy

Abstract

Objective: To culturally adapt the VISA-A into a simplified Chinese version (VISA-A-CHN) and test its measurement properties.

Design: Methodological study; SETTING: Hospital and university laboratory.

Participants: 240 subjects were divided into the healthy (n = 80), at-risk (n = 80), and tendinopathy groups (n = 80).

Main outcomes measures: The internal consistency, test-retest reliability, construct validity, and the floor and ceiling effect of the VISA-A-CHN.

Results: The VISA-A-CHN showed adequate internal consistency (Cronbach's α = 0.73, 95% CI 0.63 to 0.81), excellent test-retest reliability (ICC_3A,1 = 0.97, 95%CI = 0.95 to 0.98), standard error of measurement of 2.2 points, minimum detectable change of 6.0 points, with no floor and ceiling effects. Two factors (pain/symptoms and physical function/activity) were extracted in exploratory factor analysis. There were moderate associations of VISA-A-CHN score with scores of Lower Extremity Functional Scale and SF-36 physical components (r_s = 0.53-0.74, P < 0.01) but low associations with SF-36 mental components (r_s = 0.12-0.22, P > 0.05). VISA-A-CHN mean score of Achilles tendinopathy group was significantly lower than those of healthy and at-risk groups (P < 0.01).

Conclusions: The VISA-A-CHN is equivalent to the original version in terms of language and measurement properties. It can be used as the outcome measure for Chinese patients with Achilles tendinopathy.

Keywords: Achilles tendinopathy; Cross-cultural adaptation; Outcome measure; VISA-A.