Reliability and validity of Kannada version of Victorian Institute of Sports Assessment for patellar tendinopathy (VISA-P-K) questionnaire

Abstract

Background: In sporting activities, patellar tendon is commonly subjected to overuse and it influences the athletes' career especially in elite basketball and volleyball players. A condition specific and selfadministrated questionnaire is required for clinical and research purpose to rate disability. The Victorian Institute of Sports Assessment for patellar tendinopathy (VISA-P) questionnaire is widely accepted and a valid tool to assess pain and athletes, suffering from PT, ability to participate in sports. So, the objective of this study is to develop and validate Kannada version of VISA-P questionnaire among Kannada speaking population athletes. Objective: To translate VISA-P questionnaire into Kannada and to study reliability and validity of Kannada version. Methodology: Translation and cross-culture adaptation were performed according to the guidelines followed internationally. Those are: translation, synthesis, back-translation, revision by expert committee, pretesting and appraisal by advisory committee. The psychometric properties were tested by administering the questionnaire to 70 subjects (35 symptomatic and 35 asymptomatic). For test-retest reliability, athletes with patellar tendinopathy were tested twice within a week and test-retest reliability was assessed by Intra-class correlation coefficient (ICC). The validity was tested by comparing the VISA-P-Kannada questionnaire (VISA-P-K) against Blazina classification of patellar tendinopathy (BCPT) using Spearman correlation coefficient. Result: The test-retest reliability was excellent (ICC 0.97). Internal consistency was found to be good (Cronbach's alpha ¼ 0.98). The VISA-PK showed significant correlation by comparing against Blazina and Spearman's score (r ¼ 0.72, p < 0.01). Conclusion:The VISA-P-K translation and adaptation processes were successful. The adapted instrument demonstrated good psychometric properties. The VISA-P-K has proven to be reliable and valid tool and can be used in the Kannada speaking patients with patellar tendinopathy.

A systematic review evaluating the clinimetric properties of the Victorian Institute of Sport Assessment (VISA) questionnaires for lower limb tendinopathy shows moderate to high-quality evidence for sufficient reliability, validity and responsiveness—part II

“…Thirteen studies [ 1 , 5 , 15 , 17 , 18 , 24 , 28 , 34 , 39 , 47 , 61 , 62 , 64 ] assessed the reliability of the VISA-P in 930 patients with patellar tendinopathy and asymptomatic individuals. All summarized studies presented results of sufficient reliability ranging from 0.74 to 0.994 except two studies that the reliability coefficients did not meet the criteria of an ICC > 0.70 (Table 2 ).…”

“…Eleven studies [ 1 , 5 , 15 , 17 , 24 , 28 , 34 , 47 , 61 , 62 , 64 ] assessed construct validity using as comparators generic tendon grading systems (i.e., Nirchl pain scale, Blazina classification system), valid and reliable lower limb PROMs (i.e., Lysholm questionnaire, Cincinnati knee scale, and Kujala scoring questionnaire), or generic measures of health status (i.e., SF36), as well as assessed known group’s validity by comparing the scores of patients, asymptomatic, or “at-risk” for tendinopathy individuals (Table 2 ).…”

Evaluating lower limb tendinopathy with Victorian Institute of Sport Assessment (VISA) questionnaires: a systematic review shows very-low-quality evidence for their content and structural validity—part I

“…The difference of comparative fit index values was < 0.01 [9], indicating that VISA-P scores are comparable between men and women. However, examination [18] VISA-A D D Kaux et al [33] VISA-A D De Mesquita et al [16] VISA-A D Hernandez-Sanchez et al [28] VISA-A D Beaudart et al [3] VISA-G D Jorgensen et al [31] VISA-H D Locquet et al [40] VISA-H D Hernandez-Sanchez et al [26] VISA-P D Lohrer et al [42] VISA-P I Korakakis et al [36] VISA-P D Acharya et al [1] VISA-P D of measurement invariance was performed in a model that did not met the requirements of sufficient unidimensionality [10,64]. Low-quality evidence (very serious risk of bias) indicates sufficient measurement invariance between sexes for VISA-P.…”

“…Of the original 1511 studies, 34 remained after duplicate removal. Of these, 31 met the eligibility criteria appraising measurement properties of: VISA-A [ 15 , 16 , 18 , 28 , 30 , 33 , 34 , 41 , 43 , 45 , 51 , 69 – 71 ], VISA-G [ 3 , 19 , 20 , 31 ], VISA-H [ 6 , 40 ], and VISA-P [ 1 , 7 , 22 , 25 – 27 , 32 , 36 , 42 , 46 , 60 , 80 , 81 , 83 ]. Twenty-four cross-cultural adaptations validated the VISA questionnaires in 12 languages.…”

“… ? b VISA-H [ 6 , 40 ] – Very low a – Very low a – Very low a [ 6 ] – Low c,d VISA-P [ 1 , 26 , 36 , 42 , 80 ] + Very low a – Very low a ± Very low a [ 7 , 22 , 25 , 26 , 36 , 83 ] ± NR f NR not rated, PROMs patient-reported outcome measures, ( + ) sufficient results, (–) insufficient results, ( ± ) inconsistent results, (?) indeterminate results a Based only on reviewers’ ratings b Indeterminate evidence due to lack of sufficient detail for VISA-G structure c Risk of bias (serious): only one study of adequate quality d Indirectness: only part of the study population were patients e Inconsistency: inconsistent structural validity results between studies f Structural validity study results were inconsistent, and according to COSMIN guidelines, the evidence cannot be graded …”