Validity and Comprehensibility of Physical Activity Scales for Children With Sport Injuries

Iversen, Maura D.; Heideken, Johan von; Farmer, Elisabeth; Rihm, Jessica; Heyworth, Benton E.; Kocher, Mininder S.

doi:10.1097/bpo.0000000000000448

Cited by 27 publications

(19 citation statements)

References 19 publications

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“…Several studies showed that these questionnaires are valid, reliable and responsive in adult patients with a variety of knee disorders [3–5]. However, recent studies showed that the adult versions of the IKDC and KOOS are inappropriate for use in children due to a lack of comprehensibility [6]. Subsequently, the child friendly Pedi-IKDC and KOOS-Child were developed and validated [7–9].…”

Section: Introductionmentioning

confidence: 99%

Pedi-IKDC or KOOS-child: which questionnaire should be used in children with knee disorders?

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et al. 2019

BMC Musculoskelet Disord

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Background The Pedi International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) child are validated questionnaires for children with knee disorders. The aim of this study was to translate these questionnaires in Dutch and to recommend which questionnaires should – based on their psychometric properties – be used in clinical practice. Methods The English Pedi-IKDC and KOOS-Child were translated by the forward-backward procedure. Subsequently, content validity of the Pedi-IKDC and KOOS-Child was evaluated by both patients ( n = 18) and experts ( n = 18). To evaluate construct validity and interpretability participants with knee disorders ( n = 100) completed the Numeric Rating Scale Pain, Lysholm Knee Scoring Scale, EuroQol-5 Dimension, Pedi-IKDC and KOOS-Child at baseline. Participants completed the anchor question, Pedi-IKDC and KOOS-child two weeks ( n = 54) and one year ( n = 71) after baseline, for evaluating the test-retest reliability and responsiveness. Psychometric properties were interpreted following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. Results The Pedi-IKDC showed adequate test-retest reliability (intraclass correlation coefficient (ICC) 0.9; standard error of measurement (SEM) 8.6; smallest detectable change (SDC) 23.8), adequate content validity (> 75% relevant), adequate construct validity (75% confirmed hypotheses), low floor or ceiling effects (scores between 5 and 95) and adequate responsiveness (> 75% confirmed hypotheses). The KOOS-Child showed an adequate test-retest reliability (ICC 0.8–0.9; SEM 8.9–16.9; SDC 24.7–46.9), adequate content validity (> 75% relevant, except KOOS-Child subscale ADL), adequate construct validity (75% confirmed hypotheses), low floor and ceiling effects (scores between 5 and 95, except KOOS-Child subscale activities of daily living and Sport/play) and moderate responsiveness (40% confirmed hypotheses). Conclusions The Pedi IKDC showed better psychometric properties than the KOOS-Child and should therefore be used in children with knee disorders.

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Section: Introductionmentioning

confidence: 99%

Pedi-IKDC or KOOS-child: which questionnaire should be used in children with knee disorders?

Velden

Steen

Leenders

et al. 2019

BMC Musculoskelet Disord

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“…While the Tegner is used to accurately categorize activity in adults and adolescents, this study showed that it cannot effectively differentiate the activity level of pediatric athletes. Iversen et al 17 reported that 87% of children had difficulty distinguishing the various levels used in the Tegner, as various sports are repeated. For example, soccer and football are repeated in both Tegner level 9 and level 10; relying on the ability of the respondent to select a level with no provided directions yielded inconsistent results.…”

Section: Discussionmentioning

confidence: 99%

Activity Measures in Pediatric Athletes: A Comparison of the Hospital for Special Surgery Pediatric Functional Activity Brief Scale and Tegner Activity Level Scale

et al. 2020

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Background: In young athletes, patient-reported activity level is frequently used to determine return to the same level of sport after treatment. Purpose: To evaluate the validity and score distributions of the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) compared with the Tegner Activity Level Scale (Tegner) in pediatric athletes. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: A retrospective review of 517 consecutive youth athletes who came to a sports medicine specialty clinic for a knee evaluation was performed. Patients completed the HSS Pedi-FABS, Tegner, and a sports participation survey before evaluation. Scores were compared with reported hours, days, and weeks of participation in sports as well as level of competition. Floor or ceiling effects were identified, and finally, the means and distributions of scores in the 8 most common primary sports were analyzed. Results: A total of 398 participants (54.0% female) with an average age of 14.5 years (range, 10.0-18.8 years) were included in the study. The HSS Pedi-FABS demonstrated correlations with hours per week ( r = 0.302; P < .001), days per week ( r = 0.278; P < .001), and weeks per year ( r = 0.136; P = .014) playing a primary sport. The Tegner only demonstrated a correlation with days per week ( r = 0.211; P = .001). Additionally, club/select-level athletes scored higher than junior high/high school–level athletes on the HSS Pedi-FABS (23.8 vs 21.0; P = .004), but no difference was observed with the Tegner. No floor or ceiling effect was observed for the HSS Pedi-FABS, but a ceiling effect was present for the Tegner (32.8%). The HSS Pedi-FABS demonstrated a varied score distribution between the 8 most common primary sports ( P < .001), with soccer players scoring the highest, on average (23.5). Conclusion: The HSS Pedi-FABS, compared with the Tegner, demonstrated more correlations with an athlete’s participation in sport with no floor or ceiling effect and had a wide distribution of scores even among same-sport athletes. The HSS Pedi-FABS may be a more valuable activity measure than the Tegner in pediatric athletes.

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“…The behavioral scientist then trained the interviewer in cognitive interviewing procedures and techniques (AF), until he was deemed proficient in the interview process. This protocol has been utilized in multiple previous studies [33, 34, 39, 40].…”

Section: Methodsmentioning

confidence: 99%

A qualitative study examining the validity and comprehensibility of physical activity items: developed and tested in children with juvenile idiopathic arthritis

et al. 2019

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Background Not all physical activity (PA) questionnaires (PAQ) gather information regarding PA intensity, duration, and modes and only a few were developed specifically for children. We assessed children’s comprehensibility of items derived from two published PAQs used in children along with three items designed to ascertain PA intensity in order to assess comprehensibility of items and identify response errors. We modified items to create a new PAQ for children ( ASCeND ). We hypothesized that children would have comprehension difficulties with some original PAQ items and that ASCeND would be easier to comprehend, and would improve recall and reporting of PA. Methods For this qualitative study, we recruited 30 Swedish children [ages 10–16 years; mean age = 13.0 (SD = 1.8)]; median disease activity score = 4.5 (IQR 2.2–9.0); median disease duration = 5.0 (IQR 2.6–10.8) with juvenile idiopathic arthritis (JIA) from a children’s hospital-based rheumatology clinic. We conducted cognitive interviews to identify children’s comprehension of PAQ items. Interviews were audiotaped, transcribed, and independently analyzed. In phase one, 10 children were interviewed and items modified based on feedback. In phase two, an additional 20 children were interviewed to gather more feedback and further refine the modified items, to create the ASCeND. Results The median interview time was 41 min (IQR 36–56). In phase one, 219 comments were generated regarding directions for recording PA duration, and transportation use, walking, dancing, weight-bearing exercise and cardio fitness. Based on feedback we modified the survey layout, clarified directions and collapsed or defined items to reduce redundancy. In phase two, 95 comments were generated. Most comments related to aerobic fitness and strenuous PA. Children had difficulty recalling total walking and other activities per day. Children used the weather on a particular day, sports practice, or gym schedules to recall time performing activities. The most comments regarding comprehension were generated about the 3-item PA intensity survey, suggesting children had problems responding to intensity items. Conclusions The newer layout facilitated recall of directions or efficiency in answering items. The 3-item intensity survey was difficult to answer. Sports-specific items helped children more accurately recall the amount of daily PA. The ASCeND appeared to be easy to answer and to comprehend. Electronic supplementary material The online version of this article (10.1186/s12969-019-0317-6) contains supplementary material, which is available to authorized users.

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Validity and Comprehensibility of Physical Activity Scales for Children With Sport Injuries

Abstract: Level II.

Cited by 27 publications

References 19 publications

Pedi-IKDC or KOOS-child: which questionnaire should be used in children with knee disorders?

Pedi-IKDC or KOOS-child: which questionnaire should be used in children with knee disorders?

Activity Measures in Pediatric Athletes: A Comparison of the Hospital for Special Surgery Pediatric Functional Activity Brief Scale and Tegner Activity Level Scale

A qualitative study examining the validity and comprehensibility of physical activity items: developed and tested in children with juvenile idiopathic arthritis

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