Cross-Cultural Adaptation of Chinese Victorian Institute of Sports Assessment-Achilles (VISA-A) Questionnaire for Achilles Tendinopathy

Violet Man Chi Ko; Ngo Nam Lau; Ji Hong Qiu; Sai-Chuen Fu; Patrick Shu-Hang Yung; Samuel Ka-Kin Ling

doi:10.1177/24730114221081535

Cross-Cultural Adaptation of Chinese Victorian Institute of Sports Assessment-Achilles (VISA-A) Questionnaire for Achilles Tendinopathy

Foot Ankle Orthop. 2022 Mar 4;7(1):24730114221081535. doi: 10.1177/24730114221081535. eCollection 2022 Jan.

Authors

Violet Man Chi Ko¹, Ngo Nam Lau¹, Ji Hong Qiu¹, Sai-Chuen Fu¹, Patrick Shu-Hang Yung¹, Samuel Ka-Kin Ling¹

Affiliation

¹ Department of Orthopedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), Hong Kong SAR, China.

Abstract

Background: Victorian Institute of Sports Assessment (VISA-A) is a patient-reported outcome for assessing symptoms severity associated with Achilles tendinopathy (AT). It is a valid and reliable tool that has been used widely for measuring and monitoring treatment outcomes for AT. This clinical measurement study aims to develop a Chinese version of the VISA-A questionnaire. The study objective is to adapt the VISA-A questionnaire cross-culturally and assess its psychometric property for Chinese-speaking individuals.

Methods: VISA-A was translated and adapted cross-culturally according to international guidelines for self-reported questionnaires. During the establishment of Chinese VISA-A, there are 5 stages involved in the creation process, including translation, synthesis, reverse translation, review, and pretesting, which are performed by professionals in various fields, including orthopaedic surgeons, physiotherapists, and professional translators.

Results: A total of 60 participants were recruited to complete the Chinese VISA-A and 36-Item Short Form Health Survey (SF-36) questionnaires. The overall test-retest reliability was 0.98 (intraclass correlation coefficient = 0.97-0.99). The correlation between Chinese VISA-A and physical function subscale (r = 0.70) was strong and statistically significant. There were moderate correlations between Chinese VISA-A, limitations to role of physical function subscale (r = 0.30), and bodily pain subscale (r = 0.42), which were also statistically significant. There were statistically significant differences in Chinese VISA-A scores between healthy control and pathologic group (P < .001), at-risk group, and pathologic group (P < .001) respectively.

Conclusion: Chinese VISA-A demonstrated good reliability and validity for measuring symptom severity in patients with AT. Chinese VISA-A can be recommended as a self-reported measure for monitoring symptoms severity and treatment progress of patients with Achilles tendinopathy.Level of Evidence: Level II, cohort study.

Keywords: Achilles tendinopathy; Chinese version; Cross-cultural adaptation; VISA-A; physiotherapy; rehabilitation; research instrument.