Adaptación transcultural de la escala Victorian Institute of Sport Assessment - Patella (VISA-P) para la valoración de la gravedad de los síntomas en población deportista española con tendinopatía rotuliana

Abstract

Tendinopathies in sports have considerable prevalence, especially in lower limb. These injuries cause a functional limitation in body movements and also can limit sports participation. In the evaluation and monitoring the clinical evolution of tendinopathy ultrasound it is often used as an objective instrument of structural assessment. However, the use of patient-reported outcome measures has become important in this process, as they allow reflecting the patient's point of view in the outcomes assessment. The aim of the present study was to obtain a Spanish cross-cultural adaptation of the VISA-P scale for assessing the severity of symptoms in athletes with patellar tendinopathy. It has become the most widely patient-reported outcome measure in patellar tendinopathy and it is available in several languages. Considering the international COSMIN initiative proposed to evaluate the psychometric properties of the instruments for measuring health outcomes, the cross-cultural adaptation of the VISA-P scale and the assessment of the reliability, validity and sensitivity to change of its scores were carried out in Spanish population. Based on the obtained results it we are confident that the Spanish VISA-P adaptation (VISA-P-Sp) is conceptually similar to the original scale in English. The scores showed suitable values of reliability, both in terms of internal consistency and temporal stability. It also has external validity indicators, as the highly significant correlation with other instruments that assess the functional impact of the patellar tendinopathy. Regarding the ability to detect clinically significant changes, the threshold of minimum detectable change for the VISA-P-Sp scale is 11 points, and has a standard measurement error of 4 points. Scores of relevant clinical change are produced from 13 points, but this threshold is dependent on the VISA-P-Sp baseline score, so the more symptomatic patients require major changes in the scale to perceive a relevant clinical improvement. The confirmatory factor analysis has yielded the earliest evidence on the one-dimensional structure of the VISA-P scale, and its sex invariance. It allows using the final score of the scale as a significant element, and comparisons of scores between men and women without gender bias. Regarding its cultural validity, we obtained evidence for partial metric invariance, and more research is needed to draw conclusions about the comparability of scores between subjects from different countries or cultures. Keywords: tendinopathy; VISA-P scale; cross-cultural adaptation; invariance; validity, outcome measure.