Sá C1,2,3, Vicente S3,4,5, Murta H3,6,7, Oliveira J3,8,9
1Escola Superior de Saúde da Cruz Vermelha Portuguesa (ESS-CVP), Fisioterapia, Lisboa, Portugal, 2CERCIMB, Fisioterapia, Barreiro, Portugal, 3APFISIO, GIFA, Lisboa, Portugal, 4Escola Superior de Saúde Egas Moniz, Fisioterapia, Monte da Caparica, Portugal, 5CiiEM, Monte da Caparica, Portugal, 6Escola Superior de Saúde do Instituto Politécnico de Setúbal, Fisioterapia, Setúbal, Portugal, 7Centro Hospitalar de Setúbal, Fisioterapia, Setúbal, Portugal, 8Palmela Desporto, Fisioterapia, Setúbal, Portugal, 9Colaboradora Escola Superior Saúde Alcoitão, Fisioterapia, Lisboa, Portugal
Background: Aquatic Physical therapy plays an important role in the treatment of several clinical conditions. A therapy programme associated with water properties enhances the progress and recovery of body functions and structures, activities and participation, and quality of life1,2. Outcomes assessment is fundamental for the construction of an evidence-based practice. WOTA 1 and 2 are two important aquatic instruments that were developed to assess the mental adaptation of the swimmer and his function in the water based on the principles of the Halliwick method. WOTA 1 was developed to evaluate children with difficulties in following or understanding instructions. WOTA 2 was developed to assess children with higher functional abilities or that are able to follow instructions 3.
Purpose: The purpose of this study was to adapt and cultural validate WOTA 1 and 2 to portuguese language and to assess its psychometric properties.
Methods: This is a methodological study of adaptation and cultural validation of an instrument in a foreign language. The different steps recommended in the literature were carried out. The cross cultural equivalence was done through Delphi technique by the expert committee, composed by five aquatic physical therapists experts. One round was enough because agreement between experts was 80% or more on the items. The pretest was done by a small sample of physical therapists (PT) in order to assess if the translated instrument was understandable and the language was clear. No problems were pointed by the pretest PT to the Portuguese version so the process of cross validation continued with the assessment of psychometric properties of the instrument. A convenience sample of forty children divided into two groups participated on the study. In WOTA 1 twenty participants (80% male and 20% female; mean ± SD age, 8.3 ± 2.8 years) and in WOTA 2 twenty participants (70% male and 30% female; mean ± SD age, 13.6 ± 2.8 years). Two physical therapists evaluated the children in the beginning and one month later. All subjects' guardians signed informed consent.
Results: WOTA 1 and WOTA 2 both showed good psychometrics values. WOTA 1 showed very good values of internal consistency (Cronbach α= 0.91) and test-retest reliability (ICC= 0.94; 95%CI). The WOTA 2 also showed high internal consistency (Cronbach α= 0.89) and good test-retest reliability (ICC= 0.99 (95%CI)). The instrument is divided into two sub-scales (mental adaptation (MA) and functional performance (FP)). Both sub-scales scored with good values of consistency and test-retest reliability (MA Cronbach α= 0.68; ICC= 0.95 (95%CI); FP Cronbach α= 0.90; ICC= 0.99 (95%CI)).
Conclusion(s): WOTA-P 1 and WOTA-P 2 are a valid and reliable instrument to portuguese language and its results are comparable with the english version.
Implications: Aquatic outcome assessment is essential for the development of evidence-based practice in physiotherapy.
Instruments in Portuguese language are very important to strenghten physiotherapy practice.
Cross cultural validation of instruments are a milestone in physiotherapy practice.
Keywords: WOTA, Aquatic Physical Therapy Outcome Measure, Children
Funding acknowledgements: To the aquatic physiotherapists experts for their work on the validation of the instrument and the children that participated.
Purpose: The purpose of this study was to adapt and cultural validate WOTA 1 and 2 to portuguese language and to assess its psychometric properties.
Methods: This is a methodological study of adaptation and cultural validation of an instrument in a foreign language. The different steps recommended in the literature were carried out. The cross cultural equivalence was done through Delphi technique by the expert committee, composed by five aquatic physical therapists experts. One round was enough because agreement between experts was 80% or more on the items. The pretest was done by a small sample of physical therapists (PT) in order to assess if the translated instrument was understandable and the language was clear. No problems were pointed by the pretest PT to the Portuguese version so the process of cross validation continued with the assessment of psychometric properties of the instrument. A convenience sample of forty children divided into two groups participated on the study. In WOTA 1 twenty participants (80% male and 20% female; mean ± SD age, 8.3 ± 2.8 years) and in WOTA 2 twenty participants (70% male and 30% female; mean ± SD age, 13.6 ± 2.8 years). Two physical therapists evaluated the children in the beginning and one month later. All subjects' guardians signed informed consent.
Results: WOTA 1 and WOTA 2 both showed good psychometrics values. WOTA 1 showed very good values of internal consistency (Cronbach α= 0.91) and test-retest reliability (ICC= 0.94; 95%CI). The WOTA 2 also showed high internal consistency (Cronbach α= 0.89) and good test-retest reliability (ICC= 0.99 (95%CI)). The instrument is divided into two sub-scales (mental adaptation (MA) and functional performance (FP)). Both sub-scales scored with good values of consistency and test-retest reliability (MA Cronbach α= 0.68; ICC= 0.95 (95%CI); FP Cronbach α= 0.90; ICC= 0.99 (95%CI)).
Conclusion(s): WOTA-P 1 and WOTA-P 2 are a valid and reliable instrument to portuguese language and its results are comparable with the english version.
Implications: Aquatic outcome assessment is essential for the development of evidence-based practice in physiotherapy.
Instruments in Portuguese language are very important to strenghten physiotherapy practice.
Cross cultural validation of instruments are a milestone in physiotherapy practice.
Keywords: WOTA, Aquatic Physical Therapy Outcome Measure, Children
Funding acknowledgements: To the aquatic physiotherapists experts for their work on the validation of the instrument and the children that participated.
Topic: Paediatrics; Outcome measurement; Paediatrics: cerebral palsy
Ethics approval required: No
Institution: Escola Superior de Saúde Egas Moniz
Ethics committee: Escola Superior de Saúde Egas Moniz
Reason not required: The study was developed following the different steps recommended in literature. All subjects’ guardians signed informed consent.
All authors, affiliations and abstracts have been published as submitted.
