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Bunster J1, Besomi M1, Leppe J1, Mauri-Stecca MV1,2, Sizer PS3
1Universidad del Desarrollo, School of Physical Therapy, Santiago, Chile, 2Advanced Physical Therapy, Physical Therapy, Anchorage, United States, 3Center for Rehabilitation Research, Texas Tech University Health Sciences Center, School of Health Professions, Lubbock, United States
Background: Clinical monitoring of sports injuries recovery is critical for a safe return to sport. Such examination can be assessed through self-report questionnaires. The identification of psychometric properties of functional questionnaires, which have been validated in the athletic population and applied in the clinical setting, will facilitate appropriate selection of objectifiable methodologies for the assessment of functional recovery of patients with sports-related injuries.
Purpose: This study aims to systematically review the literature on the psychometric properties of self-reported questionnaires measuring functionality in athletes older than 18 years with lower extremity musculoskeletal conditions.
Methods: A comprehensive search in MEDLINE and Scielo databases was performed up to May 2018. Studies were included if they investigated the psychometric properties of self-reported questionnaires measuring functionality in athletic population. Methodological quality was assessed using the COSMIN checklist. Results were summarized and reported as a narrative synthesis.
Results: The search yielded 2,882 studies, from which 12 were included. A total of 8 questionnaires were analyzed: Hip Score Activity Scale (HSAS), LCA Return to Sport after Injury scale (ACL-RSI), Knee injury and Osteoarthritis Outcome Score (KOOS), Subjective Patient Outcome for Return to Sports (SPORT), Victorian Institute of Sport Assessment (VISA), Victorian Institute of Sport Assessment-Patella (VISA-P), Foot and Ankle Ability Measure (FAAM), and Sports Athlete Foot and Ankle Score (SAFAS), including conditions as anterior cruciate ligament reconstruction, patellar tendinopathy, hip impingement and chronic ankle instability, in a wide range of sports. No explicitly validated questionnaire, for a specific sport, was found. Construct validity was shown in 6 of the questionnaires, while VISA did not report any type of validity. Content validity was assessed only with the SAFAS. Test-retest reliability was reported as excellent (ICC > 0.81) for all questionnaires, while VISA-P and KOOS sub-scales of quality of life and symptoms showed good reliability (ICC from 0.61 to 0.80). FAAM did not assessed any type of reliability. The internal consistency values (Cronbach's α) ranged from 0.60 to 0.96. The standard measurement error was 0.7-5.5 in ACL-RSI, 2.1-3.1 in KOOS, 5.2 in VISA-P, and 0 in SPORTS. The minimum detectable change (points) was 1.9-3.2 in ACL-RSI, 5.8-8.5 in KOOS, and 12.2 in VISA-P.
Conclusion(s): ACL-RSI and SPORTS demonstrated appropriate psychometric properties to assess functionality in athletes following anterior cruciate ligament reconstruction, including more specific dimensions for sports performance. HSAS, VISA, FAAM, and SAFAS show acceptable psychometric properties, while VISA-P and KOOS are not recommended to examine functionality in athletes. The questionnaires available to assess the functional recovery of the athlete are general and incomplete in the included dimensions and abilities of the sport.
Implications: This review will facilitate specific clinical tools to practitioners of sports field when evaluating the rehabilitation and recovery process of sports patients and improving clinical decision-making for returning to the sport and previous performance.
Keywords: Functionality, Sports, Psychometric properties
Funding acknowledgements: This study did not receive a financial contribution
Purpose: This study aims to systematically review the literature on the psychometric properties of self-reported questionnaires measuring functionality in athletes older than 18 years with lower extremity musculoskeletal conditions.
Methods: A comprehensive search in MEDLINE and Scielo databases was performed up to May 2018. Studies were included if they investigated the psychometric properties of self-reported questionnaires measuring functionality in athletic population. Methodological quality was assessed using the COSMIN checklist. Results were summarized and reported as a narrative synthesis.
Results: The search yielded 2,882 studies, from which 12 were included. A total of 8 questionnaires were analyzed: Hip Score Activity Scale (HSAS), LCA Return to Sport after Injury scale (ACL-RSI), Knee injury and Osteoarthritis Outcome Score (KOOS), Subjective Patient Outcome for Return to Sports (SPORT), Victorian Institute of Sport Assessment (VISA), Victorian Institute of Sport Assessment-Patella (VISA-P), Foot and Ankle Ability Measure (FAAM), and Sports Athlete Foot and Ankle Score (SAFAS), including conditions as anterior cruciate ligament reconstruction, patellar tendinopathy, hip impingement and chronic ankle instability, in a wide range of sports. No explicitly validated questionnaire, for a specific sport, was found. Construct validity was shown in 6 of the questionnaires, while VISA did not report any type of validity. Content validity was assessed only with the SAFAS. Test-retest reliability was reported as excellent (ICC > 0.81) for all questionnaires, while VISA-P and KOOS sub-scales of quality of life and symptoms showed good reliability (ICC from 0.61 to 0.80). FAAM did not assessed any type of reliability. The internal consistency values (Cronbach's α) ranged from 0.60 to 0.96. The standard measurement error was 0.7-5.5 in ACL-RSI, 2.1-3.1 in KOOS, 5.2 in VISA-P, and 0 in SPORTS. The minimum detectable change (points) was 1.9-3.2 in ACL-RSI, 5.8-8.5 in KOOS, and 12.2 in VISA-P.
Conclusion(s): ACL-RSI and SPORTS demonstrated appropriate psychometric properties to assess functionality in athletes following anterior cruciate ligament reconstruction, including more specific dimensions for sports performance. HSAS, VISA, FAAM, and SAFAS show acceptable psychometric properties, while VISA-P and KOOS are not recommended to examine functionality in athletes. The questionnaires available to assess the functional recovery of the athlete are general and incomplete in the included dimensions and abilities of the sport.
Implications: This review will facilitate specific clinical tools to practitioners of sports field when evaluating the rehabilitation and recovery process of sports patients and improving clinical decision-making for returning to the sport and previous performance.
Keywords: Functionality, Sports, Psychometric properties
Funding acknowledgements: This study did not receive a financial contribution
Topic: Sport & sports injuries; Musculoskeletal: lower limb; Research methodology & knowledge translation
Ethics approval required: No
Institution: Universidad Del Desarrollo
Ethics committee: Scientific Ethical Committee of Universidad del Desarrollo
Reason not required: The study design does not require ethics committee approval.
All authors, affiliations and abstracts have been published as submitted.
