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The Turkish version of the Achilles tendon Total Rupture Score: cross-cultural adaptation, reliability and validity

Knee Surgery, Sports Traumatology, Arthroscopy volume 23, pages 2427–2432 (2015)Cite this article

Abstract

Purpose

The Achilles tendon Total Rupture Score (ATRS) is a questionnaire designed to evaluate pain, symptoms, function and physical activity after Achilles tendon rupture. The purpose of this study was to translate and culturally adapt the ATRS into Turkish and to determine its reliability and validity.

Methods

The ATRS was translated into Turkish in accordance with the stages recommended by Beaton. Seventy-four patients (73 male; average age: 42.3 ± 7.6; range 27–63 years) suffering from previous Achilles tendon ruptures were included for the study. The ATRS-Turkish was administered twice at 7–14 days intervals with 52 of the 74 patients (51 male, average age: 41.8 ± 7.8) to assess the test–retest reliability. Cronbach’s α was used for internal consistency, and the inter-rater correlation coefficient (ICC) was used to calculate the test–retest reliability. The Turkish Short-Form-12 (SF-12) and the Foot and Ankle Outcome Score (FAOS) were employed for validity estimation.

Results

The internal consistency (Cronbach’s α = 0.95) and the test–retest reliability (ICC = 0.98) were excellent. The mean interval between the two tests was 7.1 ± 3.1 days. The mean and standard deviation of the first and second assessment of the ATRS were 78.1 ± 23.1 and 79.1 ± 22.5, respectively. The correlation coefficient between the ATRS-Turkish and the FAOS subscales (pain, symptoms, activities of daily living, sports and recreational activities, and quality of life) were determined (r = 0.82, r = 0.66, r = 0.79, r = 0.83 and r = 0.60, respectively, p < 0.0001). The ATRS-Turkish displayed good correlation with the SF-12 physical component score (r = 0.63, p < 0.001) and no correlation with the SF-12 mental component score (r = 0.22, p = 0.06).

Conclusion

The ATRS-Turkish was found to be reliable and valid for outcome evaluation after Achilles tendon ruptures.

Level of evidence

II.

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References

  1. Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25:3186–3191

    CAS  PubMed  Article  Google Scholar 

  2. Button G, Pinney S (2004) A meta-analysis of outcome rating scales in foot and ankle surgery: is there a valid, reliable, and responsive system? Foot Ankle Int 25:521–525

    PubMed  Google Scholar 

  3. Carmont MR, Silbernagel KG, Nilsson-Helander K, Mei-Dan O, Karlsson J, Maffulli N (2013) Cross cultural adaptation of the Achilles tendon Total Rupture Score with reliability, validity and responsiveness evaluation. Knee Surg Sports Traumatol Arthrosc 21:1356–1360

    PubMed  Article  Google Scholar 

  4. Chiodo CP, Glazebrook M, Bluman EM, Cohen BE, Femino JE, Giza E, Watters WC 3rd, Goldberg MJ, Keith M, Haralson RH 3rd, Turkelson CM, Wies JL, Raymond L, Anderson S, Boyer K, Sluka P, American Academy of Orthopaedic Surgeons (2010) Diagnosis and treatment of acute Achilles tendon rupture. J Am Acad Orthop Surg 18:503–510

    PubMed  Google Scholar 

  5. De Vet HC, Terwee CB, Bouter LM (2003) Current challenges in clinimetrics. J Clin Epidemiol 56:1137–1141

    PubMed  Article  Google Scholar 

  6. Ganestam A, Barfod K, Klit J, Troelsen A (2013) Validity and reliability of the Achilles tendon Total Rupture Score. J Foot Ankle Surg 52:736–739

    PubMed  Article  Google Scholar 

  7. Garras DN, Raikin SM, Bhat SB, Taweel N, Karanjia H (2012) MRI is unnecessary for diagnosing acute Achilles tendon ruptures: clinical diagnostic criteria. Clin Orthop Relat Res 470:2268–2273

    PubMed Central  PubMed  Article  Google Scholar 

  8. Irrgang JJ, Marx RG (2007) Clinical outcomes in sport and exercise physical therapies. In: Kolt GS, Synder-Mackler L (eds) Physical therapies in sports and exercise, 2nd edn. Elsevier, Edinburgh, pp 206–219

    Google Scholar 

  9. Järvinen TA, Kannus P, Maffulli N, Khan KM (2005) Achilles tendon disorders: etiology and epidemiology. Foot Ankle Clin 10:255–266

    PubMed  Article  Google Scholar 

  10. Karatepe AG, Gunaydin R, Kaya T, Karlibas U, Ozbek G (2009) Validation of the Turkish version of the foot and ankle outcome score. Rheumatol Int 30:169–173

    PubMed  Article  Google Scholar 

  11. Kearney RS, Achten J, Lamb SE, Parsons N, Costa ML (2012) The Achilles tendon Total Rupture Score: a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures. Health Qual Life Outcomes 10:24

    PubMed Central  PubMed  Article  Google Scholar 

  12. Kearney RS, Achten J, Lamb SE, Plant C, Costa ML (2012) A systematic review of patient-reported outcome measures used to assess Achilles tendon rupture management: what’s being used and should we be using it? Br J Sports Med 46:1102–1109

    PubMed  Article  Google Scholar 

  13. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353

    CAS  PubMed  Article  Google Scholar 

  14. Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A (1999) Reliability and validity of Turkish version of Short form 36: a study of patients with rheumatoid disorder. J Drug Ther 12:102–106

    Google Scholar 

  15. Landorf KB, Keenan AM (2002) An evaluation of two foot-specific, health-related quality-of-life measuring instruments. Foot Ankle Int 23:538–546

    PubMed  Google Scholar 

  16. Leppilahti J, Forsman K, Puranen J, Orava S (1998) Outcome and prognostic factors of Achilles rupture repair using a new scoring method. Clin Orthop Relat Res 456:152–161

    Google Scholar 

  17. Leppilahti J, Orava S (1998) Total Achilles tendon rupture. A review. Sports Med 25:79–100

    CAS  PubMed  Article  Google Scholar 

  18. Maffulli N (1998) The clinical diagnosis of subcutaneous tear of the Achilles tendon: a prospective study in 174 patients. Am J Sports Med 26:266–270

    CAS  PubMed  Google Scholar 

  19. Maffulli N, Ajis A (2008) Management of chronic ruptures of the Achilles tendon. J Bone Joint Surg Am 90:1348–1360

    PubMed  Article  Google Scholar 

  20. Marx RG, Menezes A, Horovitz L, Jones EC, Warren RF (2003) A comparison of two time intervals for test–retest reliability of health status instruments. J Clin Epidemiol 56:730–735

    PubMed  Article  Google Scholar 

  21. Merkel M, Neumann HW, Merk H (1996) A new score for comparing outcome of surgical management of Achilles tendon ruptures. Chirurg 67:1141–1146

    CAS  PubMed  Article  Google Scholar 

  22. Movin T, Ryberg A, McBride DJ, Maffulli N (2005) Acute rupture of the Achilles tendon. Foot Ankle Clin 10:331–356

    PubMed  Article  Google Scholar 

  23. Möller A, Astron M, Westlin N (1996) Increasing incidence of Achilles tendon rupture. Acta Orthop Scand 67:479–481

    PubMed  Article  Google Scholar 

  24. Nilsson-Helander K, Thomeé R, Silbernagel KG, Thomeé P, Faxén E, Eriksson BI, Karlsson J (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35:421–426

    PubMed  Article  Google Scholar 

  25. Nunnally JC, Bernstein IR (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York

    Google Scholar 

  26. Research randomizer. http://www.randomizer.org

  27. Roos EM, Brandsson S, Karlsson J (2001) Validation of the foot and ankle outcome score for ankle ligament reconstruction. Foot Ankle Int 22:788–794

    CAS  PubMed  Google Scholar 

  28. Suchak AA, Bostick G, Reid D, Blitz S, Jomha N (2005) The incidence of Achilles tendon ruptures in Edmonton, Canada. Foot Ankle Int 26:932–936

    PubMed  Google Scholar 

  29. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42

    PubMed  Article  Google Scholar 

  30. Ware J Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    PubMed  Article  Google Scholar 

  31. Ware J Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care 30:473–483

    PubMed  Article  Google Scholar 

  32. Wilkins R, Bisson LJ (2012) Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials. Am J Sports Med 40:2154–2160

    PubMed  Article  Google Scholar 

  33. Zhao HM, Yu GR, Yang YF, Zhou JQ, Aubeeluck A (2011) Outcomes and complications of operative versus non-operative treatment of acute Achilles tendon rupture: a meta-analysis. Chin Med J 124:4050–4055

    PubMed  Google Scholar 

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Conflict of interest

The authors declare no conflict of interest.

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Affiliations

  1. Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University, 34093, Bakirkoy, Istanbul, Turkey

    Ebru Kaya Mutlu, Derya Celik & Arzu Razak Ozdincler

  2. Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Önder Kiliçoglu

  3. Department of Orthopaedics, Kungsbacka Hospital, Kungsbacka, Sweden

    Katarina Nilsson-Helander

Authors
  1. Ebru Kaya Mutlu
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  2. Derya Celik
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  3. Önder Kiliçoglu
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  4. Arzu Razak Ozdincler
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  5. Katarina Nilsson-Helander
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Correspondence to Ebru Kaya Mutlu.

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Kaya Mutlu, E., Celik, D., Kiliçoglu, Ö. et al. The Turkish version of the Achilles tendon Total Rupture Score: cross-cultural adaptation, reliability and validity. Knee Surg Sports Traumatol Arthrosc 23, 2427–2432 (2015). https://doi.org/10.1007/s00167-014-3042-1

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Keywords

  • Achilles
  • ATRS
  • Score
  • Reliability
  • Validity