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Translation, cross-cultural adaptation, validation and responsiveness in the Brazilian Portuguese version of the Knee Injury and Osteoarthritis Outcome Score (KOOS-BR)

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To carry out the translation, cultural adaptation, and validation in the Brazilian Portuguese version of Knee Osteoarthritis Outcome Score (KOOS-BR) in individuals with knee osteoarthritis (KOA).

Methods

Patients with KOA (n = 136) answered KOOS-BR, Short-Form Health Survey (SF-36) and Numerical Pain Scale (NPS) to access construct validity. KOOS-BR was answered again with an interval of five to eight days. The following were performed: Cronbach’s alpha to assess internal consistency, intraclass correction coefficient (ICC2,1) to assess reproducibility, standard error of measurement (SEM) and minimal detectable change (MDC) as error measurements. Dimensionality was tested through confirmatory factor analysis (CFA). Responsiveness was investigated by the correlation between KOOS-BR subscales with global perceived effect (GPE) before and after physical therapy treatment for 6 weeks. Floor and ceiling effects (< 15%) were also assessed.

Results

KOOS-BR version showed good test–retest reliability in all KOOS-BR subscales (ICC = 0.77–0.84), with proper internal consistency (α = 0.71–0.94). KOOS-BR showed a moderate direct correlation with physical health domains of SF-36 (r = 0.39–0.68; p < 0.001) and a moderate inverse correlation with pain intensity (r = − 0.51 to − 0.57; p < 0.001). KOOS-BR proved to be responsive, the correlation between the KOOS-BR subscales and GPE before and after treatment ranged from 0.42 to 0.60 (p < 0.001). There was no ceiling and floor effect.

Conclusion

KOOS-BR is reliable, valid, and responsive in patients with KOA.

Level of evidence

II.

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

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Authors and Affiliations

  1. Knee and Sports Research Group, Federal University of Ceará, Alexandre Baraúna Street, 949-1º andar-Rodolfo Teófilo, Fortaleza, CE, 60430-160, Brazil

    Gabriel Peixoto Leão Almeida, Rafaele Maria Oliveira da Costa, Thamyla Rocha Albano & Maria Larissa Azevedo Tavares

  2. Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, CE, Brazil

    Gabriel Peixoto Leão Almeida, Thamyla Rocha Albano & Maria Larissa Azevedo Tavares

  3. Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of Sao Paulo, São Paulo, Brazil

    Amélia Pasqual Marques

Authors
  1. Gabriel Peixoto Leão Almeida
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  2. Rafaele Maria Oliveira da Costa
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  3. Thamyla Rocha Albano
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  4. Maria Larissa Azevedo Tavares
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  5. Amélia Pasqual Marques
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Contributions

All authors contributed to the conception and design of the study. The material preparation, data collection and analysis were performed by RMOC and GPLA. The first draft of the manuscript was written by RMOC and MLAT. Supervision and written review of the study were carried out by GPLA, TRA and APM. All authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gabriel Peixoto Leão Almeida.

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Conflict of interest

All authors declare that there are no conflicts of interest involved in writing this article.

Ethical approval

This study was approved by the Ethics Committee at the Faculty of Medicine of the University of São Paulo with protocol number 199.254.

Informed consent

Patients provided informed consent to take part in the study.

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Almeida, G.P.L., da Costa, R.M.O., Albano, T.R. et al. Translation, cross-cultural adaptation, validation and responsiveness in the Brazilian Portuguese version of the Knee Injury and Osteoarthritis Outcome Score (KOOS-BR). Knee Surg Sports Traumatol Arthrosc 30, 3343–3349 (2022). https://doi.org/10.1007/s00167-022-06911-w

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