The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy

J M Robinson, J L Cook, C Purdam, P J Visentini, J Ross, N Maffulli, J E Taunton, K M Khan, Victorian Inst Sport Tendon Sport

Research output: Contribution to journalArticle

347 Citations (Scopus)

Abstract

Background-There is no disease specific, reliable, and valid clinical measure of Achilles tendinopathy.

Objective-To develop and test a questionnaire based instrument that would serve as an index of severity of Achilles tendinopathy.

Methods-Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire to assess the severity of Achilles tendinopathy. The final version consisted of eight questions that measured the domains of pain, function in daily living, and sporting activity. Results range from 0 to 100, where 100 represents the perfect score. Its validity and reliability were then tested in a population of non-surgical patients with Achilles tendinopathy (n = 45), presurgical patients with Achilles tendinopathy (n = 14), and two normal control populations (total n = 87).

Results-The VISA-A questionnaire had good test-retest (r = 0.93), intrarater (three tests, r = 0.90), and interrater (r = 0.90) reliability as well as good stability when compared one week apart (r = 0.81). The mean (95% confidence interval) VISA-A score in the non-surgical patients was 64 (59-69), in presurgical patients 44 (28-60), and in control subjects it exceeded 96 (94-99). Thus the VISA-A score was higher in non-surgical than presurgical patients (p = 0.02) and higher in control subjects than in both patient populations (p<0.001).

Conclusions-The VISA-A questionnaire is reliable and displayed construct validity when means were compared in patients with a range of severity of Achilles tendinopathy and control subjects. The continuous numerical result of the VISA-A questionnaire has the potential to provide utility in both the clinical setting and research. The test is not designed to be diagnostic. Further studies are needed to determine whether the VISA-A score predicts prognosis.

Original languageEnglish
Pages (from-to)335-341
Number of pages7
JournalBritish Journal of Sports Medicine
Volume35
Issue number5
DOIs
Publication statusPublished - 2001

Keywords

  • Achilles
  • tendinopathy
  • tendinitis
  • outcome
  • questionnaire
  • visual analog scales
  • tendon rupture
  • scoring scale
  • pain
  • injuries
  • knee
  • tendinosis
  • prevention
  • ultrasound

Cite this

Robinson, J. M., Cook, J. L., Purdam, C., Visentini, P. J., Ross, J., Maffulli, N., ... Victorian Inst Sport Tendon Sport (2001). The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy. British Journal of Sports Medicine, 35(5), 335-341. https://doi.org/10.1136/bjsm.35.5.335

The VISA-A questionnaire : a valid and reliable index of the clinical severity of Achilles tendinopathy. / Robinson, J M ; Cook, J L ; Purdam, C ; Visentini, P J ; Ross, J; Maffulli, N ; Taunton, J E ; Khan, K M ; Victorian Inst Sport Tendon Sport.

In: British Journal of Sports Medicine, Vol. 35, No. 5, 2001, p. 335-341.

Research output: Contribution to journalArticle

Robinson, JM, Cook, JL, Purdam, C, Visentini, PJ, Ross, J, Maffulli, N, Taunton, JE, Khan, KM & Victorian Inst Sport Tendon Sport 2001, 'The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy', British Journal of Sports Medicine, vol. 35, no. 5, pp. 335-341. https://doi.org/10.1136/bjsm.35.5.335
Robinson, J M ; Cook, J L ; Purdam, C ; Visentini, P J ; Ross, J ; Maffulli, N ; Taunton, J E ; Khan, K M ; Victorian Inst Sport Tendon Sport. / The VISA-A questionnaire : a valid and reliable index of the clinical severity of Achilles tendinopathy. In: British Journal of Sports Medicine. 2001 ; Vol. 35, No. 5. pp. 335-341.
@article{9308bfeea6294ecf81793e10af772b93,
title = "The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy",
abstract = "Background-There is no disease specific, reliable, and valid clinical measure of Achilles tendinopathy.Objective-To develop and test a questionnaire based instrument that would serve as an index of severity of Achilles tendinopathy.Methods-Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire to assess the severity of Achilles tendinopathy. The final version consisted of eight questions that measured the domains of pain, function in daily living, and sporting activity. Results range from 0 to 100, where 100 represents the perfect score. Its validity and reliability were then tested in a population of non-surgical patients with Achilles tendinopathy (n = 45), presurgical patients with Achilles tendinopathy (n = 14), and two normal control populations (total n = 87).Results-The VISA-A questionnaire had good test-retest (r = 0.93), intrarater (three tests, r = 0.90), and interrater (r = 0.90) reliability as well as good stability when compared one week apart (r = 0.81). The mean (95{\%} confidence interval) VISA-A score in the non-surgical patients was 64 (59-69), in presurgical patients 44 (28-60), and in control subjects it exceeded 96 (94-99). Thus the VISA-A score was higher in non-surgical than presurgical patients (p = 0.02) and higher in control subjects than in both patient populations (p<0.001).Conclusions-The VISA-A questionnaire is reliable and displayed construct validity when means were compared in patients with a range of severity of Achilles tendinopathy and control subjects. The continuous numerical result of the VISA-A questionnaire has the potential to provide utility in both the clinical setting and research. The test is not designed to be diagnostic. Further studies are needed to determine whether the VISA-A score predicts prognosis.",
keywords = "Achilles, tendinopathy, tendinitis, outcome, questionnaire, visual analog scales, tendon rupture, scoring scale, pain, injuries, knee, tendinosis, prevention, ultrasound",
author = "Robinson, {J M} and Cook, {J L} and C Purdam and Visentini, {P J} and J Ross and N Maffulli and Taunton, {J E} and Khan, {K M} and {Victorian Inst Sport Tendon Sport}",
year = "2001",
doi = "10.1136/bjsm.35.5.335",
language = "English",
volume = "35",
pages = "335--341",
journal = "British Journal of Sports Medicine",
issn = "0306-3674",
publisher = "BMJ Publishing Group",
number = "5",

}

TY - JOUR

T1 - The VISA-A questionnaire

T2 - a valid and reliable index of the clinical severity of Achilles tendinopathy

AU - Robinson, J M

AU - Cook, J L

AU - Purdam, C

AU - Visentini, P J

AU - Ross, J

AU - Maffulli, N

AU - Taunton, J E

AU - Khan, K M

AU - Victorian Inst Sport Tendon Sport

PY - 2001

Y1 - 2001

N2 - Background-There is no disease specific, reliable, and valid clinical measure of Achilles tendinopathy.Objective-To develop and test a questionnaire based instrument that would serve as an index of severity of Achilles tendinopathy.Methods-Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire to assess the severity of Achilles tendinopathy. The final version consisted of eight questions that measured the domains of pain, function in daily living, and sporting activity. Results range from 0 to 100, where 100 represents the perfect score. Its validity and reliability were then tested in a population of non-surgical patients with Achilles tendinopathy (n = 45), presurgical patients with Achilles tendinopathy (n = 14), and two normal control populations (total n = 87).Results-The VISA-A questionnaire had good test-retest (r = 0.93), intrarater (three tests, r = 0.90), and interrater (r = 0.90) reliability as well as good stability when compared one week apart (r = 0.81). The mean (95% confidence interval) VISA-A score in the non-surgical patients was 64 (59-69), in presurgical patients 44 (28-60), and in control subjects it exceeded 96 (94-99). Thus the VISA-A score was higher in non-surgical than presurgical patients (p = 0.02) and higher in control subjects than in both patient populations (p<0.001).Conclusions-The VISA-A questionnaire is reliable and displayed construct validity when means were compared in patients with a range of severity of Achilles tendinopathy and control subjects. The continuous numerical result of the VISA-A questionnaire has the potential to provide utility in both the clinical setting and research. The test is not designed to be diagnostic. Further studies are needed to determine whether the VISA-A score predicts prognosis.

AB - Background-There is no disease specific, reliable, and valid clinical measure of Achilles tendinopathy.Objective-To develop and test a questionnaire based instrument that would serve as an index of severity of Achilles tendinopathy.Methods-Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire to assess the severity of Achilles tendinopathy. The final version consisted of eight questions that measured the domains of pain, function in daily living, and sporting activity. Results range from 0 to 100, where 100 represents the perfect score. Its validity and reliability were then tested in a population of non-surgical patients with Achilles tendinopathy (n = 45), presurgical patients with Achilles tendinopathy (n = 14), and two normal control populations (total n = 87).Results-The VISA-A questionnaire had good test-retest (r = 0.93), intrarater (three tests, r = 0.90), and interrater (r = 0.90) reliability as well as good stability when compared one week apart (r = 0.81). The mean (95% confidence interval) VISA-A score in the non-surgical patients was 64 (59-69), in presurgical patients 44 (28-60), and in control subjects it exceeded 96 (94-99). Thus the VISA-A score was higher in non-surgical than presurgical patients (p = 0.02) and higher in control subjects than in both patient populations (p<0.001).Conclusions-The VISA-A questionnaire is reliable and displayed construct validity when means were compared in patients with a range of severity of Achilles tendinopathy and control subjects. The continuous numerical result of the VISA-A questionnaire has the potential to provide utility in both the clinical setting and research. The test is not designed to be diagnostic. Further studies are needed to determine whether the VISA-A score predicts prognosis.

KW - Achilles

KW - tendinopathy

KW - tendinitis

KW - outcome

KW - questionnaire

KW - visual analog scales

KW - tendon rupture

KW - scoring scale

KW - pain

KW - injuries

KW - knee

KW - tendinosis

KW - prevention

KW - ultrasound

U2 - 10.1136/bjsm.35.5.335

DO - 10.1136/bjsm.35.5.335

M3 - Article

VL - 35

SP - 335

EP - 341

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 5

ER -