Translation and cross-cultural adaptation to Spanish of the Anterior Cruciate Ligament Return to Sport after Injury Scale (SP ACL‑RSI): Measurement properties and responsiveness in a multisport sample

Rafel Donat-Roca; Violeida Sánchez-Socarrás; José M Romero-Sánchez; Salomé Tárrega; Tània Estapé-Madinabeitia; Carles Escalona-Marfil; Roberto Seijas; Georgia Romero-Cullerés; Carolina Ochoa; Kate E Webster

doi:10.1002/jeo2.70046

Translation and cross-cultural adaptation to Spanish of the Anterior Cruciate Ligament Return to Sport after Injury Scale (SP ACL‑RSI): Measurement properties and responsiveness in a multisport sample

J Exp Orthop. 2024 Nov 26;11(4):e70046. doi: 10.1002/jeo2.70046. eCollection 2024 Oct.

Affiliations

¹ Sport, Exercise and Human Movement (SEaHM) University of Vic-Central University of Catalonia Manresa Spain.
² Faculty of Healthcare Sciences of Manresa University of Vic-Central University of Catalonia Manresa Spain.
³ Nursing and Physiotherapy Department, Faculty of Nursing and Physiotherapy University of Cádiz Cádiz Spain.
⁴ Research Group in Epidemiology and Public Health in the Digital Health Context (Epi4health) University of Vic-Central University of Catalonia Manresa Spain.
⁵ Instituto Cugat, Hospital Quirón Barcelona Spain.
⁶ Physical Medicine and Rehabilitation Department Althaia Xarxa Assistencial Universitària de Manresa Barcelona Spain.
⁷ Hospital Santa Caterina, Salt Girona Spain.
⁸ School of Allied Health, Human Services and Sport La Trobe University Melbourne Victoria Australia.

Abstract

Purpose: The aim was to translate and adapt The Anterior Cruciate Ligament Return to Sport after Injury Scale (ACL-RSI) to Spanish and provide evidence of its psychometric properties and responsiveness in a both sexes multisport sample.

Methods: ACL-RSI Spanish version (SP ACL-RSI) was obtained by forward-back-translation method. Internal consistency, test-retest reliability, construct validity and responsiveness were assessed. Standardized response mean (SRM), smallest detectable change (SDC) and minimally important change (MIC) were obtained by anchor-based method. The sample consisted of n = 132 multisport patients who underwent ACL-RSI. Sixty-seven patients (Group A) completed test-retest of the SP ACL-RSI within 15 days and 65 patients (Group B) fulfilled SP ACL-RSI, the Tampa Scale of Kinesiophobia (TSK-11), the International Knee Documentation Committee-Subjective Knee Form (IKDC-SF 2000), the Knee Osteoarthritis Outcome Score (KOOS) preoperative, 6 and 12 months.

Results: The SP ACL-RSI shows satisfactory internal consistency (Cronbach's α = 0.95) and test-retest reliability (ICC = 0.92), with acceptable floor (9%) and ceiling (6%) effects. Convergent validity was supported with moderate positive correlations with KOOS and IKDC-SF 2000 dimensions, and a negative correlation with the TSK (p < 0.001). For SDC responsiveness, a high effect was observed with SRM = 0.97 at 12 months, and the MIC for SP ACL-RSI was 15.

Conclusions: The SP ACL-RSI is as valid and reliable as the original for measuring emotions, confidence in performance, and re-injury risk on return to sport after ACL-R in Spanish-speaking multisport practitioners of both sexes. Moreover, it shows acceptable responsiveness, performing better at the group level than the individual level.

Level of evidence: A cohort study (diagnosis); Level II of evidence.

Keywords: Spanish ACL‐RSI; anterior cruciate ligament; rehabilitation; responsiveness; return to sport; validation.