Cross-cultural Adaptation of VISA-P Score for Patellar Tendinopathy in Spanish Population

Study Design: Clinical measurement.

Objectives: To adapt the VISA-P questionnaire into Spanish and to assess its psychometric properties.

Background: Health status questionnaires and scales to report outcomes are increasingly used in medical research and clinical practice. Validated versions of these tools are necessary to avoid bias during use in different languages and cultures.

Methods: We followed international recommendations to perform cross-cultural adaptation. The Spanish VISA-P (VISA-P-Sp) questionnaire and the Short Form (36) Health Survey (SF-36) were administered to 150 individuals: 40 healthy students, 40 professional players in sports requiring jumping, 40 athletes with patellar tendinopathy, and 30 athletes with knee injuries other than patellar tendinopathy. Participants were assessed at baseline and after 1 week. Athletes with tendinopathy also completed questionnaires and other knee measures (the Kujala Scoring Questionnaire and the Cincinnati Knee Rating Scale) after physiotherapy treatment, which consisted of rest, ice, eccentric exercise, electrotherapy, and manual therapy.

Results: The VISA-P-Sp showed high reliability for both temporal stability (intraclass correlation coefficient [ICC] = 0.994; 95% CI: 0.992, 0.996) and internal consistency (Cronbach α = 0.885). Based on a factor analysis, a 2-factor solution explained 76.1% of the variance. The VISA-P-Sp score in the tendinopathy group was significantly correlated with scores on other knee scales (Kujala score [Spearman rho = 0.897; P<.001] and Cincinnati scale [Spearman rho = 0.782, P<.001]) and with SF-36 physical components score (Spearman rho>0.6, P<.001). The standardized size effect was 1.14, and the standardized response mean was 1.17.

Conclusion: The VISA-P-Sp questionnaire proved to be a valid and reliable instrument, sensitive to clinical changes and comparable to the original English-language version.