The French Ankle Ligament Reconstruction - Return to Sport after Injury (ALR-RSI-Fr) is a valid scale for the French population

Nahi Ajaka; Pierre-Alban Bouché; Michel Dagher; Ronny Lopes; Thomas Bauer; Alexandre Hardy

doi:10.1186/s40634-022-00463-1

The French Ankle Ligament Reconstruction - Return to Sport after Injury (ALR-RSI-Fr) is a valid scale for the French population

J Exp Orthop. 2022 Mar 21;9(1):27. doi: 10.1186/s40634-022-00463-1.

Authors

Nahi Ajaka¹, Pierre-Alban Bouché², Michel Dagher³, Ronny Lopes⁴, Thomas Bauer⁵, Alexandre Hardy⁶

Affiliations

¹ Service de chirurgie orthopédique et traumatologique, Hôpital Ambroise Pare, Paris, France. nahi.ajaka@gmail.com.
² Service de chirurgie orthopédique et traumatologique, Hôpital Lariboisière, Paris, France.
³ Service de chirurgie orthopédique et traumatologique, Hôpital Henri-Mondor, Paris, France.
⁴ Service de chirurgie orthopédique et traumatologique, Polyclinique de l'Atlantique, Nantes, France.
⁵ Service de chirurgie orthopédique et traumatologique, Hôpital Ambroise Pare, Paris, France.
⁶ Clinique du Sport, 36 boulevard Saint-Marcel, 75005, Paris, France.

Abstract

Purpose: The aim of this study was to translate, adapt and validate in French the Ankle Ligament Reconstruction - Return to Sport after Injury (ALR-RSI), a 12-item English language scale assessing the psychological impact of returning to sports after ACL reconstruction. Our hypothesis was that the French version of the ALR-RSI scale would be valid and adaptable to the French population.

Methods: The procedure followed the guidelines for the intercultural adaptation of the self-administered questionnaires. A version of the ALR-RSI-Fr questionnaire was validated according to the international guidelines of COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments). A prospective study was conducted between March 2020 and June 2021. The study included two population groups, the first one being that of adult athletes of all levels who underwent arthroscopic ankle ligament reconstruction and the second being that of adult athletes who did not suffer from any ankle problems. After consent, patients completed three questionnaires, the ALR-RSI-Fr, the AOFAS and the Karlsson score.

Results: The study included 30 patients and 30 controls who were all athletes. The mean age of the patients was 34.6 with 60% male and 40% female. The average time for patients to return to sport was 5.6 months. Twenty-nine patients (96.6%) underwent arthroscopic ankle reconstruction while only one was eligible for ligament reinsertion. The control group with demographic data matched to the patient group was included in this study. Correlations between ALRSI, the total Karlsson score and its different sub items and the AOFAS were estimated using Spearman coefficients. Discriminant validity was tested between the "patient" and "control" groups and sub-groups using the Wilcoxon tests. Reliability was evaluated on the ρ intraclass correlation coefficient (ICCC). A strong correlation was noted between the ALR-RSI-Fr , Karlsson and AOFAS with a Spearman score of 0.90 [0.76-0.96].A highly significant difference was found between the "patient" and "control" groups. The internal consistency of the questionnaire was excellent with a Cronbach's alfa of 0.94. Reproducibility was "excellent" with an interclass correlation coefficient of q = 0.97 [0.94-0.99].

Conclusion: This study showed that the cross-cultural adaptation of the English version of the ALR-RSI was successful and validated for the French-speaking population. The discriminant capacity of the scale between patients who underwent reconstruction and healthy subjects was also confirmed. This questionnaire will allow surgeons to better evaluate the psychological impact of returning to sports after ankle ligament reconstruction in French speaking patients LEVEL OF EVIDENCE: LEVEL II: Prospective cohort study (patients enrolled at different points in their disease) Control arm of randomized trial.