Translation, Validity, and Reliability of the Indonesian Version of the Anterior Cruciate Ligament-Return to Sport After Injury Scale

Romy Deviandri; Hugo C van der Veen; Andri M T Lubis; Maarten J Postma; Inge van den Akker-Scheek

doi:10.1177/23259671231157769

Translation, Validity, and Reliability of the Indonesian Version of the Anterior Cruciate Ligament-Return to Sport After Injury Scale

Orthop J Sports Med. 2023 May 3;11(5):23259671231157769. doi: 10.1177/23259671231157769. eCollection 2023 May.

Authors

Romy Deviandri^{1

2

3}, Hugo C van der Veen¹, Andri M T Lubis⁴, Maarten J Postma^{5

6

7

8}, Inge van den Akker-Scheek¹

Affiliations

¹ Department of Orthopedics Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
² Department of Physiology, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia.
³ Division of Orthopedics-Sports Injury, Arifin Achmad Hospital, Pekanbaru, Indonesia.
⁴ Department of Orthopedics, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
⁵ Department of Health Sciences, University of Groningen, University Medical Center Groningen, the Netherlands.
⁶ Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Groningen, the Netherlands.
⁷ Department of Pharmacology and Therapy, Universitas Airlangga, Surabaya, Indonesia.
⁸ Investigation performed at the Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Abstract

Background: The Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale measures athletes' emotion, confidence, and risk appraisal when returning to sports after an anterior cruciate ligament (ACL) injury and/or ACL reconstruction (ACLR).

Purpose: To translate the ACL-RSI into the Indonesian language and to assess its validity and reliability in Indonesian-speaking patients after ACLR.

Study design: Cohort study (diagnosis); Level of evidence, 2.

Methods: After a forward-and-backward translation procedure, the validity and reliability of the Indonesian version of the ACL-RSI (I-ACL-RSI) were investigated. Patients who had undergone ACLR at a single hospital were asked to complete 4 questionnaires: I-ACL-RSI, Injury-Psychological Readiness to Return to Sport, Tampa Scale of Kinesiophobia, and International Knee Documentation Committee. After a 2-week interval, patients were asked to complete the I-ACL-RSI a second time. Following the COSMIN reporting guidelines (Consensus-Based Standards for the Selection of Health Measurement Instruments), we determined construct validity using hypothesis testing, as well as test-retest reliability, internal consistency, floor and ceiling effects, and measurement error.

Results: Of 200 eligible patients, 102 (51%) were included in the analysis. All predefined hypotheses on correlations between the I-ACL-RSI and the other questionnaires were confirmed, indicating good construct validity. An intraclass correlation coefficient of 0.90 (2-way random, type agreement) was found for the first and second I-ACL-RSI scores, indicating good test-retest reliability. A Cronbach α of 0.95 indicated good internal consistency, and no floor or ceiling effects were found. The standard error of measurement was 3.9, with the minimal detectable change calculated as 10.9 points at the individual level and 1.1 points at the group level.

Conclusion: Based on the study findings, the I-ACL-RSI can be considered a valid and reliable questionnaire for Indonesian-speaking patients after ACL injury and/or ACLR.

Keywords: ACL injuries; ACL-RSI; Indonesian translation; PROM; questionnaire.