Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2013

01-06-2013 | Ankle

Cross cultural adaptation of the Achilles tendon Total Rupture Score with reliability, validity and responsiveness evaluation

Authors: Michael R. Carmont, Karin Grävare Silbernagel, Katarina Nilsson-Helander, Omer Mei-Dan, Jon Karlsson, Nicola Maffulli

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2013

Login to get access

Abstract

Purpose

The Achilles tendon Total Rupture Score (ATRS) was developed because of the need for a reliable, valid and sensitive instrument to evaluate symptoms and their effects on physical activity in patients following either conservative or surgical management of an Achilles tendon rupture. Prior to using the score in larger randomized trial in an English-speaking population, we decided to perform reliability, validity and responsiveness evaluations of the English version of the ATRS. Even though the score was published in English, the actual English version has not be validated and compared to the results of the Swedish version.

Methods

From 2009 to 2010, all patients who received treatment for Achilles tendon rupture were followed up using the English version of the ATRS. Patients were asked to complete the score at 3, 6 and 12 months following treatment for Achilles tendon rupture. The ATRS was completed on arrival in the outpatient clinic and again following consultation.

Results

The outcomes of 49 (13 female and 36 male) patients were assessed. The mean (SD) age was 49 (12) years, and 27 patients had treatment for a left-sided rupture, 22 the right. All patients received treatment for ruptured Achilles tendons: 38 acute percutaneous repair, 1 open repair, 5 an Achilles tendon reconstruction using a Peroneus Brevis tendon transfer for delayed presentation, 1 gracilis augmented repair for re-rupture and 4 non-operative treatment for mid-portion rupture. The English version of ATRS was shown to have overall excellent reliability (ICC = 0.986). There was no significant difference between the results with the English version and the Swedish version when compared at the 6-month- or 12-month (n.s.) follow-up appointments. The effect size was 0.93. The minimal detectable change was 6.75 points.

Conclusions

The ATRS was culturally adapted to English and shown to be a reliable, valid and responsive method of testing functional outcome following an Achilles tendon rupture.
Literature
1.
go back to reference Carmont MR, Maffulli N (2008) Modified percutaneous repair of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203PubMedCrossRef Carmont MR, Maffulli N (2008) Modified percutaneous repair of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203PubMedCrossRef
2.
go back to reference Carmont MR, Maffulli N (2007) Less invasive Achilles tendon reconstruction. BMC Musculoskelet Disord 8:100PubMedCrossRef Carmont MR, Maffulli N (2007) Less invasive Achilles tendon reconstruction. BMC Musculoskelet Disord 8:100PubMedCrossRef
3.
go back to reference Cetti R, Christiansen SE, Ejsted R et al (1993) Treatment of Achilles tendon rupture. A prospective randomised study and review of the literature. Am J Sports Med 21:791–799PubMedCrossRef Cetti R, Christiansen SE, Ejsted R et al (1993) Treatment of Achilles tendon rupture. A prospective randomised study and review of the literature. Am J Sports Med 21:791–799PubMedCrossRef
4.
go back to reference Denegar CR, Ball DW (1993) Assessing reliability and precision measurement: an introduction to intraclass correlation and standard error of measurement. J Sport Rehab 2:35–42 Denegar CR, Ball DW (1993) Assessing reliability and precision measurement: an introduction to intraclass correlation and standard error of measurement. J Sport Rehab 2:35–42
5.
6.
go back to reference Kazis LE, Anderson JJ, Meenan RF (1989) Effect sizes for interpreting changes in health status. Med Care 27:S178–S189PubMedCrossRef Kazis LE, Anderson JJ, Meenan RF (1989) Effect sizes for interpreting changes in health status. Med Care 27:S178–S189PubMedCrossRef
7.
go back to reference Kearney RS, Achten J, Lamb SE, Parsons N, Costa ML (2012) The Achilles tendon Total Rupture Score: a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures. Health Qual Life Outcomes 10:24PubMedCrossRef Kearney RS, Achten J, Lamb SE, Parsons N, Costa ML (2012) The Achilles tendon Total Rupture Score: a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures. Health Qual Life Outcomes 10:24PubMedCrossRef
8.
go back to reference Keating JF, Will EM (2011) Operative versus non-operative management of the acute rupture of the tendo Achillis: a prospective randomised evaluation of functional outcome. J Bone Joint Surg Br 8:1071–1078 Keating JF, Will EM (2011) Operative versus non-operative management of the acute rupture of the tendo Achillis: a prospective randomised evaluation of functional outcome. J Bone Joint Surg Br 8:1071–1078
9.
go back to reference Khan RJ, Fick D, Keogh A et al (2005) Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized controlled trials. J Bone Joint Surg Am 87:2202–2210PubMedCrossRef Khan RJ, Fick D, Keogh A et al (2005) Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized controlled trials. J Bone Joint Surg Am 87:2202–2210PubMedCrossRef
10.
go back to reference Kitaoka HB, Alexander IJ, Adelaar RS et al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 15:349–353PubMedCrossRef Kitaoka HB, Alexander IJ, Adelaar RS et al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 15:349–353PubMedCrossRef
11.
12.
go back to reference Leppilahti J, Forsman K, Puranen J et al (1998) Outcome and prognositic factors of Achilles rupture repair using a new scoring method. Clin Orthop Relat Res 346:152–161PubMedCrossRef Leppilahti J, Forsman K, Puranen J et al (1998) Outcome and prognositic factors of Achilles rupture repair using a new scoring method. Clin Orthop Relat Res 346:152–161PubMedCrossRef
13.
go back to reference Maffulli N, Wateston SW, Squair J et al (1999) Changing incidence of Achilles tendon rupture in Scotland: a 15 year study. Clin J Sport Med 9:157–160PubMedCrossRef Maffulli N, Wateston SW, Squair J et al (1999) Changing incidence of Achilles tendon rupture in Scotland: a 15 year study. Clin J Sport Med 9:157–160PubMedCrossRef
14.
go back to reference Merkel M, Neumann HW, Merk H (1996) A new score for comparing outcome of surgical management of Achilles tendon ruptures. Chirug 67:1141–1146CrossRef Merkel M, Neumann HW, Merk H (1996) A new score for comparing outcome of surgical management of Achilles tendon ruptures. Chirug 67:1141–1146CrossRef
15.
go back to reference Moller M, Movin T, Granhed H et al (2001) Acute rupture of the tendon Achillis. A prospective randomised study of comparison between surgical and non surgical treatment. J Bone Joint Surg Br 83:843–848PubMedCrossRef Moller M, Movin T, Granhed H et al (2001) Acute rupture of the tendon Achillis. A prospective randomised study of comparison between surgical and non surgical treatment. J Bone Joint Surg Br 83:843–848PubMedCrossRef
16.
go back to reference Nilsson-Helander K, Thomee R, Silbernagel KG et al (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35:421–426PubMedCrossRef Nilsson-Helander K, Thomee R, Silbernagel KG et al (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35:421–426PubMedCrossRef
17.
go back to reference Nilsson-Helander K, Silbernagel KG, Thomee R et al (2010) Acute Achilles tendon rupture: a randomized controlled study comparing surgical and non surgical treatments using validated outcome measure. Am J Sports Med 38:2186–2193PubMedCrossRef Nilsson-Helander K, Silbernagel KG, Thomee R et al (2010) Acute Achilles tendon rupture: a randomized controlled study comparing surgical and non surgical treatments using validated outcome measure. Am J Sports Med 38:2186–2193PubMedCrossRef
18.
go back to reference Nistor L (1981) Surgical and non-surgical treatment of Achilles tendon rupture. A prospective randomised study. J Bone Joint Surg Am 63:394–399PubMed Nistor L (1981) Surgical and non-surgical treatment of Achilles tendon rupture. A prospective randomised study. J Bone Joint Surg Am 63:394–399PubMed
19.
go back to reference Olsson N, Nilsson-Helander K, Karlsson J et al (2011) Major functional deficits persist 2 years after acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 19(8):1385–1393PubMedCrossRef Olsson N, Nilsson-Helander K, Karlsson J et al (2011) Major functional deficits persist 2 years after acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 19(8):1385–1393PubMedCrossRef
20.
go back to reference Rohner-Spengler M, Mannion AF, Babst R (2007) Reliability and minimal detectable change for the figure-of-eight-20 method of, measurement of ankle edema. J Orthop Sports Phys Ther 37:199–205PubMed Rohner-Spengler M, Mannion AF, Babst R (2007) Reliability and minimal detectable change for the figure-of-eight-20 method of, measurement of ankle edema. J Orthop Sports Phys Ther 37:199–205PubMed
21.
go back to reference Silbernagel KG, Nilsson-Helander K, Thomee R et al (2010) A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 18:258–264PubMedCrossRef Silbernagel KG, Nilsson-Helander K, Thomee R et al (2010) A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 18:258–264PubMedCrossRef
22.
go back to reference Thermann H (1996) Die funktionelle Behandlung der frischen Achillessehnen ruptur. Springer, BerlinCrossRef Thermann H (1996) Die funktionelle Behandlung der frischen Achillessehnen ruptur. Springer, BerlinCrossRef
23.
go back to reference Wallace RG, Heyes GJ, Michael AL (2011) The non-operative functional management of patients with a rupture of the tendo Achillis leads to low rates of re-rupture. J Bone Joint Surg Br 93(10):1362–1366PubMed Wallace RG, Heyes GJ, Michael AL (2011) The non-operative functional management of patients with a rupture of the tendo Achillis leads to low rates of re-rupture. J Bone Joint Surg Br 93(10):1362–1366PubMed
24.
go back to reference Willits K, Amendola A, Bryant D et al (2010) Operative versus non-operative treatment of acute Achilles tendon ruptures: a multicenter randomized trail using accelerated functional rehabilitation. J Bone Joint Surg Am 92:767–775CrossRef Willits K, Amendola A, Bryant D et al (2010) Operative versus non-operative treatment of acute Achilles tendon ruptures: a multicenter randomized trail using accelerated functional rehabilitation. J Bone Joint Surg Am 92:767–775CrossRef
Metadata
Title
Cross cultural adaptation of the Achilles tendon Total Rupture Score with reliability, validity and responsiveness evaluation
Authors
Michael R. Carmont
Karin Grävare Silbernagel
Katarina Nilsson-Helander
Omer Mei-Dan
Jon Karlsson
Nicola Maffulli
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2146-8

Other articles of this Issue 6/2013

Knee Surgery, Sports Traumatology, Arthroscopy 6/2013 Go to the issue