Cross-cultural Adaptation and Measurement Properties of the Brazilian Portuguese Version of the Victorian Institute of Sport Assessment-Achilles (VISA-A) Questionnaire

BACKGROUND: Achilles tendon disorders are very common among athletes. It is important to measure symptoms and functional limitations objectively related to Achilles tendinopathy using outcome measures that have been validated in the language of the target population. OBJECTIVES: To perform a cross-cultural adaptation and to evaluate the measurement properties of the Brazilian version of the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire. METHODS: This clinical measurement study adapted the VISA-A questionnaire to Brazilian Portuguese (VISA-A-Br). The adapted questionnaire was then tested on 2 occasions within an interval of 5 to 14 days. This study evaluated the following measurement properties: internal consistency, test-retest reliability, measurement error, construct validity, and ceiling and floor effects. RESULTS: The VISA-A-Br showed good internal consistency (Cronbach a =.79; after excluding 1 item at a time, Cronbach a =.73-. 84), good test-retest reliability (intraclass correlation coefficient model 2,1 = 0.84; 95% confidence interval: 0.71, 0.91), an acceptable measurement error (standard error of measurement, 3.25 points; smallest detectable change, 9.02 points), good construct validity (Spearman correlation coefficients for the Lower Extremity Functional Scale, 0.73; the Foot and Ankle Outcome Score pain subscale, 0.66; other symptoms subscale, 0.48; function in daily living subscale, 0.59; function in sport and recreation subscale, 0.67; and foot and ankle-related quality of life subscale, 0.70), and no ceiling and floor effects. CONCLUSION: The clinical measurement properties of the VISA-A-Br are equivalent to those of the original version, and the instrument has been validated and confirmed as reliable to measure pain and function among the Brazilian population with Achilles tendinopathy. This adaptation of the questionnaire may be used in clinical and scientific settings.