Abstract
Introduction:
The Lysholm knee score and Tegner activity scale are frequently used patient-reported outcome measures (PROMs) in patients with anterior cruciate ligament (ACL) injury because of their excellent psychometric properties.
Objectives:
To assess the validity, reliability, and responsiveness of the Indonesian version of Lysholm and Tegner scales for use in the Indonesian-speaking ACL population.
Material & Methods:
After a forward-and-backward translation procedure and cross-cultural adaptation, validity, reliability, and responsiveness were investigated. The responses of 106 ACL injury patients on four questionnaires – Indonesian Lysholm knee score (I-LK), Indonesian Tegner scale (I-TS), Short Form–36, and Kujala scores – were used. Following COSMIN guidelines, construct validity, test-retest reliability, internal consistency, floor and ceiling effects, measurement error, and responsiveness were determined. The Bland and Altman method was used to explore absolute agreement.
Results:
Construct validity is good, as more than 75% of the predefined hypotheses on correlations between I-LK, I-TS and other scores were confirmed. Reliability proved excellent, with a high test-retest correlation for both questionnaires (ICC = 0.99). Bland and Altman analyses showed no systematic bias between test and retest. Internal consistency of I-LK was good (Cronbach alpha = .73). For I-LK and I-TS, respectively, floor and ceiling effects were less than 15% (floor 0%, 4.7%; ceiling 12.3%, 3.8%); standard error of measurement (SEM) 1.8 and 0.9; minimal detectable change at the individual level (MDCind) 5.1 and 0.6, and at the group level (MDCgrp) 2.4 and 0.5. Responsiveness was considered good, especially at the group level.
Conclusion:
The I-LK and I-TS appears to be a good evaluation instrument for Indonesian patients with anterior cruciate ligament injuries.