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. 2022 Sep 15;10(9):23259671221123297.
doi: 10.1177/23259671221123297. eCollection 2022 Sep.

Translation, Validity, and Reliability of the Dutch Anterior Cruciate Ligament-Quality of Life Questionnaire

Astrid J de Vries  1 , Reinoud W Brouwer  1 , Rianne Huis In T' Veld  2 , Wybren A van der Wal  3 , Inge H F Reininga  4 , Roy A G Hoogeslag  2
Affiliations

Translation, Validity, and Reliability of the Dutch Anterior Cruciate Ligament-Quality of Life Questionnaire

Astrid J de Vries et al. Orthop J Sports Med. .

Abstract

Background: The Anterior Cruciate Ligament-Quality of Life (ACL-QoL) questionnaire is a valid and reliable injury-specific instrument to assess the impact of an ACL rupture on the daily life of a patient.

Purpose: To translate the ACL-QoL into Dutch (ACL-QoL-NL) and to study its psychometric properties in patients with an ACL rupture.

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

Methods: The original ACL-QoL questionnaire was translated from English to Dutch according to international guidelines. The study population consisted of 122 patients with a confirmed ACL rupture who completed the ACL-QoL-NL as well as 4 questionnaires: the International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score, 36-item Short Form Health Survey, and Lysholm Knee Score. We determined the internal consistency, construct validity, and prevalence of floor and ceiling effects of the ACL-QoL-NL total score as well as its 5 subscales. To determine test-retest reliability, we analyzed the data of 68 patients who had a stable knee condition and who completed the ACL-QoL-NL a second time after a 2-week interval.

Results: The confirmatory factor analysis showed that the original structure of the ACL-QoL-NL was confirmed, except for 4 of 31 items. Internal consistency of the total scale and all 5 subscales was good. More than 75% of the predefined hypotheses on the correlations between the ACL-QoL-NL and the 4 questionnaires were met, indicating good construct validity. No significant floor or ceiling effects were observed. Test-retest reliability was good, and no systematic bias between test and retest was found. Standard error of measurement for the total score was 4.8 points out of 100, and the smallest detectable changes at the group and individual levels were 1.6 and 13.2 points, respectively.

Conclusion: The ACL-QoL-NL questionnaire was successfully translated from English to Dutch and demonstrated good internal consistency, validity, and reliability, with no presence of floor or ceiling effects.

Keywords: Dutch; anterior cruciate ligament; quality of life; questionnaire; reliability; validity.

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Conflict of interest statement

The authors declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart of inclusion of participants. ACL-QOL-NL, Anterior Cruciate Ligament–Quality of Life, Dutch version; GRC, global rating of change.
Figure 2.
Figure 2.
Bland-Altman graphs show the mean difference (95% CI) between the first and second ACL-QoL-NL test administrations. When zero lies within the 95% CI of the mean difference, the criterion for absolute agreement is met, and when zero lies outside the 95% CI, it means that there is a measurement bias. The 95% limit of agreement (LOA) is also shown. (A) Total score and (B-F) subscales: Physical Complaints, Work-Related Concerns, Recreational Activities and Sports, Lifestyle, and Social and Emotional Concerns. ACL-QoL-NL, Anterior Cruciate Ligament–Quality of Life, Dutch version.
See this image and copyright information in PMC

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