Cross-cultural adaptation and validation of the VISA-P questionnaire for German-speaking patients with patellar tendinopathy

J Orthop Sports Phys Ther. 2011 Mar;41(3):180-90. doi: 10.2519/jospt.2011.3354. Epub 2011 Feb 2.


Study design: Clinical measurement study.

Objectives: To cross-culturally adapt and validate the Victorian Institute of Sports Assessment Patellar Tendinopathy Questionnaire (VISA-P) for German-speaking patients.

Background: Like most questionnaires, the VISA-P was developed for English-speaking patients. There is a need to adapt the scale for German-speaking patients and thereby add to the total body of psychometric evidence relating to this instrument.

Methods: The VISA-P questionnaire was translated and cross-culturally adapted into German (VISA-P-G) in 6 steps: translation, synthesis, back translation, expert committee review, pretesting, and advisory committee appraisal. The psychometric properties of the VISA-P-G were determined using 23 patients with patellar tendinopathy and 57 active healthy persons (32 sport students and 25 basketball players). Reliability was evaluated by applying the questionnaire twice within a week to all 80 participants. Known group validity was calculated using a 1-way analysis of variance. Additionally, VISA-P-G results were correlated with the Blazina classification system for patellar tendinopathy, using the Spearman rank correlation coefficient. VISA-P-G ratings from the present study groups were further compared with respective data published in the original English, Dutch, and Swedish versions by a 2-sample t test. Internal consistency for the individual items of the questionnaire was determined within the patient group using a Cronbach alpha.

Results: Test-retest revealed excellent reliability for the patient and the asymptomatic control group (ICC = 0.88 and 0.87, respectively). Internal consistency for the patients was 0.88. Concurrent validity was almost perfect (ρ = -0.81; P<.001).

Conclusion: The VISA-P-G is a reliable and valid questionnaire for the self-assessment of pain, symptoms, and function in German-speaking patients with patellar tendinopathy. Its psychometric properties are comparable with the original English and international adaptations (Swedish, Dutch, and Italian).

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Analysis of Variance
  • Athletic Injuries / diagnosis*
  • Athletic Injuries / physiopathology
  • Cultural Characteristics
  • Female
  • Germany
  • Humans
  • Language
  • Male
  • Patella / physiopathology*
  • Predictive Value of Tests
  • Psychometrics
  • Reproducibility of Results
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • Tendinopathy / diagnosis*
  • Tendinopathy / physiopathology
  • Translations