Measuring individual hierarchy of anxiety invoking sports related activities: development and validation of the Photographic Series of Sports Activities for Anterior Cruciate Ligament Reconstruction (PHOSA-ACLR).

BACKGROUND: Fear of harm (FoH) after Anterior Cruciate Ligament Reconstruction (ACLR) should be addressed in physical therapy as it hampers return to sports. However, there are no instruments assessing FoH specific for ACLR. The objective of this study is to describe the development and measurement properties of the Photograph Series of Sports Activities for ACLR (PHOSA-ACLR) measuring ACL injury related FoH. METHODS: Based on literature and opinion of physical therapists with extensive experience in ACLR treatment, photographs depicting FoH inducing situations in ACL injury were considered for inclusion in the instrument. For each photograph the patients is asked to report perceived harmfulness. The set of photographs was completed by two samples of patients with ACLR: 1 cross-sectional sample (n = 55), and 1 test-retest reliability sample (n = 58). Internal consistency and structural validity were assessed in 109 patients. In 58 patients criterion validity was assessed by calculating pearson correlations with the Tampa Scale of Kinesiophobia (TSK). Correlations with self-reported knee function (KOOS and Lysholm score), and Knee Self-efficacy Scale (K-SES) were computed for hypothesis testing. Test-retest reliability was determined in a group of 55 patients, assessed twice with 1 week between assessments. RESULTS: Twelve photographs depicting sports related movements that are likely to invoke FoH after ACLR were selected. Two items were deleted because of lack of discrimination. The remaining 10 items were included in the PHOSA-ACLR, and the scale showed excellent internal consistency (Cronbach's Alpha is .95). Items reflected one dimension, and was strongly correlated with TSK (r = .59). A priori formulated hypotheses are confirmed and test-retest correlation was excellent (ICC = .86). CONCLUSION: The PHOSA-ACLR showed acceptable measurement properties. The PHOSA-ACLR gives specific information about fear invoking sports situations that are not measured by other kinesophobia measures. Therefore, the PHOSA-ACLR might be a valuable additional tool in rehabilitation of ACLR patients. Additional research is needed to determine responsiveness to change.

A comparison of telephone interview versus on-site completion of Lysholm knee score in patients who underwent arthroscopic ACL reconstruction: are the results equivalent?

INTRODUCTION: The purpose of this study was to compare two different modes of administration (telephone versus face to face) for Lysholm knee score (LKS) to test their multi-mode equivalence and reliability. MATERIALS AND METHODS: Two LKSs were obtained in 100 patients who underwent ACL reconstruction surgery. First LKS was completed through telephone interview, and second LKS, which was at least 2 weeks later, was completed face-to-face interview at the hospital. To analyze the test-retest reliability, the relative level of agreement between the two modes of administration for LKS was calculated using interclass correlation coefficient (ICC) in 95 % confidence interval. RESULTS: The mean LKS was 93.01 ± 9.12 (range 59-100) at telephone interview and 93.56 ± 7.93 (range 59-100) at face-to-face interview (p = 0.130). Both the total point and the each item's point were statistically similar (p < 0.05 for each item). The total score was same in 66 (66 %) subjects. The mean difference between two scoring was only 1.83 ± 3.14 points (range 0-15). However, eight (8 %) patients were assigned to different grading groups (excellent, good, fair, and poor). The overall LKS and the each item of the LKS had acceptable test-retest reliability [ICC = 0.954 (95 % CI 0.931-0.969)]. CONCLUSIONS: LKS can be reliably completed through telephone interview, which would provide accurate data similar to face-to-face interview. Researchers can design studies using telephone interview as a mode of administration for LKS or use mix-mode designs.