Arp Kamilla, Varnum Claus, Dalgas Ulrik, Knudsen Bettina Mølri, Timm Signe, Viberg Bjarke, Ingwersen Kim Gordon
Department of Orthopedic Surgery, Lillebaelt Hospital - University Hospital of Southern Denmark,, Beriderbakken 4, Vejle, 7100, Denmark.
Department of Regional Health Research, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark.
BMC Musculoskelet Disord. 2025 Jan 13;26(1):42. doi: 10.1186/s12891-024-08000-0.
The Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS) is a patient-reported outcome measure (PROM) developed to assess symptoms and functional limitations in patients with various knee disorders. The aim of this study was to translate and culturally adapt the KOS-ADLS to Danish and to evaluate the psychometric properties of the Danish version (KOS-ADLS-DK) in patients with anterior cruciate ligament (ACL) injury.
The KOS-ADLS was translated and culturally adapted to Danish in accordance with recommended guidelines. To evaluate psychometric properties in a test-retest design 115 Danish patients with ACL injury completed KOS-ADLS-DK and other knee specific PROMs at baseline and after 14 days. A sub-population of 79 patients completed the KOS-ADLS-DK before and after 3 months of rehabilitation. Structural validity (factor analysis), Internal consistency (Cronbach`s alpha), construct validity (hypothesis testing), test-retest reliability (Intraclass Correlation Coefficient [ICC]), test-retest agreement (Bland-Altman plots with 95% Limits of Agreement), Standard Error of Measurement (SEM), Smallest Detectable Chance (SDC), responsiveness (construct approach with hypothesis testing) and floor/ceiling effects were assessed.
No major problems were revealed in the cross-cultural adaptation process. The KOS-ADLS-DK was uni-dimensional and showed a high internal consistency (Chronbach's alpha = 0.90). Construct validity was not perfect as only five of seven hypotheses were confirmed, but there was a good reliability (ICC = 0.88) and test-retest agreement showed equal distribution of measurement error across the scale and the SEM was 4.9% and SDC was 13.6%. However, hypotheses testing on change scores revealed the KOS-ADLS-DK to be responsive and there were no floor/ceiling effects.
Overall, the Danish version of KOS-ADLS is considered a valid, reliable and responsive PROM for assessing symptoms and functional limitations in patients with ACL injury but may show some limitations in its construct validity.
膝关节功能评定量表 - 日常生活活动量表（KOS - ADLS）是一种患者报告的结局指标（PROM），旨在评估各种膝关节疾病患者的症状和功能受限情况。本研究的目的是将KOS - ADLS翻译成丹麦语并进行文化调适，并评估丹麦语版（KOS - ADLS - DK）在前交叉韧带（ACL）损伤患者中的心理测量学特性。
按照推荐指南将KOS - ADLS翻译成丹麦语并进行文化调适。为了在重测设计中评估心理测量学特性，115名丹麦ACL损伤患者在基线和14天后完成了KOS - ADLS - DK及其他膝关节特定的PROM。79名患者的亚组在康复3个月前后完成了KOS - ADLS - DK。评估了结构效度（因子分析）、内部一致性（克朗巴哈α系数）、构想效度（假设检验）、重测信度（组内相关系数[ICC]）、重测一致性（具有95%一致性界限的布兰德 - 奥特曼图）、测量标准误（SEM）、最小可检测变化（SDC）、反应度（采用假设检验的构想方法）以及地板/天花板效应。
在跨文化调适过程中未发现重大问题。KOS - ADLS - DK是单维度的，显示出较高的内部一致性（克朗巴哈α系数 = 0.90）。构想效度并不完美，因为七个假设中仅证实了五个，但具有良好的信度（ICC = 0.88），重测一致性表明测量误差在量表上分布均匀，SEM为4.9%，SDC为13.6%。然而，对变化分数的假设检验表明KOS - ADLS - DK具有反应度，且不存在地板/天花板效应。
总体而言，丹麦语版的KOS - ADLS被认为是评估ACL损伤患者症状和功能受限的有效、可靠且具有反应度的PROM，但在构想效度方面可能存在一些局限性。
