title: Development and validation of a new visa questionnaire (VISA-H) for patients with proximal hamstring tendinopathy.
abstract: BACKGROUND
  There is a need for a patient-reported outcome (PRO) questionnaire to evaluate patients with proximal hamstring tendinopathy (PHT).
  
  
  OBJECTIVE
  To develop a PRO questionnaire based on VISA questionnaire forms for patients with PHT.
  
  
  METHODS
  Item generation, item reduction, item scaling and evaluation of the psychometric properties were used to develop a questionnaire to assess the severity of symptoms, function and ability to play sports in patients with PHT and healthy subjects. The final version, named Victorian Institute of Sport Assessment-Proximal Hamstring Tendons (VISA-H), consisted of eight questions that measured the domains of pain, function and sporting activity. The psychometric properties of a questionnaire were estimated in a population of non-surgical (n=20) and surgical (n=10) patients, as well as in healthy subjects (n=30).
  
  
  RESULTS
  The VISA-H questionnaire displayed a high degree of internal consistency, with a Cronbach α of 0.84. (The test-retest reliability was high for all groups of participants with an intraclass correlation coefficient ranging from 0.90 to 0.95.) The VISA-H exhibited a high correlation with the Nirschl phase rating scale (r ranging from -0.75 to -0.89) and a generic tendon grading system proposed by Curwin and Stanish (r ranging from -0.70 to -0.88). Also, the responsiveness was higher for the VISA-H questionnaire with an area under the curve of 0.90 and a minimum clinically important difference of 22 points.
  
  
  CONCLUSIONS
  The VISA-H is a PRO questionnaire with high psychometric properties for measuring pain, function and sporting activity in patients with PHT.
authors.affiliation: Department of Life, Health and Environmental Sciences, School of Medicine, University of L'Aquila, , L'Aquila, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cacchio
authors.forename: Fosco
authors.initials: F
authors.lastname: De Paulis
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000293:Adolescent; D000328:Adult; D012090:Cumulative Trauma Disorders / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D063868:Patient Outcome Assessment; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013177:Sports / Q000502:physiology*; D011795:Surveys and Questionnaires / Q000592:standards*; D052256:Tendinopathy / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult
keywords: Hamstring injuries