title: Assessing participation in the ACL injured population: Selecting a patient reported outcome measure on the basis of measurement properties.
abstract: OBJECTIVE
  A return to pre injury activity participation remains a common but often elusive goal following ACL injury. Investigations to improve our understanding of participation restrictions are limited by inconsistent use of insufficiently investigated measurement tools. The aim of this study was to follow the consensus based standards for the selection of health measurement instruments (COSMIN) guideline to provide a comparative evaluation of four patient reported outcomes (PROMs) on the basis of measurement properties. This will inform recommendations for measuring participation of ACL injured subjects, particularly in the United Kingdom (UK) National Health Service (NHS).
  
  
  METHODS
  Thirteen criteria were compiled from the COSMIN guideline. These included reliability, measurement error, content validity, construct validity, responsiveness and interpretability. Data from 51 subjects collected as part of a longitudinal observational study of recovery over the first year following ACLR was used in the analysis.
  
  
  RESULTS
  Of the thirteen criteria, the required standard was met in 11 for Tegner, 11 for International Knee Documentation Committee (IKDC), 6 for Cincinnati Sports Activity Scale (CSAS) and 6 for Marx. The two weaknesses identified for the Tegner are more easily compensated for during interpretation than those in the IKDC; for this reason the Tegner is the recommended PROM.
  
  
  CONCLUSIONS
  The Tegner activity rating scale performed consistently well in respect of all measurement properties in this sample, with clear benefits over the other PROMs. The measurement properties presented should be used to inform implementation and interpretation of this outcome measure in clinical practice and research.
  
  
  METHODS
  Level II prospective study.
authors: School of Healthcare Sciences, Cardiff University, Second Floor, Cardigan House, Heath Park Campus, Cardiff CF14 4XN, United Kingdom; Aneurin Bevan Health Board, Physiotherapy Department, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, Gwent, United Kingdom. Electronic address: letchfordrh@cardiff.ac.uk.
authors: Robert
authors: R
authors: Letchford
authors: School of Healthcare Sciences, Cardiff University, Second Floor, Cardigan House, Heath Park Campus, Cardiff CF14 4XN, United Kingdom; Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff, United Kingdom.
authors: Valerie
authors: V
authors: Sparkes
authors: School of Healthcare Sciences, Cardiff University, Second Floor, Cardigan House, Heath Park Campus, Cardiff CF14 4XN, United Kingdom; Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff, United Kingdom.
authors: Robert W M
authors: RW
authors: van Deursen
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000175:diagnosis*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008297:Male; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D018579:Patient Selection; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: ACL reconstruction; Activity; Measurement properties; Participation; Patient reported outcome measure