title: Cross-cultural adaptation and validation of Persian Achilles tendon Total Rupture Score.
abstract: OBJECTIVE
  To cross-culturally adapt the Achilles tendon Total Rupture Score (ATRS) to Persian language and to preliminary evaluate the reliability and validity of a Persian ATRS.
  
  
  METHODS
  A cross-sectional and prospective cohort study was conducted to translate and cross-culturally adapt the ATRS to Persian language (ATRS-Persian) following steps described in guidelines. Thirty patients with total Achilles tendon rupture and 30 healthy subjects participated in this study. Psychometric properties of floor/ceiling effects (responsiveness), internal consistency reliability, test-retest reliability, standard error of measurement (SEM), smallest detectable change (SDC), construct validity, and discriminant validity were tested. Factor analysis was performed to determine the ATRS-Persian structure.
  
  
  RESULTS
  There were no floor or ceiling effects that indicate the content and responsiveness of ATRS-Persian. Internal consistency was high (Cronbach's α 0.95). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.58-0.95). The test-retest reliability was excellent [(ICC)agreement 0.98]. SEM and SDC were 3.57 and 9.9, respectively. Construct validity was supported by a significant correlation between the ATRS-Persian total score and the Persian Foot and Ankle Outcome Score (PFAOS) total score and PFAOS subscales (r = 0.55-0.83). The ATRS-Persian significantly discriminated between patients and healthy subjects. Explanatory factor analysis revealed 1 component.
  
  
  CONCLUSIONS
  The ATRS was cross-culturally adapted to Persian and demonstrated to be a reliable and valid instrument to measure functional outcomes in Persian patients with Achilles tendon rupture.
  
  
  METHODS
  II.
authors.affiliation: Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran. nakhostin@sina.tums.ac.ir.
authors.forename: Noureddin Nakhostin
authors.initials: NN
authors.lastname: Ansari
authors.affiliation: Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran.
authors.forename: Soofia
authors.initials: S
authors.lastname: Naghdi
authors.affiliation: Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran.
authors.forename: Sahar
authors.initials: S
authors.lastname: Hasanvand
authors.affiliation: Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Ave, Pitch-e-shemiran, Tehran, 11489, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Fakhari
authors.affiliation: Sports Medicine Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Kordi
authors.affiliation: Department of Orthopaedic, Sahlgrenska Academy, Gothenburg University, Kungsbacka Hospital Tölövägen 5, 434 40, Kungsbacka, Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Nilsson-Helander
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003469:Culture; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007492:Iran; D007802:Language; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012421:Rupture; D014177:Translations; D055815:Young Adult
keywords: ATRS; Achilles tendon rupture; Cross-cultural; Persian; Reliability; Validity