title: The Accuracy of the VISA-P Questionnaire, Single-Leg Decline Squat, and Tendon Pain History to Identify Patellar Tendon Abnormalities in Adult Athletes.
abstract: Study Design Cross-sectional clinical assessment. Background Patellar tendinopathy is not always accompanied by patellar tendon abnormalities (PTAs). Thus, clinical screening tools to help identify patients with patellar tendon pain who have PTAs could enhance clinical decision making and patient prognosis. Objectives To test the diagnostic accuracy of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire, a single-leg decline squat (SLDS), tendon pain history, age, and years of sports participation to identify athletes with symptomatic patellar tendons who have PTAs confirmed on imaging. Methods Data provided by ultrasound examination, the VISA-P questionnaire, the SLDS, tendon pain history, age, and years of sport participation were collected in 43 athletes. A classification and regression tree (CART) model was developed to verify variables associated with PTA occurrence. Likelihood ratios (LRs) were computed for positive and negative tests. Results The SLDS, VISA-P questionnaire, and tendon pain history were associated with PTA occurrence. Athletes with negative results on all 3 tests (CART model) had a lower likelihood of having PTAs (negative LR = 0.3; 95% confidence interval [CI]: 0.2, 0.5). The isolated use of the SLDS or tendon pain history (positive LR = 4.2; 95% CI: 2.3, 7.14 and 4.5; 95% CI: 1.8, 11.1, respectively) had similar influence on probability of PTA presence compared to the CART model (positive LR = 4.1; 95% CI: 2.5, 6.3). Conclusion Although the objective was to investigate a clinical test to identify PTAs, the combined use of the tests had greater accuracy to identify individuals without PTAs. Level of Evidence Diagnosis, level 3b. J Orthop Sports Phys Ther 2016;46(8):673-680. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6192.
authors.forename: Luciana de Michelis
authors.initials: Lde M
authors.lastname: Mendonça
authors.forename: Juliana Melo
authors.initials: JM
authors.lastname: Ocarino
authors.forename: Natália Franco Netto
authors.initials: NF
authors.lastname: Bittencourt
authors.forename: Ludmila Maria Oliveira
authors.initials: LM
authors.lastname: Fernandes
authors.forename: Evert
authors.initials: E
authors.lastname: Verhagen
authors.forename: Sérgio Teixeira
authors.initials: ST
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D000367:Age Factors; D018771:Arthralgia / Q000209:etiology*; D056352:Athletes; D001696:Biomechanical Phenomena; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D017847:Patellar Ligament / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000175:diagnosis / Q000209:etiology*; D013710:Tendons / Q000002:abnormalities* / Q000503:physiopathology; D013997:Time Factors; D014463:Ultrasonography
keywords: sensitivity; specificity; tendinopathy; ultrasound imaging