title: The chinese version of achilles tendon total rupture score: cross-cultural adaptation, reliability and validity.
abstract: BACKGROUND
  The Achilles tendon Total Rupture Score (ATRS), which is originally developed in 2007 in Swedish, is the only patient-reported outcome measure (PROM) for specific outcome assessment of an Achilles tendon rupture.Purpose of this study is to translate and cross-culturally adapt Achilles tendon Total Rupture Score (ATRS) into simplified Chinese, and primarily evaluate the responsiveness, reliability and validity.
  
  
  METHODS
  International recognized guideline which was designed by Beaton was followed to make the translation of ATRS from English into simplified Chinese version (CH-ATRS). A prospective cohort study was carried out for the cross-cultural adaptation. There were 112 participants included into the study. Psychometric properties including floor and ceiling effects, Cronbach's alpha, intraclass correlation coefficient, effect size, standard response mean, and construct validity were tested.
  
  
  RESULTS
  The mean scores of CH-ATRS are 57.42 ± 13.70. No sign of floor or ceiling effect was found of CH-ATRS. High level of internal consistency was supported by the value of Cronbach's alpha (0.893). ICC (0.979, 95%CI: 0.984-0.993) was high to indicate the high test-retest reliability. Great responsive ness was proved with the high absolute value of ES and SRM (0.84 and 8.98, respectively). The total CH-ATRS score had very good correlation with physical function and body pain subscales of SF-36 (r = -0.758 and r = -0.694, respectively, p < 0.001), while poor correlation with vitality and role physical subscales of SF-36 (r = -0.033 and r = -0.025, respectively, p ≥ 0.05), which supported construct validity of CH-ATRS.
  
  
  CONCLUSIONS
  This Chinese version of Achilles tendon Total Rupture Score (CH-ATRS) can be used as a reliable and valid instrument for Achilles tendon rupture assessing in Chinese-speaking population. Level of evidence II.
authors.affiliation: Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Jin
authors.initials: J
authors.lastname: Cui
authors.affiliation: Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Jia
authors.affiliation: Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhi
authors.affiliation: Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Xiaoqun
authors.initials: X
authors.lastname: Li
authors.affiliation: Graduate Management Unit, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhai
authors.affiliation: Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Liehu
authors.initials: L
authors.lastname: Cao
authors.affiliation: Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Weizong
authors.initials: W
authors.lastname: Weng
authors.affiliation: Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China. sirchenxiao@126.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Changhai hospital affiliated to the Second Military Medical University, Shanghai, People's Republic of China. drsuiacan@163.com.
authors.forename: Jiacan
authors.initials: J
authors.lastname: Su
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D003431:Cross-Cultural Comparison; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013708:Tendon Injuries / Q000523:psychology*; D014177:Translations
keywords: ATRS; Achilles tendon rupture; Chinese; Cross-cultural; Reliability; Validity