Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics1649410.17816/2311-2905-16494CLINICAL STUDIESКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯClinical studiesResearch ArticleCross-Cultural Adaptation and Validation of the Russian-Language Version of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS)Кросс-культурная адаптация и валидация русскоязычной версии шкалы Американской ассоциации хирургов стопы и голеностопного сустава AOFAS-AHShttps://orcid.org/0000-0002-0864-0171FomichevViktor A.ФомичевВкитор Андреевич
Russian Federation
fomichef@mail.ruhttps://orcid.org/0000-0002-9948-9015SorokinEvgenii P.СорокинЕвгений Петрович
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук

Sorokinortoped@gmail.comhttps://orcid.org/0000-0002-2762-816XKonovalchukNikita S.КоновальчукНикита Сергеевич
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук

konovalchuk91@yandex.ruhttps://orcid.org/0000-0003-3198-9985PashkovaEkaterina A.ПашковаЕкатерина Анатольевна
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук

caterinapashkova@yandex.ruhttps://orcid.org/0000-0001-7500-9219SeredaAndrey P.СередаАндрей Петрович
Russian Federation

Dr. Sci. (Med.)

д-р мед. наук

drsereda@gmail.comVreden National Medical Research Center of Traumatology and OrthopedicsФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Р.Р. Вредена» Минздрава РоссииAcademy of Postgraduate Education of Federal Medical Biological AgencyАкадемия постдипломного образования ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России»121220232812202329478862809202304122023Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-ВекторCopyright ©; 2023,2023Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journal.rniito.org/jour/article/view/16494

Background. Developed in 1994 by H. Kitaoka et al. the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale (AOFAS-AHS) allows to assess pain, function, deformity and alignment of the foot and ankle. There is no Russian-language AOFAS-AHS questionnaire adapted according to current standards in the scientific literature.

The aim of this paper is to perform the cross-cultural adaptation and to assess the validity of the Russian-language version of the AOFAS-AHS scale, including the evaluation of its psychometric properties.

Methods. The original English version of the AOFAS-AHS scale was translated from English into Russian by a native Russian speaker. Then the questionnaire was back-translated into English by another translator whose native language is English. The next stage was the comparison of the original and back-translated versions, followed by the presentation of a pre-final cross-culturally adapted version, which was tested on 10 patients to ensure that the questions were comprehensible. The next step was the approval of the final version and its completion by patients to be operated on the hindfoot or ankle. The printed copy of the final version of the questionnaire was completed by the patients with an interval of 3 days. Total of 44 consecutive patients were enrolled, including 18 women (41%) and 26 men (59%), with a mean age of 61.7 (32-78) years. The psychometric properties of the Russian-language version of the AOFAS-AHS questionnaire (internal consistency, retest reliability, measurement error, responsiveness, and construct validity) were assessed based on the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) principles.

Results. The mean score according to the AOFAS-AHS scale was 49.6 (min 2; max 82) out of a possible 100. The average time to complete the questionnaire was 4.2 minutes. All hypotheses formulated showed correlations of varying moderate to strong degrees. The Cronbach’s alpha coefficient was 0.76, which indicates a high level of internal consistency of the elements of the validated questionnaire. A good intra-class consistency of 0.83 was obtained, which shows a high degree of reliability of the questionnaire’s reproducibility. The ceiling and floor effects for the primary results of the questionnaires did not exceed 15%. The mean value of the Russian-language version of the AOFAS-AHS increased to 86.6 after surgical treatment. The values of standardized effect size (ES) and standardized response mean (SRM) were 5.56 and 4.83, respectively.

Conclusion. The adapted Russian-language version of the AOFAS-AHS scale showed good psychometric properties and can be recommended for assessment of the physical activity in patients with ankle and hindfoot-related pathology and can also be used for monitoring the changes during the treatment.

Актуальность. Разработанная в 1994 г. H. Kitaoka с соавторами шкала Американской ассоциации хирургов стопы и голеностопного сустава AOFAS-AHS позволяет оценить боль, функцию, степень деформации и опороспособность заднего отдела стопы и голеностопного сустава. В научной литературе отсутствуют русскоязычные версии AOFAS-AHS, адаптированные согласно современным методикам.

Целью работы является культурная адаптация и валидация русскоязычной версии шкалы AOFAS-AHS, включая оценку психометрических свойств опросника.

Материал и методы. Оригинальная англоязычная версия шкалы AOFAS-AHS была переведена с английского на русский язык носителем русского языка. Затем был выполнен обратный перевод анкеты на английский язык другим переводчиком, родным языком которого является английский. Затем выполнено сравнение оригинальной и обратно переведенной версий с последующим представлением предфинальной кросс-культурно адаптированной версии, которая была протестирована на 10 пациентах, чтобы убедиться, что все вопросы понятны. Следующим этапом было утверждение финальной версии и ее заполнение пациентами, ожидающими оперативного вмешательства на заднем отделе стопы или голеностопном суставе. Печатный вариант финальной версии опросника заполнялся пациентами с промежутком в 3 дня. Для заполнения опросника были отобраны 44 последовательных пациента, из них 18 (41%) женщин и 26 (59%) мужчин, средний возраст которых составил 61,7 (32–78) лет. Оценка психометрических свойств русскоязычной версии опросника AOFAS-AHS (внутренняя согласованность, ретестовая надежность, ошибка измерения, отзывчивость и конструктная валидность) была выполнена на основании принципов COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments).

Результаты. Средний балл по шкале AOFAS-AHS составил 49,6 (min 2; max 82) из 100 возможных. Среднее время заполнения анкеты — 4,2 мин. Во всех сформулированных гипотезах была выявлена корреляционная связь умеренной или сильной степени. Коэффициент альфа Кронбаха составил 0,76, что свидетельствует о высоком уровне внутренней согласованности элементов валидируемого опросника. Был получен хороший показатель внутриклассовой согласованности (0,83), что свидетельствует о высокой степени воспроизводимости анкеты. Эффект «потолка» и «пола» для первичных результатов опросников не превышал 15%. Средний балл по русскоязычной версии AOFAS-AHS вырос до 86,6 после оперативного лечения. Значения стандартизированного размера эффекта (ES) и стандартизированного среднего ответа (SRM) составили 5,56 и 4,83 соответственно.

Заключение. Адаптированная русскоязычная версия шкалы AOFAS-AHS обладает хорошими психометрическими свойствами и может быть рекомендована для оценки физической активности пациентов с патологией области голеностопного сустава и заднего отдела стопы, а также использована для оценки динамики изменений в процессе лечения.

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