Cross-cultural adaptation and measurement properties of the Brazilian–Portuguese version of the Cincinnati Knee Rating System

Abstract

Purpose: To translate, culturally adapt, evaluate the measurement properties, and propose a new scoring system of the Cincinnati Knee Rating System for the Brazilian population.

Materials and Methods: One hundred fifty people with anterior cruciate ligament injury completed Cincinnati Knee Rating System and Lysholm Knee Scoring Scale on three occasions: 1-week prior to surgery, 90-days after and 95-days after reconstruction. The measurement properties of the Brazilian–Portuguese Cincinnati Knee Rating System, internal consistency, construct validity, reproducibility, ceiling and floor effect and responsiveness, were tested.

Results: Using the original scoring system (multiple scores), the internal consistency (Cronbach’s α) varied between 0.54–0.79 (if item deleted = 0.07–0.73); the construct validity (Pearson’s r) varied between 0.19–0.82 (related to Lysholm); the reliability (intraclass correlation coefficient) varied between 0.96–0.99; the standard error of measurement varied between 0.2–1.3 points; the minimum detectable change varied between 0.4–3.5 points; no ceiling or floor effect was detected, and responsiveness (effect size) varied between −0.3–2.7. Using the new proposed scoring system (single score), Cronbach’s α was 0.78 (if item deleted = 0.65–0.71); the Pearson’s r was 0.79 (related to Lysholm); the intraclass correlation coefficient was 0.99; the standard error of measurement was 0.5 points, the minimum detectable change was 1.3 points; no ceiling or floor effect was detected, and effect size was 1.4.

Conclusions: The Brazilian–Portuguese Cincinnati Knee Rating System has adequate property measurement and can be used in a Brazilian population. The new proposed scoring system is appropriate.

Implications for rehabilitation

• The Brazilian–Portuguese Cincinnati Knee Rating System is a valid and reliable instrument which can identify consistent clinical changes over the time.

• The Brazilian–Portuguese Cincinnati Knee Rating System can be used to evaluate and to follow-up a Brazilian population with anterior cruciate ligament injuries and postoperative reconstruction.

• The new proposed score for Cincinnati Knee Rating System is appropriate and did not compromise the quality of the measurement properties.

• The new scoring system generates a unique score, creating a potentially simpler and faster clinical understanding of the patient’s condition.

Keywords:

• Anterior cruciate ligament
• validation
• reliability
• translation
• questionnaire

Disclosure statement

The authors declare that there is no conflict of interests in this manuscript.