[ research report ]

JEAN-FRANÇOIS KAUX, MD, PhD1 • FRANÇOIS DELVAUX, PT2 • JULIAN OPPONG-KYEI, PT2
CHARLOTTE BEAUDART, MSc3 • FANNY BUCKINX, MSc3 • JEAN-LOUIS CROISIER, PT, PhD2
BÉNÉDICTE FORTHOMME, PT, PhD2 • JEAN-MICHEL CRIELAARD, MD, PhD1 • OLIVIER BRUYÈRE, PT, PhD3

Cross-cultural Adaptation
and Validation of the Victorian
Institute of Sport Assessment-Patella
Questionnaire for French-Speaking
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Patients With Patellar Tendinopathy

P
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

atellar tendinopathy is the most common kind of overuse assess subjective or complex phenomena,
injury of the knee.7 It usually occurs in sports requiring jumps such as pain, quality of life, disability,
or significant quadriceps work.17 Pathophysiological research etc.3,15
The Victorian Institute of Sport As-
focuses on exploring new therapeutic approaches.6,7 As part sessment-Patella (VISA-P) is a question-
of these studies or at clinical follow-up, rating scales are used to naire originally developed in English to
assess the symptoms and repercussions of
patellar tendinopathies and their impact
TTSTUDY DESIGN: Clinical measurement study. TTRESULTS: All members of the expert com-
on daily and physical activities.18 The max-
TTBACKGROUND: The Victorian Institute of Sport mittee agreed with the final version. On a scale
Journal of Orthopaedic & Sports Physical Therapy®

Assessment-Patella (VISA-P), originally developed
in English, assesses the severity of patellar tendi-
nopathy symptoms. To date, no French version of
the questionnaire exists.
TTOBJECTIVES: The aim of our study was to
translate the VISA-P into French and verify its
psychometric properties.
TTMETHODS: The translation and cultural adapta-
tion were performed according to international
recommendations in 6 steps: initial translation,
translation merging, back translation to the
original language, use of an expert committee
to reach a prefinal version, test of the prefinal
version, and expert committee appraisal of a final
version. Afterward, the psychometric properties of
the final French version (VISA-PF) were assessed
in 92 subjects, divided into 3 groups: pathological
subjects (n = 28), asymptomatic subjects (n = 22),
and sports-risk subjects (n = 42).
ranging from 0 to 100, with 100 representing an
asymptomatic subject, the average  SD scores
on the VISA-PF were 53  17 for the pathological
group, 99  2 for the healthy group, and 86  14
for the sports-risk group. The test-retest reliability
of the VISA-PF was excellent, with good internal
consistency. Correlations between the VISA-PF and
divergent validity of the Medical Outcomes Study
36-Item Short-Form Health Survey (SF-36) were
low, and the correlation coefficient values mea-
sured between the VISA-PF scores and converged
items of the SF-36 were higher.
TTCONCLUSION: The VISA-PF is understandable,
valid, and suitable for French-speaking patients
with patellar tendinopathy. J Orthop Sports Phys
Ther 2016;46(5):384-390. Epub 21 Mar 2016.
doi:10.2519/jospt.2016.5937
TTKEY WORDS: clinimetrics, French, jumper’s
knee, outcome measurement, tendon, translation
imum score of the VISA-P is 100, which
represents an asymptomatic subject. The
theoretical minimum score is 0, corre-
sponding to major functional impairment.
Although this questionnaire has al-
ready been translated into different
languages,4,5,10-12,19,20 it has never been
adapted for French-speaking patients. A
French translation would be useful, be-
cause French is one of the most widely
spoken languages, with approximately
275 million people who speak the lan-
guage worldwide.
Accordingly, in this study, the goals
were, first, to translate and to adapt the
VISA-P to a valid French version, and,
second, to validate this version and assess
its psychometric properties.

Physical Medicine, Rehabilitation and Sports Traumatology Department, FIFA Medical Centre of Excellence, University and University Hospital of Liège, Belgium. 2Physiotherapy
1

Service, Department of Motility Sciences, University of Liège, Liège, Belgium. 3Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège,
Belgium. The protocol was approved by the Ethics Committee of the University of Liège, Belgium. The authors certify that they have no affiliations with or financial involvement in
any organization or entity with a direct financial interest in the subject matter or materials discussed in the article. Address correspondence to Dr Jean-François Kaux, Physical
Medicine, Rehabilitation and Sports Traumatology Department, University Hospital of Liège, Avenue de l’Hôpital, B35, 4000 Liège, Belgium. E-mail: jfkaux@chu.ulg.ac.be t
Copyright ©2016 Journal of Orthopaedic & Sports Physical Therapy®

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 METHODS
T
he protocol was approved by the
Ethics Committee of the University
of Liège, Belgium.
Translation
The final translated questionnaire was
achieved in 6 steps, according to the in-
ternational recommendations for cross-
cultural adaptation of questionnaires
measuring health status1: (1) initial
translation from English to French; (2)
merging translations from the 2 French
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translated versions; (3) back translation
into the original language by a bilingual
English native speaker; (4) review by an
expert committee (1 health professional, 1
language professional, and all translators)
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
to obtain a prefinal version of the ques-
tionnaire from the different translations
with semantic, idiomatic, experiential,
and conceptual equivalence; (5) prefinal
version testing on a group of 10 people;
and (6) expert committee approval of the
final version of the questionnaire.
Participants
Journal of Orthopaedic & Sports Physical Therapy®
The participants who tested (self-admin-
istered) the French version of the VISA-P
(VISA-PF) were divided into 3 groups: (1)
a group of patients who suffered from pa-
tellar tendinopathy (first episode of inju-
ry), (2) a group of asymptomatic amateur
athletes who were at high risk of devel-
oping patellar tendinopathy (basketball,
volleyball, and handball players), and (3)
a group of healthy individuals who were
not involved in a sport that would put
them at risk for patellar tendinopathy.
The subjects had to be at least 18 years
old, to be aware of the purpose of the
study, and to give their informed consent
to participate.
Assessment of the Construct Validity
All participants in the study answered
a questionnaire on quality of life, the
Medical Outcomes Study 36-Item Short-
Form Health Survey (SF-36),9 in order
to establish correlations with other items
measuring various aspects of the indi-
journal of orthopaedic & sports physical therapy | volume 46 | number 5 | may 2016 |
46-05 Kaux.indd 385
viduals’ health status. The score range
of the questionnaire was from 0 to 100,
with 0 corresponding to extremely seri-
ous health problems and 100 reflecting
no health problems.9
Assessment of Test-Retest Reliability
This assessment tested the stability over
time of the results using intraclass cor-
relation coefficients (ICCs). A single
judge assessed each patient twice, at a
30-minute interval, while the subject’s
status remained unchanged.14 Reliability
increases as the ICC approaches 1. It was
also important to consider the 95% confi-
dence interval of each ICC to have a clear
idea of the possible variation range of the
reliability value in the groups.1
The standard error of the measure-
ment (SEM) was calculated using the fol-
lowing formula: SEM = SD × √ 1 – ICC.
The minimum detectable change (MDC)
statistic based on a 95% confidence in-
terval (MDC95) was calculated: MDC95 =
1.96 × √2 × SEM.13
Assessment of Internal Consistency
Cronbach’s alpha coefficient may be used
to assess the internal consistency of a set
of items, scale, or subscale, correspond-
ing to a single clinical dimension. The aim
was to estimate the strength of the inter-
correlations between items. The more
items that were interconnected, the more
the alpha value increased.15 The alpha
value ranges from 0 to 1, and internal con-
sistency increases as alpha approaches 1.1
Assessment of the Discriminant Validity
To assess construct validity, convergent
and discriminant validity were assessed.
We assessed the following assumptions:
(1) the scale scores were considered mod-
erately or highly correlated with the sub-
scales of the SF-36 that measure concepts
similar to those measured by the adapted
questionnaires (convergent validity); (2)
the scale scores were weakly correlated
with the SF-36 subscales of mental health,
emotional role functioning, social role
functioning, and vitality, because those
subscales assess different concepts (dis-
criminant validity); and (3) comparison of
the VISA-PF scores between the 3 groups
reflected their logic (discriminant validity)
(ie, analysis of variance was used to test the
hypothesis that the average score would
differ significantly between the 3 groups).
If the experimental results were consistent
with those expected, the construct validity
of the scale could be trusted.
Assessment of the Minimum
and Maximum Effects
Minimum or maximum effects (floor or
ceiling effects, respectively) are consid-
ered present when more than 15% of par-
ticipants obtain the lowest possible score
(minimum effect) or the highest possible
score (maximum effect). Persons with
a minimum score or a maximum score
cannot obtain a lower or higher score, re-
spectively, at retest, reducing the poten-
tial responsiveness of the questionnaire.14
Data Processing
Results were expressed as means and
standard deviations for continuous vari-
ables and as numbers and frequencies
(percent) for qualitative variables. All
quantitative variables were submitted to a
Shapiro-Wilk normality test. Depending
on the result, the relationship between
quantitative variables was measured by
the Pearson or Spearman correlation co-
efficient: low correlations were less than
0.3, moderate correlations were between
0.3 and 0.6, and strong correlations were
greater than 0.6. The group means were
compared using an analysis of variance
with the Tukey honest significant differ-
ence post hoc test. Results were consid-
ered significant at a level of uncertainty
of 5% (P<.05).
RESULTS
Translation
T
he translators did not encoun-
ter any major difficulties during the
translation of the questionnaire.
The back translation was very similar to
the original. When testing the prefinal
version, none of the subjects had difficul-
385
4/20/2016 4:47:02 PM
 [ research report
ty understanding the questionnaire. All
members of the expert committee gave
their approval after showing their satis-
faction with the final version (APPENDIX A).
Study Sample
The total study sample for the valida-
tion of the VISA-PF was 92 subjects. Out
of these, 28 were patients with patellar
tendinopathy, 42 were athletes at risk
of developing the disorder, and 22 were
people not suffering from this condition
(TABLE 1). All patients were athletes and
the most represented sport was football.
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In the sports-risk group, volleyball was
the most represented sport, followed by
basketball. In the healthy group, 27.3%
of participants were sedentary.
TABLE 2 shows the scores (mean  SD)
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
obtained for the different items of the VI-
SA-PF, and TABLE 3 shows the comparison
between the VISA-PF scores and those
obtained in other languages.
Test-Retest Reliability
The results obtained from the test-retest
reliability of the VISA-PF questionnaire
showed that the reliability was excellent,
Journal of Orthopaedic & Sports Physical Therapy®
with a total ICC of 0.99 (APPENDIX B, avail-
able online). All the SEM and most of the
MDC values were below 10% (APPENDIX B).
Internal Consistency
The internal consistency of the VISA-PF
was assessed with the Cronbach alpha
coefficient, which was close to .9 (APPEN-
DIX C, available online).
Construct Validity
The SF-36 questionnaire was com-
pleted by 85 subjects (21 pathological
subjects, 22 healthy subjects, and 42
sports-risk subjects). As the set of vari-
ables did not follow a normal distribu-
tion, comparisons were performed using
the Spearman correlation coefficient (rs)
(APPENDIX D , available online).
The VISA-PF scores obtained were
highly correlated with the total SF-36
score (rs = 0.69, P<.001) and those of
the physical functioning and bodily pain
subscales (rs = 0.72, P<.001; rs = 0.72,
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46-05 Kaux.indd 386
]
TABLE 1 Characteristics of Participants*
Pathological Group (n = 28) At-Risk Group (n = 42) Healthy Group (n = 22)
Mean  SD age, y 29.1  8.6 26.3  6.9 31  13.5
Sex (women) 2 (7.1) 16 (38.1) 8 (36.4)
Right tendinopathy 12 (42.9) NA NA
Left tendinopathy 12 (42.9) NA NA
Bilateral tendinopathy 1 (3.6) NA NA
Abbreviation: NA, not applicable.
*Values are n (%) unless otherwise indicated.
TABLE 2 Results for Each Item of the VISA-PF*
Item Pathological Group (n = 28) At-Risk Group (n = 42) Healthy Group (n = 22)
1 5.7  3.6 8.4  2.4 10.0  0
2 5.6  2.8 9.0  1.7 10.0  0
3 7.2  3.1 8.8  1.9 9.9  0.2
4 5.6  2.4 8.6  1.7 9.8  0.5
5 6.4  2.6 8.4  1.8 9.6  0.8
6 6.6  3.0 8.7  1.9 9.6  0.8
7 3.2  3.6 8.7  2.0 10.0  0
8 12.6  7.8 25.4  5.9 30.0  0
Abbreviation: VISA-PF, French version of the Victorian Institute of Sport Assessment-Patella.
*Values are mean  SD.
P<.001, respectively). There were signifi- Minimum and Maximum Effects
cantly moderate correlations between Out of the 28 subjects in the pathological
the VISA-PF and the SF-36 physical role group, none achieved a minimum score
functioning subscale (rs = 0.41, P<.05 of 0 or a maximum score of 100.
[APPENDIX D]) and the general health per-
ceptions subscale (rs = 0.52, P<.001). DISCUSSION
As expected, correlations between the
T
VISA-PF and the SF-36 mental health, he objective of this study was
emotional role functioning, social role to translate, adapt, and validate a
functioning, and vitality subscales were French version of the VISA-P, as
moderate to low (rs = 0.16, P>.05; rs = well as to assess its psychometric prop-
0.25, P<.05; rs = 0.29, P<.05; rs = 0.33, erties. Original to this work is that the
P<.05, respectively). translation was compared with the
The analysis of variance revealed a sig- French version of the SF-369 to establish
nificant difference between the 3 groups correlations with other items measuring
who responded to the VISA-PF. The different aspects of individuals’ health
post hoc test revealed that the score of status.
the pathological group was significantly No major difficulties were encoun-
different (P<.05) from the scores of the tered during the translation process,
healthy group and the sports-risk group. and the expert committee considered
4/20/2016 4:47:03 PM

Results of the VISA-P in French
TABLE 3
and Other Languages*
Pathological Group Score
French version 53  17 (n = 28)
Original version (English) 55  12 (n = 14)
Swedish version 48  20 (n = 17)
Italian version 44 (n = 25)
Dutch version 58  19 (n = 20)
German version 62  13 (n = 23)
Spanish version 56  13 (n = 40)
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Brazilian Portuguese version 59  18 (n = 52)
Korean version 68  16 (n = 23)
Abbreviation: VISA-P, Victorian Institute of Sport Assessment-Patella.
*Values are mean  SD.
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
the final French version of the VISA-P
equivalent to the original English ver-
sion. Other adaptations of the VISA-P
have followed a translation process simi-
lar to the one described in this study and
have also attained satisfactory linguistic
equivalence.4,10-12,19,20
A significant difference was observed
between the 3 groups in VISA-PF scores.
Journal of Orthopaedic & Sports Physical Therapy®
Subjects in the pathological group scored
significantly lower than the other 2
groups on all questions. This confirms the
hypothesis developed at the beginning of
the study and is also consistent with the
VISA-P translation results carried out in
other countries.4,5,10-12,19,20 The scores ob-
tained in previous studies were similar to
those of the VISA-PF (TABLE 3).
Concerning the test-retest reliability,
based on the methodology of the Italian
adaptations of the VISA-P, the choice of
30 minutes was made for practical rea-
sons and to avoid change in the status
of the subjects.11 However, the time in-
terval chosen could have been longer to
avoid a recall effect when responding for
the second time to the questionnaire.
The reliability would perhaps be lower
with a longer interval between tests.
The ICC calculated for this time inter-
val set an excellent test-retest reliability
coefficient because the ICC was higher
than 0.91. The test-retest reliabilities of
journal of orthopaedic & sports physical therapy | volume 46 | number 5 | may 2016 |
46-05 Kaux.indd 387
At-Risk Group Score Healthy Group Score
86  14 (n = 42) 99  2 (n = 22)
75  17 (n = 100) 95  8 (n = 26)
79  24 (n = 17) 83  13 (n = 17)
... ...
89  11 (n = 15) 95  9 (n = 18)
... 95  6 (n = 52)
90  9 (n = 40) 96  2 (n = 40)
... ...
... 93  9 (n = 5)
the other translated versions, as well as
the original version of the VISA-P, were
slightly lower (0.74-0.97).4,5,10-12,19,20 In-
ternal consistency confirmed that the
items were not redundant. In addition,
the scores of different items were highly
correlated with the total score of the VI-
SA-PF. The alpha coefficient measured
in this study was slightly higher than
that of the other translations, which
ranged from .71 to .88.4,5,10-12,19,20
Interestingly, when comparing the
results obtained for each item for each
group, item 3 seems to be the least dis-
criminant (TABLE 2). Indeed, scores in the
3 groups showed greater variance for the
other 7 items.
Spearman correlation coefficients of
the subscales of the physical health com-
ponent of the SF-36 were higher than
those of the mental health component.
The mental health subscale correlation
was not the only statistically significant
value observed. The discriminant valid-
ity demonstrated for the mental health
component was weakly correlated with
the VISA-PF. The total score of the VI-
SA-PF was strongly correlated with that
of the SF-36, as well as with the physical
functioning and bodily pain subscales.
Moreover, these correlations were sig-
nificant, which confirmed the conver-
gent validity. The presence of moderate
correlations was demonstrated by a close
theoretical construct (but not complete-
ly identical) between the VISA-PF and
SF-36. The objectives established at the
beginning of the study for the construct
validity of the VISA-PF appear to have
been achieved.
No pathological subject obtained a
maximum score of 100 or a minimum
score of 0. Thus, no minimum and maxi-
mum effects were observed. No other VI-
SA-P adaptations assessed the minimum
and maximum effects.4,5,10-12,19,20
A limitation of the present study is
the 30-minute interval between tests to
assess test-retest reliability. Whether the
measures would remain stable after a lon-
ger, more clinically relevant period, such
as 1 week, is not known. While the ICC
provides an estimate of error in group
comparisons, it does not give useful in-
formation regarding the magnitude of er-
ror in the scores obtained from individual
patients. This could be improved by the
inclusion of SEM95 and MDC95, which are
likely to be biased downward due to the
short follow-up period and are reported
to reflect uncertainty. It appears that an
SEM variability of lower than 10% (as in
our series) may be considered appropri-
ate for clinical purposes.2 However, one
must apply caution when interpreting
the MDC values reported in this inves-
tigation, because they are not indicative
of clinically meaningful change; thus,
the minimal clinically important differ-
ence would be necessary to determine
this.8,16 In our results, most of the MDC
values were below 10%, attesting that the
French version of the VISA-P is appropri-
ate for clinical use. Furthermore, to assess
the presence or absence of the minimum
and maximum effects, a greater number
of subjects could have been taken into ac-
count. Finally, the aim of this study was
not to assess the severity of symptoms
but to obtain a reliable French version
of the VISA-P. Nevertheless, the test-
retest evaluation provided here confirms
that the assessment of symptom severity
is just as reproducible as in the original
version.18
387
4/20/2016 4:47:03 PM
 [ research report
CONCLUSION
T
he French version of the VISA-
P, originally developed in English to
assess patellar tendinopathy symp-
toms, showed satisfactory construct va-
lidity, good test-retest reliability (at a
30-minute interval), good internal con-
sistency, no influence of minimum and
maximum effects, and good discrimi-
nant validity. The VISA-PF can be used
by French-speaking subjects.5 t
KEY POINTS
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FINDINGS: The VISA-PF questionnaire is
a valid translation of the original VISA-
P, from English into French.
IMPLICATIONS: The VISA-PF question-
naire is a valid instrument that can be
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
used by researchers and clinicians to as-
sess the severity of pain and disability in
French-speaking subjects with patellar
tendinopathy.
CAUTION: The VISA-PF is a question-
naire to assess the severity of patellar
tendinopathy symptoms but is not a di-
agnostic tool. The minimal clinically im-
portant difference has not been reported
Journal of Orthopaedic & Sports Physical Therapy®
for the French version of the VISA-P.
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19. Wageck BB, de Noronha M, Lopes AD, da Cunha
RA, Takahashi RH, Costa LO. Cross-cultural
adaptation and measurement properties of the
Brazilian Portuguese version of the Victorian
Institute of Sport Assessment-Patella (VISA-P)
scale. J Orthop Sports Phys Ther. 2013;43:163-
171. http://dx.doi.org/10.2519/jospt.2013.4287
20. Zwerver J, Kramer T, van den Akker-Scheek I.
Validity and reliability of the Dutch translation of
the VISA-P questionnaire for patellar tendinopa-
thy. BMC Musculoskelet Disord. 2009;10:102.
http://dx.doi.org/10.1186/1471-2474-10-102
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 APPENDIX A

FINAL VERSION OF THE VISA-PF

1. Combien de minutes pouvez-vous rester assis sans douleur?

0 min 100 min
0 1 2 3 4 5 6 7 8 9 10
Points ______
2. Ressentez-vous des douleurs lorsque vous descendez les escaliers (avec un cycle de marche normal)?
Douleur Pas de
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extrême douleur
0 1 2 3 4 5 6 7 8 9 10
Points ______
3. Ressentez-vous des douleurs au genou lors de son extension active sans appui?
Douleur Pas de
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

extrême douleur
0 1 2 3 4 5 6 7 8 9 10
Points ______
4. Ressentez-vous des douleurs lorsque vous êtes debout pieds joints, et que vous vous laissez aller en avant pour vous réceptionner
avec la jambe douloureuse (fente avant genou en charge)?
Douleur Pas de
extrême douleur
0 1 2 3 4 5 6 7 8 9 10
Journal of Orthopaedic & Sports Physical Therapy®

Points ______
5. Présentez-vous des difficultés lors de squats?
Incapable Aucun
problême
0 1 2 3 4 5 6 7 8 9 10
Points ______
6. Présentez-vous des douleurs pendant ou immédiatement après avoir réalisé 10 sautillements unipodaux (sur une jambe)?
Douleur
extrême/ Pas de
incapable douleur
0 1 2 3 4 5 6 7 8 9 10
Points ______
7. Pratiquez-vous actuellement un sport ou une autre activité physique?
0 Pas du tout
4 Entraînement/compétition modifié
7 Entraînement/compétition complet mais à un niveau différent (inférieur) de celui qui a vu les symptômes apparaître
10 Entraînement/compétition à un niveau identique ou supérieur de celui qui a vu les symptômes apparaître
Points ______

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 [ research report ]
APPENDIX A

8. Complétez uniquement A, B ou C pour cette question:

• Si vous ne ressentez aucune douleur pendant la pratique sportive, veuillez compléter uniquement la 8A.
• Si vous ressentez une douleur pendant la pratique sportive mais qu'elle ne vous empêche pas de poursuivre celles-ci,
veuillez compléter uniquement la 8B.
• Si vous ressentez une douleur qui vous empêche de poursuivre l'activité sportive, veuillez compléter uniquement la 8C.

8A. Si vous ne ressentez aucune douleur pendant la pratique sportive, combien de temps pouvez-vous vous entraîner/jouer?
0 min 0-5 min 6-10 min 11-15 min >15 min

0 7 14 21 30
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Points ______
8B. Si vous ressentez de la douleur pendant la pratique sportive mais qu'elle ne vous empêche pas de poursuivre celle-ci, combien
de temps pouvez-vous vous entraîner/jouer?
0 min 0-5 min 6-10 min 11-15 min >15 min
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

0 4 10 14 20
Points ______
8C. Si vous ressentez une douleur qui vous empêche de poursuivre l'activité sportive, combien de temps pouvez-vous vous
entraîner/jouer?
0 min 0-5 min 6-10 min 11-15 min >15 min

0 2 5 7 10
Journal of Orthopaedic & Sports Physical Therapy®

Points ______

Total ______ / 100

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 APPENDIX B

TEST-RETEST RELIABILITY OF THE VISA-PF

Nonparametric
Wilcoxon Signed-
Item Rank Test ICC* SEM MDC95 SEM, % MDC, %
1 1.00 0.99 (0.997, 0.999) 0.129 0.358 1.62 4.50
2 0.63 0.99 (0.995, 0.998) 0.149 0.413 1.80 5.00
3 0.63 0.99 (0.994, 0.997) 0.149 0.413 1.74 4.81
4 1.00 0.98 (0.972, 0.988) 0.325 0.901 4.05 11.2
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5 1.00 0.95 (0.926, 0.967) 0.506 1.401 6.24 17.3

6 0.13 0.98 (0.976, 0.989) 0.298 0.826 3.61 10.0
7 1.00 0.99 (0.994, 0.997) 0.224 0.620 3.01 8.34
8 1.00 0.99 (0.996, 0.998) 0.447 1.240 1.96 5.44
Total score 0.62 0.99 (0.996, 0.999) 0.522 1.446 0.657 1.82
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

Abbreviations: ICC, intraclass correlation coefficient; MDC, minimal detectable change; SEM, standard error of the measurement; VISA-PF, French
version of the Victorian Institute of Sport Assessment-Patella.
*Values in parentheses are 95% confidence interval.

APPENDIX C
Journal of Orthopaedic & Sports Physical Therapy®

INTERNAL CONSISTENCY OF THE VISA-PF

Correlation With
Item the Total Score Cronbach Alpha
1 0.65 .89
2 0.77 .88
3 0.60 .90
4 0.81 .88
5 0.61 .89
6 0.66 .89
7 0.62 .90
8 0.79 .88
Abbreviation: VISA-PF, French version of the Victorian Institute of Sport Assessment-Patella.

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 [ research report ]
APPENDIX D

CONSTRUCT VALIDITY
OF THE VISA-PF VERSUS THE SF-36
SF-36 Subscale rs
Physical functioning 0.72*
Physical role functioning 0.41†
Bodily pain 0.72*
General health perceptions 0.52*
Mental health 0.16
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Emotional role functioning 0.25†

Social role functioning 0.29†
Vitality 0.33†
SF-36 total score 0.69*
Copyright © 2016 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

 bbreviations: SF-36, Medical Outcomes Study 36-Item Short-Form

A
Health Survey; VISA-PF, French version of the Victorian Institute of Sport
Assessment-Patella.
*P<.001.
†
P<.05.
Journal of Orthopaedic & Sports Physical Therapy®

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