Translation, Validation and Cross-Cultural Adaptation of a Simplified-Chinese Version of the Tegner Activity Score in Chinese Patients with Anterior Cruciate Ligament Injury

Aims To translate the English version of Tegner Activity Score into a Simplified-Chinese version (Tegner-C) and evaluate its psychometric properties. Methods Tegner-C was cross-culturally adapted according to established guidelines. The validity and reliability of Tegner-C were assessed in 78 participants, with 19-20 participants in each of the four groups: before anterior cruciate ligament reconstruction (pre-ACLR) group, 2-3 months after ACLR group, 3-12 months after ACLR group, and healthy control group. Each participant was asked to complete the Tegner-C and Chinese version of International Knee Documentation Committee Subjective Knee Form (IKDC-SKF-C) twice, with an interval of 5 +/- 2 days. Intra-class correlation coefficient (ICC2, 1) was used to assess the reliability and Spearman's rank correlation was used for construct validity. Results The ICC2,1 was higher than 0.90 for all groups except in the pre-ACLR group, for which the ICC2,1 was 0.71 (0.41, 0.87) (All with p<0.001). The absolute reliability as evaluated by the smallest detectable change was 0.43, 2.12, 0.89, and 0.44 for the healthy control group, pre-ACLR group, 2-3 months after ACLR group, and 3-12 months after ACLR group, respectively. Neither a ceiling effect nor a floor effect was observed for any group. Significant difference was observed for both Tegner-C and IKDC-SKF-C scores between the control and the other three groups (all with p<0.001), and between pre-ACLR and the 2-3 months after ACLR group (p<0.001). Conclusions Tegner-C demonstrated comparable psychometric properties to the original English version and thus is reliable and valid for Chinese-speaking patients with ACL injury.