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Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation

Year 2024, Volume: 16 Issue: 3, 266 - 272, 29.10.2024
https://doi.org/10.18521/ktd.1498688

Abstract

Objective: This study aimed to calculate the minimal detectable change (MDC) in the Norwich Patellar Instability score (NPI) and validate the score for Turkish-speaking individuals with patellar instability.
Method: Sixty-four patients (mean age 21.87 ± 9.44 years) who had experienced at least one patellar dislocation during athletic activities participated in the study. The Turkish version of the NPI (NPI-T) was evaluated for reliability and internal consistency. The Minimal Detectable Change was calculated as an overall value for the participants. MDC was calculated based on the standard error of measurement (SEM) and the selected confidence level (ICC) for the study population. Pearson's correlations were examined to assess construct validity between the Kujala Patellofemoral Disorder score and the Lysholm Knee Score.
Result: The MDC for the NPI-T was 17.29, with a SEM of 6.24. The score demonstrated high internal consistency, with a Cronbach’s alpha value of 0.85, indicating substantial reliability. The consistency of measurements was excellent, with an ICC2,1 of 0.95. Additionally, the NPI-T score exhibited a strong negative correlation with both the Kujala (r = -0.85, p < 0.001) and Lysholm (r = -0.89, p < 0.001) scores. A floor effect was observed, but no ceiling effect was present.
Conclusion: The study confirms that the NPI-T demonstrates strong psychometric properties, with high internal consistency and excellent reliability, as evidenced by its low MDC and SEM. The use of the NPI-T as a reliable and valid tool for assessing patellar instability in patients with patellar dislocation will provide valuable information to clinicians.

References

  • Ayas IH, Hazar Z, Kaya I, Ataoğlu MB, Kanatlı U. Is kinesiophobia associated with functional outcome measures in patients following medial patellofemoral ligament reconstruction? Knee. 2024;49:45-51.
  • 2. Colvin AC, West RV. Patellar instability. J Bone Joint Surg Am. 2008;90(12):2751-62.
  • 3. Fithian DC, Paxton EW, Cohen AB. Indications in the treatment of patellar instability. J Knee Surg. 2004;17(1):47-56.
  • 4. Sanders TL, Pareek A, Hewett TE, Stuart MJ, Dahm DL, Krych AJ. Incidence of first-time lateral patellar dislocation: a 21-year population-based study. Sports health. 2018;10(2):146-51.
  • 5. Paxton EW, Fithian DC, Stone ML, Silva P. The reliability and validity of knee-specific and general health instruments in assessing acute patellar dislocation outcomes. Am J Sports Med. 2003;31(4):487-92.
  • 6. Hiemstra LA, Page JL, Kerslake S. Patient-Reported Outcome Measures for Patellofemoral Instability: a Critical Review. Curr Rev Musculoskelet Med. 2019;12(2):124-37.
  • 7. Clark D, Metcalfe A, Wogan C, Mandalia V, Eldridge J. Adolescent patellar instability: current concepts review. Bone Joint J. 2017;99-B(2):159-70.
  • 8. Smith TO, Donell ST, Clark A, Chester R, Cross J, Kader DF, et al. The development, validation and internal consistency of the Norwich Patellar Instability (NPI) score. Knee Surg Sports Traumatol Arthrosc. 2014;22(2):324-35.
  • 9. Smith TO, Choudhury A, Navratil R, Hing CB. Psychometric properties of the Norwich Patellar Instability Score in people with recurrent patellar dislocation. Knee. 2019;26(6):1192-7.
  • 10. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 2010;18:10:22.
  • 11. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;15;25(24):3186-91.
  • 12. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9(2):159-63.
  • 13. Kuru T, Dereli EE, Yaliman A. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2010;44(2):152-6.
  • 14. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982;10(3):150-4.
  • 15. Celik D, Coşkunsu D, Kiliçoğlu O. Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res. 2013;471(8):2602-10.
  • 16. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231-40.
  • 17. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011; 27:2:53-5.
  • 18. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. New Jersey: Pearson/Prentice Hall; 2015
  • 19. Marx RG, Menezes A, Horovitz L, Jones EC, Warren RF. A comparison of two time intervals for test-retest reliability of health status instruments. J Clin Epidemiol. 2003;56(8):730-5.
  • 20. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
  • 21. Smith TO, Davies L, O'Driscoll M-L, Donell ST. An evaluation of the clinical tests and outcome measures used to assess patellar instability. The Knee. 2008;15(4):255-262.
  • 22. Smith TO, Donell ST, Chester R, Clark A, Stephenson R. What activities do patients with patellar instability perceive makes their patella unstable? Knee. 2011;18(5):333-9.
  • 23. Van Sambeeck JD, Van de Groes SA, Koëter S. Dutch translation and validation of the Norwich Patellar Instability score and Banff Patella Instability Instrument in patients after surgery for patellar instability. Acta Orthop Belg. 2020;86(3):470-81.
  • 24. Arrebola LS, Campos TVO, Smith T, Pereira AL, Pinfildi CE. Translation, cross-cultural adaptation and validation of the Norwich Patellar Instability score for use in Brazilian Portuguese. Sao Paulo Med J. 2019;15;137(2):148-54.
  • 25. Smith T, Chester R, Hunt N, Cross JL, Clark A, Donell ST. The Norwich Patellar Instability Score: validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation. Knee. 2016;23(2):256-60.

Norwich Patellar İnstabilite Skorunun Türkçe Versiyonu: Travmatik Patellar Dislokasyonu Olan Hastalarda Minimal Tespit Edilebilen Değişiklik

Year 2024, Volume: 16 Issue: 3, 266 - 272, 29.10.2024
https://doi.org/10.18521/ktd.1498688

Abstract

Amaç: Bu çalışmanın amacı, Norwich Patellar İnstabilite Skoru'nun (NPI) minimum tespit edilebilir değişikliğini (MDC) hesaplamak ve patellar instabilitesi olan Türkçe konuşan bireyler için skoru doğrulamaktır.
Yöntem: Çalışmaya, spor aktiviteleri sırasında en az bir patella çıkığı yaşayan 64 hasta (ortalama yaş 21,87 ± 9,44 yıl) katılmıştır. NPI'nin Türkçe versiyonu (NPI-T) güvenilirlik ve iç tutarlılık açısından değerlendirilmiştir. MDC, katılımcılar için genel bir değer olarak, çalışma popülasyonu için standart ölçüm hatasına (SEM) ve seçilen güven düzeyine (sınıf içi korelasyon katsayısı, ICC) dayalı olarak hesaplanmıştır. Kujala Patellofemoral Bozukluk Skoru ile Lysholm Diz Skoru arasındaki yapı geçerliliğini değerlendirmek için Pearson korelasyonları incelenmiştir.
Sonuçlar: NPI-T'nin MDC'si 17,29 ve SEM'i 6,24 olarak bulunmuştur. Skor, 0,85'lik Cronbach alfa değeriyle yüksek bir iç tutarlılık sergilemiş; bu da önemli bir güvenirliğe işaret etmektedir. Ölçümlerin tutarlılığı 0,95'lik ICC2,1 ile mükemmel seviyede bulunmuştur. Ek olarak, NPI-T puanı hem Kujala (r = -0,85, p < 0,001) hem de Lysholm (r = -0,89, p < 0,001) puanlarıyla güçlü bir negatif korelasyon göstermiştir. Zemin etkisi gözlenmiş ancak tavan etkisi mevcut olmamıştır.
Sonuç: Çalışma, NPI-T'nin düşük MDC ve SEM ile yüksek iç tutarlılık ve mükemmel güvenilirliğe sahip olduğunu doğrulamaktadır. NPI-T'nin patellar dislokasyonu olan hastalarda patellar instabiliteyi değerlendirmede güvenilir ve geçerli bir araç olarak kullanılması, klinisyenlere değerli bilgiler sağlayacaktır.

References

  • Ayas IH, Hazar Z, Kaya I, Ataoğlu MB, Kanatlı U. Is kinesiophobia associated with functional outcome measures in patients following medial patellofemoral ligament reconstruction? Knee. 2024;49:45-51.
  • 2. Colvin AC, West RV. Patellar instability. J Bone Joint Surg Am. 2008;90(12):2751-62.
  • 3. Fithian DC, Paxton EW, Cohen AB. Indications in the treatment of patellar instability. J Knee Surg. 2004;17(1):47-56.
  • 4. Sanders TL, Pareek A, Hewett TE, Stuart MJ, Dahm DL, Krych AJ. Incidence of first-time lateral patellar dislocation: a 21-year population-based study. Sports health. 2018;10(2):146-51.
  • 5. Paxton EW, Fithian DC, Stone ML, Silva P. The reliability and validity of knee-specific and general health instruments in assessing acute patellar dislocation outcomes. Am J Sports Med. 2003;31(4):487-92.
  • 6. Hiemstra LA, Page JL, Kerslake S. Patient-Reported Outcome Measures for Patellofemoral Instability: a Critical Review. Curr Rev Musculoskelet Med. 2019;12(2):124-37.
  • 7. Clark D, Metcalfe A, Wogan C, Mandalia V, Eldridge J. Adolescent patellar instability: current concepts review. Bone Joint J. 2017;99-B(2):159-70.
  • 8. Smith TO, Donell ST, Clark A, Chester R, Cross J, Kader DF, et al. The development, validation and internal consistency of the Norwich Patellar Instability (NPI) score. Knee Surg Sports Traumatol Arthrosc. 2014;22(2):324-35.
  • 9. Smith TO, Choudhury A, Navratil R, Hing CB. Psychometric properties of the Norwich Patellar Instability Score in people with recurrent patellar dislocation. Knee. 2019;26(6):1192-7.
  • 10. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 2010;18:10:22.
  • 11. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;15;25(24):3186-91.
  • 12. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy. 1993;9(2):159-63.
  • 13. Kuru T, Dereli EE, Yaliman A. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2010;44(2):152-6.
  • 14. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med. 1982;10(3):150-4.
  • 15. Celik D, Coşkunsu D, Kiliçoğlu O. Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clin Orthop Relat Res. 2013;471(8):2602-10.
  • 16. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231-40.
  • 17. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011; 27:2:53-5.
  • 18. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. New Jersey: Pearson/Prentice Hall; 2015
  • 19. Marx RG, Menezes A, Horovitz L, Jones EC, Warren RF. A comparison of two time intervals for test-retest reliability of health status instruments. J Clin Epidemiol. 2003;56(8):730-5.
  • 20. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.
  • 21. Smith TO, Davies L, O'Driscoll M-L, Donell ST. An evaluation of the clinical tests and outcome measures used to assess patellar instability. The Knee. 2008;15(4):255-262.
  • 22. Smith TO, Donell ST, Chester R, Clark A, Stephenson R. What activities do patients with patellar instability perceive makes their patella unstable? Knee. 2011;18(5):333-9.
  • 23. Van Sambeeck JD, Van de Groes SA, Koëter S. Dutch translation and validation of the Norwich Patellar Instability score and Banff Patella Instability Instrument in patients after surgery for patellar instability. Acta Orthop Belg. 2020;86(3):470-81.
  • 24. Arrebola LS, Campos TVO, Smith T, Pereira AL, Pinfildi CE. Translation, cross-cultural adaptation and validation of the Norwich Patellar Instability score for use in Brazilian Portuguese. Sao Paulo Med J. 2019;15;137(2):148-54.
  • 25. Smith T, Chester R, Hunt N, Cross JL, Clark A, Donell ST. The Norwich Patellar Instability Score: validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation. Knee. 2016;23(2):256-60.
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

İnci Hazal Ayas 0000-0002-1928-2146

Zeynep Hazar 0000-0003-3104-8974

İbrahim Kaya 0000-0001-8205-6515

Muhammet Baybars Ataoglu 0000-0003-1359-7013

Ulunay Kanatlı 0000-0002-9807-9305

Publication Date October 29, 2024
Submission Date June 10, 2024
Acceptance Date October 10, 2024
Published in Issue Year 2024 Volume: 16 Issue: 3

Cite

APA Ayas, İ. H., Hazar, Z., Kaya, İ., Ataoglu, M. B., et al. (2024). Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation. Konuralp Medical Journal, 16(3), 266-272. https://doi.org/10.18521/ktd.1498688
AMA Ayas İH, Hazar Z, Kaya İ, Ataoglu MB, Kanatlı U. Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation. Konuralp Medical Journal. October 2024;16(3):266-272. doi:10.18521/ktd.1498688
Chicago Ayas, İnci Hazal, Zeynep Hazar, İbrahim Kaya, Muhammet Baybars Ataoglu, and Ulunay Kanatlı. “Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change Among Patients With Traumatic Patellar Dislocation”. Konuralp Medical Journal 16, no. 3 (October 2024): 266-72. https://doi.org/10.18521/ktd.1498688.
EndNote Ayas İH, Hazar Z, Kaya İ, Ataoglu MB, Kanatlı U (October 1, 2024) Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation. Konuralp Medical Journal 16 3 266–272.
IEEE İ. H. Ayas, Z. Hazar, İ. Kaya, M. B. Ataoglu, and U. Kanatlı, “Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation”, Konuralp Medical Journal, vol. 16, no. 3, pp. 266–272, 2024, doi: 10.18521/ktd.1498688.
ISNAD Ayas, İnci Hazal et al. “Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change Among Patients With Traumatic Patellar Dislocation”. Konuralp Medical Journal 16/3 (October 2024), 266-272. https://doi.org/10.18521/ktd.1498688.
JAMA Ayas İH, Hazar Z, Kaya İ, Ataoglu MB, Kanatlı U. Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation. Konuralp Medical Journal. 2024;16:266–272.
MLA Ayas, İnci Hazal et al. “Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change Among Patients With Traumatic Patellar Dislocation”. Konuralp Medical Journal, vol. 16, no. 3, 2024, pp. 266-72, doi:10.18521/ktd.1498688.
Vancouver Ayas İH, Hazar Z, Kaya İ, Ataoglu MB, Kanatlı U. Turkish Version of the Norwich Patellar Instability Score: Minimal Detectable Change among Patients with Traumatic Patellar Dislocation. Konuralp Medical Journal. 2024;16(3):266-72.