Construct validity, reliability and interpretability of the Turkish version of the TENDINopathy Severity Assessment – Achilles (TENDINS-A) questionnaire

Abstract

Background This study aimed to develop the Turkish version of TENDINS-A (TENDINS-A-TR) and evaluate its measurement properties. Materials and methods A total of 130 participants (n = 60 Achilles tendinopathy, 34.7 ± 11.7 years; n = 70 healthy, 27.8 ± 8.9 years) completed TENDINS-A-TR, Victorian Institute of Sport Assessment-Achilles (VISA-A), Foot and Ankle Outcome Score (FAOS), and Numeric Pain Rating Scale (NPRS). Construct validity, discriminative validity (cut-off score, sensitivity, specificity), test-retest reliability, standard error of measurement (SEM), internal consistency, minimal detectable change (MDC), minimal important change (MIC) and ceiling/floor effects were assessed. Results TENDINS-A-TR showed strong correlations with VISA-A (r = -0.71, p < 0.001), FAOS subscales (rrange=-0.55 to −0.77, all p < 0.001), and NPRS (rrange=0.61–0.80, all p < 0.001). The area under the ROC curve was 0.961 (95 %CI:0.934–0.988, p < 0.001) showing excellent accuracy with 0.817 sensitivity and 0.871 specificity at 18.5 cut-off score. Test-retest reliability was excellent (ICC=0.94, 95 %CI 0.90–0.97) with an excellent internal consistency (Cronbach’s alpha=0.97). SEM and MDC were 5.92 and 16.4, respectively. MIC was 10.1, representing 26.4 % points of change in participants with Achilles tendinopathy. Lastly, there was no ceiling/floor effects. Conclusion Turkish version of TENDINS-A demonstrated strong validity, reliability and accuracy to evaluate pain, symptoms, and physical function in people with Achilles tendinopathy.

Document Type

Journal Article

Date of Publication

1-1-2025

PubMed ID

41318330

Publication Title

Foot and Ankle Surgery

Publisher

Elsevier

School

Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences

Comments

Tayfur, A., Özyurt, F., Büyükperdah, B. N., Genç, B. E., Rio, E. K., Murphy, M. C., & Tayfur, B. (2025). Construct validity, reliability and interpretability of the Turkish version of the TENDINopathy Severity Assessment – Achilles (TENDINS-A) questionnaire. Foot and Ankle Surgery. Advance online publication. https://doi.org/10.1016/j.fas.2025.11.009

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Link to publisher version (DOI)

10.1016/j.fas.2025.11.009