Tradução, adaptação transcultural e validação do questionário Oslo Sports Research Trauma Center - Patella (OSTRC-P) para o português brasileiro

Abstract

Patellar tendinopathy is a musculoskeletal condition characterized by chronic pain in the patellar tendon, with a high prevalence among athletes involved in sports requiring repetitive jumping, such as volleyball and basketball, as well as in individuals engaged in physical activity. In Brazil, the lack of validated questionnaires for early screening of this condition hinders the identification of its initial stages, potentially resulting in delayed diagnoses, invasive treatments, and high costs to the healthcare system. To address this gap, this study aimed to translate, cross-culturally adapt, and validate the Brazilian version of the Oslo Sports Trauma Research Center – Patella (OSTRC-P) questionnaire, originally developed to assess functional impairments associated with patellar tendinopathy. The cross-cultural adaptation process followed international COSMIN guidelines, involving independent translation by two bilingual professionals, synthesis of the translated versions, back-translation into English, and review by a committee of experts in sports and orthopedic physiotherapy. After semantic and cultural adjustments—such as replacing specific terms (e.g., "experienced pain" with "felt pain")—the pre-final version was pre-tested with participants from the target population to assess item clarity.For psychometric validation, 105 physically active individuals were recruited and divided into three groups: Control (asymptomatic), Risk (engaged in high-impact sports without symptoms), and Tendinopathy (clinically diagnosed based on pain upon palpation of the patellar tendon—intensity ≥3 on the Numeric Pain Rating Scale—and a VISA-P score <80). Participants completed the OSTRC-P-Br, the Victorian Institute of Sport Assessment–Patella (VISA-P), and the Lower Extremity Functional Scale (LEFS) at two time points, 15 minutes apart. The Delphi committee reached consensus after three review rounds, with over 90% agreement on the adapted items. In the pre-test, 98% of participants reported clear understanding of the items. During validation, the OSTRC-P-Br demonstrated high internal consistency (Cronbach’s alpha = 0.88; 95% CI 0.84–0.91), excellent inter-rater reliability (ICC = 0.955; 95% CI 0.92–0.98), and significant inverse correlations with the VISA-P (rho = –0.825; p < 0.001) and LEFS (rho = –0.659; p < 0.001), supporting its construct validity.In diagnostic analysis, the OSTRC-P-Br demonstrated high accuracy, with a sensitivity of 90% and a specificity of 91.4%, showing excellent discriminatory power for detecting patellar tendinopathy and ruling out false positives. A floor effect was observed in the control group, which had fixed scores (0.0 ± 0.0), while no ceiling effect was found in the other groups. The tendinopathy group showed significantly higher mean scores (38.0 ± 22.0) compared to the Control (0.0 ± 0.0) and Risk (0.0 ± 9.5) groups. These findings support the conclusion that the OSTRC-P-Br is a valid, reliable, and culturally adapted instrument for early screening of dysfunctions related to patellar tendinopathy in the Brazilian context. Its use in clinical practice may facilitate early detection and timely intervention, helping prevent chronic complications. Additionally, the questionnaire contributes to the standardization of epidemiological studies and the generation of internationally comparable data, thereby strengthening prevention and management strategies for patellar tendinopathy in Brazil.