Validity and Reliability of the Indonesian Version of Anterior Knee Pain Scale in Measuring Functional Limitations of Army Soldiers with Anterior Knee Pain
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Published:
Dec 28, 2024
Keywords:
Kujala score, AKPS, patellofemoral pain
Main Article Content
Abstract
Introduction: Anterior knee pain (AKP), also referred as patellofemoral pain, commonly affects physically active individuals. The underreporting of AKP in the military necessitates the need for reliable clinical outcome evaluation instruments, especially for military personnel. The Anterior Knee Pain Scale (AKPS) or Kujala Score is an instrument devised for assessing functional limitations in AKP sufferers. AKPS has been proven to be valid and reliable in Bahasa Indonesia for assessing functional limitations in patients with patellofemoral pain syndrome. This study aims to test the validity and reliability of the Indonesian version of AKPS in measuring functional limitations of Army soldiers suffering from AKP.
Methods: Cross-sectional study, validity assessment using Pearson correlation and reliability testing by assessing internal consistency and test-retest reliability. A total of 34 male soldiers with AKP who fulfilled the inclusion and exclusion criteria. Subjects provided informed consent, underwent history taking and physical examination, then completed the AKPS. Three day interval for test-retest.
Results: Correlation coefficient range: 0.423-0.779, overall Cronbach's alpha: 0.806, ICC: 0.993 at 95% confidence level, p<0.05.
Conclusion: The Indonesian version of the AKPS was valid and reliable for assessing functional limitations in Army soldiers with anterior knee pain.
Keywords: Kujala score, AKPS, patellofemoral pain.
Methods: Cross-sectional study, validity assessment using Pearson correlation and reliability testing by assessing internal consistency and test-retest reliability. A total of 34 male soldiers with AKP who fulfilled the inclusion and exclusion criteria. Subjects provided informed consent, underwent history taking and physical examination, then completed the AKPS. Three day interval for test-retest.
Results: Correlation coefficient range: 0.423-0.779, overall Cronbach's alpha: 0.806, ICC: 0.993 at 95% confidence level, p<0.05.
Conclusion: The Indonesian version of the AKPS was valid and reliable for assessing functional limitations in Army soldiers with anterior knee pain.
Keywords: Kujala score, AKPS, patellofemoral pain.
Article Details
How to Cite
Susmex, R. F., Tamin, T. Z., Anestherita, F., & Friska, D. (2024). Validity and Reliability of the Indonesian Version of Anterior Knee Pain Scale in Measuring Functional Limitations of Army Soldiers with Anterior Knee Pain. Indonesian Journal of Physical Medicine and Rehabilitation, 13(2), 115 - 128. https://doi.org/10.36803/indojpmr.v13i2.413
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Original Article
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References
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11. Sanchis-Alfonso V, Dye SF. How to Deal With Anterior Knee Pain in the Active Young Patient. Sports Health: A Multidisciplinary Approach. 2016 Nov;9(4):346–51.
12. Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. British journal of sports medicine [Internet]. 2018 [cited 2019 Mar 12];52(18):1170–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29925502
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14. Dammerer D, Liebensteiner MC, Kujala UM, Emmanuel K, Kopf S, Dirisamer F, et al. Validation of the German version of the Kujala score in patients with patellofemoral instability: a prospective multi-centre study. Archives of Orthopaedic and Trauma Surgery. 2018 Jan 25;138(4):527–35.
15. Bennell K, Bartam S, Crossley K, Green S. Outcome measures in patellofemoral pain syndrome: test retest reliability and inter-relationships. Physical Therapy in Sport. 2000 May;1(2):32–41.
16. Myer GD, Barber Foss KD, Gupta R, Hewett TE, Ittenbach RF. Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents. Knee Surgery, Sports Traumatology, Arthroscopy. 2014 Apr 30;24(3):653–60.
17. Mustamsir E, Phatama KY, Pratianto A, Pradana AS, Sukmajaya WP, Pandiangan RAH, et al. Validity and Reliability of the Indonesian Version of the Kujala Score for Patients With Patellofemoral Pain Syndrome. Orthopaedic Journal of Sports Medicine [Internet]. 2020 May 28;8(5). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7257862/
18. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing clinical research. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.
19. Sugiyono S. Metode Penelitian Kuantitatif, Kualitatif Dan R&D. Bandung: Alfabeta; 2013.
20. Hajjar STE. Statistical Analysis: Internal-Consistency Reliability and Construct Validity. International Journal of Quantitative and Qualitative Research Methods (IJQQRM). 2018;6(1):46–57.
21. Bobak CA, Barr PJ, O’Malley AJ. Estimation of an inter-rater intra-class correlation coefficient that overcomes common assumption violations in the assessment of health measurement scales. BMC Medical Research Methodology [Internet]. 2018 Sep 12;18(1). Available from: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-018-0550-6
22. Roush JR, Curtis Bay R. PREVALENCE OF ANTERIOR KNEE PAIN IN 18–35 YEAR-OLD FEMALES. International Journal of Sports Physical Therapy [Internet]. 2012 Aug 1;7(4):396–401. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414071/
23. Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR. The Effect of Foot Structure and Range of Motion on Musculoskeletal Overuse Injuries. The American Journal of Sports Medicine. 1999 Sep;27(5):585–93.
24. Negahban H, Pouretezad M, Yazdi MJS, Sohani SM, Mazaheri M, Salavati M, et al. Persian translation and validation of the Kujala Patellofemoral Scale in patients with patellofemoral pain syndrome. Disability and Rehabilitation. 2012 May 27;34(26):2259–63.
25. Iqbal M, Salam R, Hasanuddin I, Hassan AB. Body Segment Dimensions of Indonesian Male Army. IOP Conference Series: Materials Science and Engineering. 2020 Sep 1;931(1):012013–3.
26. Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. British Journal of Sports Medicine [Internet]. 2018 Sep 21;53(5):270–81. Available from: https://bjsm.bmj.com/content/53/5/270
27. Glaviano NR, Boling MC, Fraser JJ. Anterior Knee Pain Risk in Male and Female Military Tactical Athletes. Journal of Athletic Training. 2021 Mar 31;56(11).
28. Kuru T. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthopaedica et Traumatologica Turcica. 2010;44(2):152–6.
29. Gil-Gámez J, Pecos-Martín D, Kujala UM, Martínez-Merinero P, Montañez-Aguilera FJ, Romero-Franco N, et al. Validation and cultural adaptation of “Kujala Score” in Spanish. Knee Surgery, Sports Traumatology, Arthroscopy. 2015 Feb 4;24(9):2845–53.
30. Mellinger S, Neurohr GA. Evidence based treatment options for common knee injuries in runners. Annals of Translational Medicine [Internet]. 2019 Oct;7(S7):S249–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829001/
31. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi Journal of Anaesthesia. 2017;11(5):80.
32. Kim Y, Youm C, Son M, Kim J, Lee M. The effect of knee flexor and extensor fatigue on shock absorption during cutting movements after a jump landing. The Knee. 2017 Dec;24(6):1342–9.
33. Louw Q, Grimmer K. Biomechanical factors associated with the risk of knee injury when landing from a jump. South African Journal of Sports Medicine. 2006 Feb 3;18(1):18.
34. Bosshardt L, Ray T, Sherman S. Non-operative Management of Anterior Knee Pain: Patient Education. Current Reviews in Musculoskeletal Medicine. 2021 Feb;14(1):76–81.
35. Neumann DA, Kelly ER, Kiefer CL, Martens K, Grosz CM. Kinesiology of the musculoskeletal system : foundations for rehabilitation. St. Louis, Missouri: Elsevier; 2017.
36. Willy RW, Meira EP. CURRENT CONCEPTS IN BIOMECHANICAL INTERVENTIONS FOR PATELLOFEMORAL PAIN. International Journal of Sports Physical Therapy [Internet]. 2016 Dec 1;11(6):877–90. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095941/
37. Sakunkaruna S, Sakunkaruna Y, Sakulsriprasert P. Thai Version of the Kujala Patellofemoral Questionnaire in Knee Pain Patients: Cross-Cultural Validation and Test-Retest Reliability. PubMed. 2015 Jun 1;98(Suppl 5):S81-5.
38. Papadopoulos C, Constantinou A, Cheimonidou AZ, Stasinopoulos D. Greek cultural adaption and validation of the Kujala anterior knee pain scale in patients with patellofemoral pain syndrome. Disability and Rehabilitation. 2016 Apr 6;39(7):704–8.
2. Coppack RJ, Etherington J, Wills AK. The Effects of Exercise for the Prevention of Overuse Anterior Knee Pain. The American Journal of Sports Medicine. 2011 Jan 6;39(5):940–8.
3. Powers CM, Witvrouw E, Davis IS, Crossley KM. Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester, UK: part 3. British Journal of Sports Medicine. 2017 Nov 6;51(24):1713–23.
4. Petersen W, Rembitzki I, Liebau C. Patellofemoral pain in athletes. Open Access Journal of Sports Medicine. 2017 Jun;2017(8):143–54.
5. Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, et al. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. Screen HR, editor. PLOS ONE [Internet]. 2018 Jan 11;13(1):e0190892. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0190892
6. Dorotka R, Jimenez-Boj E, Kypta A, Kollar B. The Patellofemoral Pain Syndrome in Recruits Undergoing Military Training: A Prospective 2-Year Follow-Up Study. Military Medicine. 2003 Apr 1;168(4):337–40.
7. Buckinx F, Bornheim S, Remy G, Van Beveren J, Reginster Jy, Bruyère O, et al. French translation and validation of the “Anterior Knee Pain Scale” (AKPS). Disability and Rehabilitation. 2017 Dec 21;41(9):1089–94.
8. TNI-AD. Buku Petunjuk Teknik Pemeriksaan/Uji Badan Calon/Anggota TNI AD. Bandung: Kodiklat; 2012.
9. Schram B, Orr R, Pope R. A Profile of Knee Injuries Suffered by Australian Army Reserve Soldiers. International Journal of Environmental Research and Public Health. 2018 Dec 20;16(1):12.
10. Smith L, Westrick R, Sauers S, Cooper A, Scofield D, Claro P, et al. Underreporting of Musculoskeletal Injuries in the US Army: Findings From an Infantry Brigade Combat Team Survey Study. Sports Health: A Multidisciplinary Approach. 2016 Oct 27;8(6):507–13.
11. Sanchis-Alfonso V, Dye SF. How to Deal With Anterior Knee Pain in the Active Young Patient. Sports Health: A Multidisciplinary Approach. 2016 Nov;9(4):346–51.
12. Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. British journal of sports medicine [Internet]. 2018 [cited 2019 Mar 12];52(18):1170–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29925502
13. Kujala UM, Jaakkola LH, Koskinen SK, Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy: The Journal of Arthroscopic & Related Surgery: Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Internet]. 1993;9(2):159–63. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8461073
14. Dammerer D, Liebensteiner MC, Kujala UM, Emmanuel K, Kopf S, Dirisamer F, et al. Validation of the German version of the Kujala score in patients with patellofemoral instability: a prospective multi-centre study. Archives of Orthopaedic and Trauma Surgery. 2018 Jan 25;138(4):527–35.
15. Bennell K, Bartam S, Crossley K, Green S. Outcome measures in patellofemoral pain syndrome: test retest reliability and inter-relationships. Physical Therapy in Sport. 2000 May;1(2):32–41.
16. Myer GD, Barber Foss KD, Gupta R, Hewett TE, Ittenbach RF. Analysis of patient-reported anterior knee pain scale: implications for scale development in children and adolescents. Knee Surgery, Sports Traumatology, Arthroscopy. 2014 Apr 30;24(3):653–60.
17. Mustamsir E, Phatama KY, Pratianto A, Pradana AS, Sukmajaya WP, Pandiangan RAH, et al. Validity and Reliability of the Indonesian Version of the Kujala Score for Patients With Patellofemoral Pain Syndrome. Orthopaedic Journal of Sports Medicine [Internet]. 2020 May 28;8(5). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7257862/
18. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing clinical research. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.
19. Sugiyono S. Metode Penelitian Kuantitatif, Kualitatif Dan R&D. Bandung: Alfabeta; 2013.
20. Hajjar STE. Statistical Analysis: Internal-Consistency Reliability and Construct Validity. International Journal of Quantitative and Qualitative Research Methods (IJQQRM). 2018;6(1):46–57.
21. Bobak CA, Barr PJ, O’Malley AJ. Estimation of an inter-rater intra-class correlation coefficient that overcomes common assumption violations in the assessment of health measurement scales. BMC Medical Research Methodology [Internet]. 2018 Sep 12;18(1). Available from: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-018-0550-6
22. Roush JR, Curtis Bay R. PREVALENCE OF ANTERIOR KNEE PAIN IN 18–35 YEAR-OLD FEMALES. International Journal of Sports Physical Therapy [Internet]. 2012 Aug 1;7(4):396–401. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414071/
23. Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR. The Effect of Foot Structure and Range of Motion on Musculoskeletal Overuse Injuries. The American Journal of Sports Medicine. 1999 Sep;27(5):585–93.
24. Negahban H, Pouretezad M, Yazdi MJS, Sohani SM, Mazaheri M, Salavati M, et al. Persian translation and validation of the Kujala Patellofemoral Scale in patients with patellofemoral pain syndrome. Disability and Rehabilitation. 2012 May 27;34(26):2259–63.
25. Iqbal M, Salam R, Hasanuddin I, Hassan AB. Body Segment Dimensions of Indonesian Male Army. IOP Conference Series: Materials Science and Engineering. 2020 Sep 1;931(1):012013–3.
26. Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. British Journal of Sports Medicine [Internet]. 2018 Sep 21;53(5):270–81. Available from: https://bjsm.bmj.com/content/53/5/270
27. Glaviano NR, Boling MC, Fraser JJ. Anterior Knee Pain Risk in Male and Female Military Tactical Athletes. Journal of Athletic Training. 2021 Mar 31;56(11).
28. Kuru T. Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthopaedica et Traumatologica Turcica. 2010;44(2):152–6.
29. Gil-Gámez J, Pecos-Martín D, Kujala UM, Martínez-Merinero P, Montañez-Aguilera FJ, Romero-Franco N, et al. Validation and cultural adaptation of “Kujala Score” in Spanish. Knee Surgery, Sports Traumatology, Arthroscopy. 2015 Feb 4;24(9):2845–53.
30. Mellinger S, Neurohr GA. Evidence based treatment options for common knee injuries in runners. Annals of Translational Medicine [Internet]. 2019 Oct;7(S7):S249–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829001/
31. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi Journal of Anaesthesia. 2017;11(5):80.
32. Kim Y, Youm C, Son M, Kim J, Lee M. The effect of knee flexor and extensor fatigue on shock absorption during cutting movements after a jump landing. The Knee. 2017 Dec;24(6):1342–9.
33. Louw Q, Grimmer K. Biomechanical factors associated with the risk of knee injury when landing from a jump. South African Journal of Sports Medicine. 2006 Feb 3;18(1):18.
34. Bosshardt L, Ray T, Sherman S. Non-operative Management of Anterior Knee Pain: Patient Education. Current Reviews in Musculoskeletal Medicine. 2021 Feb;14(1):76–81.
35. Neumann DA, Kelly ER, Kiefer CL, Martens K, Grosz CM. Kinesiology of the musculoskeletal system : foundations for rehabilitation. St. Louis, Missouri: Elsevier; 2017.
36. Willy RW, Meira EP. CURRENT CONCEPTS IN BIOMECHANICAL INTERVENTIONS FOR PATELLOFEMORAL PAIN. International Journal of Sports Physical Therapy [Internet]. 2016 Dec 1;11(6):877–90. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095941/
37. Sakunkaruna S, Sakunkaruna Y, Sakulsriprasert P. Thai Version of the Kujala Patellofemoral Questionnaire in Knee Pain Patients: Cross-Cultural Validation and Test-Retest Reliability. PubMed. 2015 Jun 1;98(Suppl 5):S81-5.
38. Papadopoulos C, Constantinou A, Cheimonidou AZ, Stasinopoulos D. Greek cultural adaption and validation of the Kujala anterior knee pain scale in patients with patellofemoral pain syndrome. Disability and Rehabilitation. 2016 Apr 6;39(7):704–8.