Measurement properties of UCLA Activity Scale for hip and knee arthroplasty patients and translation and cultural adaptation into Danish

Anne Mørup- Petersen; Søren T Skou; Christina E  Holm; Pætur M Holm; Claus Varnum; Michael R Krogsgaard; Mogens Laursen; Anders Odgaard

doi:10.1080/17453674.2021.1977533

Authors

Anne Mørup- Petersen Department of Orthopedic Surgery, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen
Søren T Skou Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense; Research unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand
Christina E Holm Department of Orthopedic Surgery, Copenhagen University Hospital, Rigshospitalet
Pætur M Holm Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense; Research unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand
Claus Varnum Department of Orthopedic Surgery, Lillebaelt Hospital—Vejle, University Hospital of Southern Denmark; Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark
Michael R Krogsgaard Section for Sports Traumatology, Bispebjerg and Frederiksberg Hospital, Copenhagen, University of Copenhagen
Mogens Laursen Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg & Farsø
Anders Odgaard Department of Orthopedic Surgery, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen; Department of Orthopaedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

DOI:

https://doi.org/10.1080/17453674.2021.1977533

Abstract

Background and purpose — The UCLA Activity Scale (UCLA) is a questionnaire assessing physical activity level from 1 (low) to 10 (high) in patients undergoing hip or knee arthroplasty (HA/KA). After translation and cultural adaptation, we evaluated the measurement properties of the Danish UCLA.

Patients and methods — After dual panel transla- tion, cognitive interviews were performed among 55 HA/ KA patients. An orthopedic surgeon and a physiotherapist estimated UCLA scores for 80 KA patients based on short interviews. Measurement properties were evaluated in 130 HA and 134 KA patients preoperatively and 1-year postop- eratively.

Results — To suit Danish patients of today, several adaptations were required. Prior to interviews, 4 patients were excluded, and 11 misinterpreted the answer options. Examiners rated the remaining 65 patients (mean age 67 years) 0.2–1.6 UCLA levels lower than patients themselves. The 130 HA and 134 KA patients (mean age 71/68 years) changed from 4.3 (SD 1.9)/4.5 (1.8) preoperatively to 6.6 (1.8)/6.2 (1.0) at 1-year follow-up. 103 (79%) HA and 89 (66%) KA patients reported increased activity. Effect sizes were large (1.2/0.96). Knee patients reaching minimal important change (MIC, ≥ 8 Oxford Knee Score points) had higher 1-year UCLA scores than patients not reaching MIC.

Interpretation — Original scale development was undoc- umented. Content validity was questionable, and there was discrepancy between patient and examiner estimates. UCLA appears valuable for measuring change in self-reported phys- ical activity on a group level. 4 out of 5 HA patients and 2 out of 3 KA patients were more physically active 1 year after joint replacement surgery.