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Cross Cultural Adaptation of the TENDINopathy Severity Assessment - Achilles (TENDINS-A) for Spanish speaking populations
Journal article   Peer reviewed

Cross Cultural Adaptation of the TENDINopathy Severity Assessment - Achilles (TENDINS-A) for Spanish speaking populations

Timothy R. Fleagle, Elizabeth G. Castillo, Zahra Amerian, Igor Sancho, Alberto Marcos Heredia Rizo, Nicolas Maragano-Campisto, Guillermo Ceniza-Bordallo, Diego Ruffino, Jessica F. Danielson, Shane C. Scott, …
Musculoskeletal science & practice, Vol.85, 103625
07/24/2026
DOI: 10.1016/j.msksp.2026.103625
PMID: 42526178

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Abstract

The TENDINopathy Severity assessment – Achilles (TENDINS-A) was developed as a patient-reported outcome measure of Achilles tendinopathy related disability but is limited to the English language. The objective of this study was to cross-culturally adapt the TENDINS-A to be used in Spanish speaking populations and assess its measurement properties. The TENDINS-A was cross-culturally adapted using a multistep process then administered online to individuals with Achilles tendinopathy, non-Achilles tendinopathy foot pain, and pain-free controls. Test-retest reliability of the TENDINS-A Spanish was determined using inter-class coefficients (ICC). Internal consistency and structural validity were assessed using Rasch analysis. Discriminate validity was measured comparing the TENDINS-A Spanish scores between the three groups. Convergent validity was assessed using correlations between the TENDINS-A, heel raise pain, and Victorian Institute of Sport Assessment-Achilles (VISA-A). The TENDINS-A Spanish Total score demonstrated excellent test re-test reliability (ICC(95%CI): 0.932(0.897 to 0.955) and excellent internal consistency (person reliability=0.89). There was evidence of structural validity of the TENDINS-A Spanish for a 3-factor structure (First contrast from PCA of residuals has Eigenvalue <2). TENDINS-A Spanish Total scores were higher in individuals with Achilles tendinopathy compared to those with non-Achilles tendinopathy foot pain (Mean Dif (95%CI): 19.8%(6.5% to 33.0%) and pain-free controls (46.7%(32.8% to 60.6%). The TENDINS-A Spanish showed convergent validity (r (95%CI)) with moderate to strong correlations with heel raise pain (0.86(0.79 to 0.91), and VISA-A Spanish (-0.64(-0.49 to -0.74) The TENDINS-A Spanish is a reliable and valid measure for Achilles tendinopathy related disability in Spanish speaking populations. •TENDINS-A Spanish total score and each subscore show adequate reliability.•TENDINS-A Spanish has acceptable construct validity retaining a 3-factor structure.•TENDINS-A Spanish measures Achilles tendinopathy disability in Spanish speakers
Achilles tendon Psychometrics Reliability Tendinitis Validity VISA-A

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