Brazilian version of the OSTRC Questionnaire on health problems (OSTRC-BR): translation, cross-cultural adaptation and measurement properties

Psychometric Properties of the Improved Report of Oslo Trauma Research Centre Questionnaires on Overuse Injuries (OSTRC-O2) and Health Problems (OSTRC-H2)

Background and Objectives: The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O2) and the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H2) scales are designed to objectively monitor various overuse or acute injuries of professional and non-professional athletes in association with other physical problems that relate to health spheres. The aim of this study was to validate these questionnaires in a population of professional and amateur Italian athletes and to analyze their psychometric properties, in order to verify that both scales have equivalent properties in different linguistic and cultural contexts. Materials and Methods: The Italian versions of the OSTRC-O2 (OSTRC-O2-IT) and the OSTRC-H2 (OSTRC-H2-IT) were administered to 102 professional and non-professional athletes over a period of 3 months, once a week, for each rating scale. The inclusion criteria were: age over 18 years, practicing a sports activity for at least 1 year and having had at least one injury. The internal consistency and reliability of both scales and their correlations with pain and quality of life scales have been analyzed. Results: The psychometric properties of the scales turned out to be very high and statistically significant for both scales proposed to the athletes. A Cronbach's Alpha of 0.946 and an ICC between 0.705 and 0.746 confirmed the good reliability of the questionnaires. Conclusions: The Italian versions of the OSTRC-O2-IT and OSTRC-H2-IT assessment scales are reliable and valid tools for the monitoring of overload injuries. This study shows that they are easy to understand for the Italian sports population and may be of help to the scientific community to increase precautionary control and prevention measures for overuse injuries in professional and amateur athletes, favoring a safer return to the field.

Prevalence and severity of injuries and illnesses among university handball players: A prospective cohort study

OBJECTIVES

To clarify the prevalence and severity of injuries and illnesses in university handball players.

DESIGN

Prospective cohort study.

SETTING

Survey-based online questionnaire.

PARTICIPANTS

231 university handball players (109 males and 122 females) over 38 weeks.

MAIN OUTCOME MEASURES

Each participant completed the Japanese version of the Oslo Sports Trauma Research Center Questionnaire on Health Problems every Sunday. The main outcome measures were the average weekly prevalence of injuries and illnesses, duration, average weekly severity scores rated on a scale of 0-100 based on answers to four key questions, and cumulative severity scores.

RESULTS

The average weekly prevalence was 27.4 % (95 % CI: 25.6-29.1 %) for injuries and 2.2 % (95 % CI: 1.6-2.8 %) for illnesses. Among injuries, traumatic injuries had higher average weekly severity scores (50.0 vs 32.0, p < 0.05) and cumulative severity scores per case (65.0 vs 42.0, p < 0.05) than overuse injuries. Conversely, overuse injuries lasted approximately 10 days longer than traumatic injuries (18 days vs 10 days, p < 0.05). Traumatic knee injuries and overuse shoulder injuries ranked the highest in prevalence, duration, and cumulative severity scores.

CONCLUSIONS

We found that, although overuse injuries were less severe than traumatic injuries, they interfered with handball activities for extended periods.

Associations between subjective and objective measures of stress and load: an insight from 45-week prospective study in 189 elite athletes

Introduction

The aim of this study was to investigate the associations between subjective and objective measures of stress and load in elite male handball players at both the group and individual levels.

Methods

In this 45-week prospective cohort study, 189 elite male handball players weekly reported their perceived stress and load across training, competition, academic, and work domains. Blood samples were collected five times during the 2022/23 season to measure cortisol and the free testosterone to cortisol ratio (FTCR). We derived a "load" variable as the sum of training, competition, academic and work hours and calculated acute, chronic, and acute-to-chronic ratio variables for both load and stress. Associations between subjective and objective measures were analyzed using Spearman's rank correlation.

Results

Weak to moderate positive associations were found between load and perceived stress (r = 0.19 to 0.46, p < 0.001), and between perceived stress and cortisol (r = 0.10, p = 0.023). Weak negative associations were found between perceived stress and FTCR (r = -0.18 to -0.20, p < 0.001) and between load and FTCR (r = -0.13, p = 0.003). A total of 86% of athletes had positive associations between stress and load (47% weak, 34% moderate, 5% high); 78% between stress and cortisol (27% weak, 22% moderate, 29% high); and 63% demonstrated negative associations between FTCR and load (18% weak, 32% moderate, 13% high).

Conclusion

This study highlights the complexity between subjective and objective measures of stress and load in athletes. Understanding the link between these measures may help coaches and sports scientists streamline athlete monitoring. In cases where moderate to strong associations exist, subjective measures might serve as a reliable substitute for objective ones, making the monitoring process more time- and cost-efficient.

Chinese Translation and Validation of the Oslo Sports Trauma Research Center Questionnaires on Overuse Injuries and Health Problems

Background

The importance of monitoring both physical and mental health in athletes across different levels of sport is increasingly acknowledged due to potential injury risks. However, for the Chinese-speaking population, there has not yet been an appropriate assessment tool available.

Purpose

To translate, culturally adapt, and assess the validity and reliability of the Chinese versions of the updated Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2) and the Health Problems Questionnaire (OSTRC-H2) among Taiwanese collegiate athletes.

Study Design

Cohort study (diagnosis); Level of evidence: 3.

Methods

The OSTRC-O2 and OSTRC-H2 questionnaires were translated from English to Chinese following international guidelines. Subsequently, 80 and 84 collegiate athletes, respectively, were invited to complete these questionnaires on a weekly basis for 8 weeks. Internal consistency was evaluated using Cronbach alpha coefficient, while test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Severity scores from the questionnaires were also documented.

Results

High response rates of 90% (n = 72/80) and 90.5% (n = 76/84) were achieved in the OSTRC-O2.CH and OSTRC-H2.CH groups, respectively, demonstrating strong acceptance among athletes, with no significant issues in back-translation. High content validity was observed across the different body parts in the translated OSTRC-O2, with Cronbach alpha values of .82, .83, .82, and .83 for the knee, shoulder, elbow, and lower back, respectively. The translated OSTRC-H2 also showed excellent internal consistency, with a Cronbach alpha of .95. The ICC values for test-retest reliability were 0.88, 0.82, 0.92, and 0.92 for the knee, shoulder, elbow, and lower back in the OSTRC-O2, and the ICC for the OSTRC-H2 was 0.90, indicating very good reliability for both questionnaires.

Conclusion

The Chinese versions of the OSTRC questionnaires were found to be valid and reliable for monitoring overuse injuries and health issues among Chinese-speaking collegiate athletes.

Slovenian Translation, Cross-Cultural Adaptation, and Content Validation of the Updated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2)

Background

The updated Oslo Sports Trauma Research Questionnaire on Health Problems (OSTRC-H2) has been translated into a limited set of languages and lacks full validation of its new measures.

Purpose

To (1) translate, cross-culturally adapt, and evaluate the measurement properties of the OSTRC-H2 for the Slovenian population and (2) investigate the construct validity for the severity score and time lost due to a health problem.

Study Design

Cohort study (diagnosis); Level of evidence, 3.

Methods

The OSTRC-H2 was translated from English to Slovenian (OSTRC-H2-SLO) according to international guidelines. A 15-week study was conducted among 188 elite athletes, with a test-retest performed in the 10th week. Internal consistency, reliability, content validity, feasibility, and potential ceiling effects were investigated. Internal consistency was measured using the Cronbach alpha coefficient, while reliability was measured with the intraclass correlation coefficient (ICC). Construct validity was measured with the Spearman rank correlation coefficient (r S).

Results

There was a 95% response rate and an 18% mean weekly prevalence of health problems. The OSTRC-H2-SLO showed excellent test-retest reliability (ICC, 0.94 [95% CI, 0.67-0.99]), with a Cronbach α of .93. A strong positive correlation was found between the OSTRC-H2-SLO severity score and days lost due to an acute injury (r S = 0.754), overuse injury (r S = 0.785), and illness (r S = 0.894) (P < .001 for all). Moderate to strong negative correlations were observed between severity score and total load (training and competition load in hours) as well as between days lost and total load (P < .001 for all).

Conclusion

The OSTRC-H2-SLO was found to be valid, reliable, and well accepted among Slovenian athletes. The authors confirmed the questionnaire's construct validity and identified total load as an indicator of an increase in the severity score.

Registration

NCT05471297 (ClinicalTrials.gov identifier).

Malay Translation and Validation of the Oslo Sports Trauma Research Center Questionnaire on Health Problems

Background

The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H) is a proven surveillance method to register acute injury, overuse injury, or illness in athletes. However, it has not yet been translated into Malay.

Purpose

To translate, culturally adapt, and validate the OSTRC-H into Malay using internationally established guidelines.

Study Design

Cohort study (diagnosis); Level of evidence, 3.

Methods

The Malay translation of the OSTRC-H (OSTRC-H.M) was distributed to 54 elite (ie, professional) and recreational athletes. Face validity, content validity, and construct validity were assessed for the validity measurement properties, while test-retest and internal consistency were used for reliability measurement properties.

Results

The content validity index was satisfactory at 0.93. The OSTRC-H.M showed good internal consistency, with a Cronbach α value of .84. Confirmatory factor analysis showed a good model for construct validity, with values of 0.99 and 0.04 for comparative fit index and root mean square error of approximation, respectively. Per-item intraclass correlation coefficients (ICCs) for test-retest reliability ranged from 0.55 to 0.80. The overall test-retest reliability of the questionnaire was good (ICC, 0.8; 95% CI, 0.63-0.88; P < .001).

Conclusion

The OSTRC-H.M was found to be valid and reliable and therefore acceptable for application among Malay-speaking athletes.

Prevalence and incidence of health problems and their characteristics in Brazilian para athletes: A one-season single-center prospective pilot study

BACKGROUND

Para athletes experience high prevalence and incidence of health problems related to sport. Despite this, there are few longitudinal studies.

OBJECTIVE

To describe the characteristics, prevalence, incidence, and severity of health problems in para athletes from one of the Brazilian Paralympic Reference Centers during a sports season and to compare the prevalence of health problems between para athletics, para powerlifting, and para swimming.

METHODS

This prospective pilot study was conducted from October 2019 to March 2020. The Oslo Sports Trauma Research Center Questionnaire on Health Problems was used to record injuries and illnesses every week for 24 weeks. The characteristics, prevalence, incidence, and severity of health problems were described for each modality. The prevalence of health problems was compared among the three sport modalities.

RESULTS

Thirty-five para athletes participated. Most of the injuries occurred in the shoulder, and most illnesses caused respiratory and gastrointestinal symptoms. The average weekly prevalence and the incidence rate of health problems were 40.6% (95% CI 17.0-64.4) and 12.7 (95% CI 9.6-15.9) per 1000 athlete hours, respectively. Para powerlifting had the highest prevalence of all and substantial health problems; para swimming had the lowest prevalence of injuries; and para athletics had the lowest prevalence of illnesses.

CONCLUSIONS

This group of Brazilian para athletes showed a high prevalence and incidence of health problems throughout the season. Para athletics, para powerlifting, and para swimming each had a different prevalence of injuries and illnesses.

Spanish Cross-Cultural Adaptation and Validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in Handball Players

OBJECTIVES

The aim of this study was the cultural adaptation, Spanish translation and validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in an adult population.

DESIGN

In this study, a cross-sectional design was used.

METHODS

This study was divided into two phases: (1) cross-cultural adaptation of the original version of the OSTRC to a Spanish version (OSTRC-Sp) and (2) analysis of the psychometric properties of the OSTRC-Sp. A total of 427 handball players of both sexes and over 18 years of age participated in the study.

RESULTS

The translated version of the questionnaire showed a very high internal consistency (Cronbach's α = 0.954), while the subscales showed an internal consistency between 0.832 and 0.961, with the endmost values being for shoulder and low back pain, respectively. On the other hand, when analysing item responses, the OSTRC-Sp showed ICC values ranging from 0.844 to 0.956, the former being for the first back question (back_1), and the latter for the fourth shoulder question (shoulder_4), in line with most published versions.

CONCLUSION

The Spanish version of the OSTRC is a reliable and valid tool that can be used by researchers and clinicians in a Spanish-speaking population with musculoskeletal disorders.