Italian translation, cultural adaptation and validation of the “American Orthopaedic Foot and Ankle Society’s (AOFAS) ankle-hindfoot scale”

Background and Aim of the work: Ankle and hindfoot injuries are common and may lead to functional impairment, disability, exclusion from occupational and daily activities. It’s necessary a standardized method for assessing treatment outcomes in people with same condition and disease. American-Orthopaedics- Foot-and-Ankle-Society’s-Ankle-Hindfoot-Evaluation-Scale (AOFAS-AHES) is specific to estimate clinical problems of the ankle-hindfoot. Outcome evaluation scales should be translated and culturally adapted into the language of the investigated patient. Our purpose was to translate and culturally adapt into Italian AOFAS-AHES, and to check its reproducibility and validity. Methods: An Italian translation of the AOFASscale was retranslated into English by a native English and compared to the original to define a second correct Italian-version, that was submitted to 50 randomized patients operated at their ankle or hindfoot with a minimum follow-up of 6 months for cultural adaptation, and to 10 healthcare professionals to check comprehension of the medical part. To check intra and inter-observer reproducibility each patient underwent 2 interviews by interviewer-A and 1 by B. ShortForm(SF)-36-questionnaire for quality of life and Visual-Analogue-Scale (VAS) for pain were also compared for validation. The Pearson’s-Correlation-Coefficient and the Intra-Class- Correlation coefficient were calculated to check inter and intra-observer reproducibility for validation. Results: Cultural adaptation revealed to be good. We obtained a good correlation of the inter and intra-observer reproducibility. Further validation of the Italian-AOFAS-AHES was obtained comparing AOFAS results to SF-36. Conclusions: Italian translation, cultural adaptation and validation of the AOFAS-AHES has been performed successfully and could be useful to improve assistance quality in care practice.