VISA-P Questionnaire

The Victorian Institute of Sport Assessment (VISA-) Patella (P) Questionnaire is a self-report clinical outcome measure used in patients with Patellar Tendinopathy. It consists of eight questions that measure the domains of pain, function in daily living, and sports activities (Visentini et al. 1998).

Validity and Reliability

The VISA-P questionnaire is a tool used to assess the severity of symptoms and treatment effects in athletes with patellar tendinopathy.

The psychometric properties of the questionnaire have been evaluated in various studies. The validity and reliability of the questionnaire have been determined in different languages and cultures. For example, the Korean version of the VISA-P questionnaire was found to be reliable and valid in assessing patellar tendinopathy in adolescent elite volleyball athletes (Park et al. 2013). The Turkish version of the questionnaire was also found to be valid and reliable (Çelebi et al. 2016). The Kannada version of the questionnaire was found to be reliable and valid in assessing pain and athletes’ ability to participate in sports (Acharya et al. 2019).

Additionally, the Spanish version of the questionnaire was also found to be valid and reliable in assessing knee function and activity level when comparing scores to other PROMS such as the Kujala score and SF-36 (Hernandez-Sanchez et al. 2011). The Arabic version of the questionnaire was also validated and found to be reliable and valid (Alshabanat et al. 2022). The translated Dutch version of the VISA-P questionnaire showed satisfactory test-retest reliability and is a valid score to evaluate symptoms, knee function and ability to play sports of Dutch athletes with patellar tendinopathy (Zwerver et al. 2009).

However, a recent systematic review evaluating the content and structural validity evidence of the VISA questionnaires showed very-low-quality evidence for their content and structural validity (Korakakis et al. 2021).

Furthermore, a recent reliability generalization meta-analysis claims that greater evaluation with more scientific evidence is required before it can be implemented in clinical practice (Palazón-Bru et al. 2021).

Scoring and Interpretation

• Questions 1-6 receive a VAS rating of 0 to 10. (10 is optimal health)
• The 4 categories on question 7 can be scored as 0, 4, 7, or 10.
• Question 8 is graded according to how long the patient can train in spite of their current level of pain.

The maximum score for an asymptomatic person is 100; theoretically, the smallest score is 0.

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References

Visentini PJ, Khan KM, Cook JL, Kiss ZS, Harcourt PR, Wark JD. The VISA score: an index of severity of symptoms in patients with jumper’s knee (patellar tendinosis). Victorian Institute of Sport Tendon Study Group. J Sci Med Sport. 1998;1(1):22-28. doi:10.1016/s1440-2440(98)80005-4

Çelebi MM, Köse SK, Akkaya Z, Zergeroglu AM. Cross-cultural adaptation of VISA-P score for patellar tendinopathy in Turkish population. Springerplus. 2016;5(1):1453. Published 2016 Aug 30. doi:10.1186/s40064-016-3100-x

Park BH, Seo JH, Ko MH, Park SH. Reliability and Validity of the Korean Version VISA-P Questionnaire for Patellar Tendinopathy in Adolescent Elite Volleyball Athletes. Ann Rehabil Med. 2013;37(5):698-705. doi:10.5535/arm.2013.37.5.698

Acharya GU, Kumar A, Rajasekar S, Samuel AJ. Reliability and validity of Kannada version of Victorian Institute of Sports Assessment for patellar tendinopathy (VISA-P-K) questionnaire. J Clin Orthop Trauma. 2019;10(Suppl 1):S189-S192. doi:10.1016/j.jcot.2018.08.017

Hernandez-Sanchez S, Hidalgo MD, Gomez A. Cross-cultural adaptation of VISA-P score for patellar tendinopathy in Spanish population. J Orthop Sports Phys Ther. 2011;41(8):581-591. doi:10.2519/jospt.2011.3613

Alshabanat AS, Alshewaier SA, Alotaibi RM, Alkathiry AA. Arabic Translation and Cross-Cultural Adaptation of the Victorian Institute of Sport Assessment Questionnaire for Patellar Tendinopathy. Orthop J Sports Med. 2022;10(11):23259671221134791. Published 2022 Nov 28. doi:10.1177/23259671221134791

Palazón-Bru A, Tomás Rodríguez MI, Mares-García E, Hernández-Sánchez S, Carbonell-Torregrosa MÁ, Gil-Guillén VF. The Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P): A Reliability Generalization Meta-analysis. Clin J Sport Med. 2021;31(5):455-464. doi:10.1097/JSM.0000000000000810

Zwerver J, Kramer T, van den Akker-Scheek I. Validity and reliability of the Dutch translation of the VISA-P questionnaire for patellar tendinopathy. BMC Musculoskelet Disord. 2009;10:102. Published 2009 Aug 11. doi:10.1186/1471-2474-10-102

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