Self-Reported Foot and Ankle Score: Italian Translation, Validation and Cross-Cultural Adaptation

Background. Nowadays the use of measurement instruments that evaluate the patient’s condition is very common in the orthopedic field. We know that the most distal district of the lower limb, the osteoarticular complex of the ankle, is one of the most evaluated with rating scales; in fact, there are at least 76 different scoring systems for evaluating ankle problems. Furthermore, there is no measurement tool considered to be the abso­lute Gold Standard for evaluating problems affecting the ankle joint. Objectives. The main aim of this study was to translate, culturally adapt, and validate in Italian language the Self-Reported Foot and Ankle Score (SEFAS). Methods. The English version of the SEFAS has been translated according to interna­tional guidelines. The measurement properties (construct validity and reliability) have been tested according to COSMIN checklists. Cronbach’s alpha was calculated to assess the internal consistency and the Intraclass Correlation Coefficient (ICC) was calcu­lated to estimate the reliability. The Kaiser-Meier-Olkin (KMO), The Short-Form 36 (SF-36) and the EuroQol Health Questionnaire 5 Dimensions 5 Levels (EQ-5D-5L) were used to assess the construct validity and to verify sampling adequacy. A factorial analysis was used to confirm the mono-factorial nature of the scale. Results. All the items were similar in meaning to the originals. Cronbach’s alpha was 0,880 and the ICC was 0.869. The Pearson’s Correlation Coefficient showed significant correlations (p < 0.01) between SEFAS and SF-36 and EQ-5D-5L items. Conclusions. Based on the results obtained, we suggest the use of SEFAS in daily clin­ical practice, also promoting its continuation in the field of scientific research.