Development and validation of a questionnaire to evaluate the return to preinjury level in non-athletic individuals following Anterior Cruciate Ligament Reconstruction among Indian population

The study aims to help develop and validate a new questionnaire to evaluate the return to pre-injury level in non-athletes following ACL reconstruction surgery. The study is indicated for the reason that, despite having numerous scales and scoring systems to study return to sports, none of the questionnaires shed any light on non-sports-related activities of daily living or occupational activities. Most studies are inspired by and benefit high-demand patients (sportspersons).

Moreover, cultural and social factors greatly influence the recovery of patients and also affect activities of daily living (ADLs). Indian patients, who are in the habit of sitting cross-legged and squatting, will be fearful to do so post-operatively, but these factors are not taken into account in the pre-existing questionnaires.

After IEC approval, the study will proceed with expert validation involving approximately 10 orthopedicians, physiatrists, and physiotherapists, who will assess the questionnaire items for representativeness, clarity, relevance, and distribution using established quantitative indices, such as the Content Validity Ratio and Content Validity Index. Following this, cognitive interviews with approximately 10 participants will be conducted to ensure that the items are interpreted as intended and to validate the response process. The refined questionnaire will then be pilot tested with 75 patients, each at least one year post-ACL reconstruction, to evaluate its practicality and gather user feedback. Finally, data from the pilot will undergo exploratory and confirmatory factor analyses to determine the questionnaire’s structural validity, and reliability will be assessed using Cronbach’s alpha to ensure internal consistency of the scale.