Turkish Validity and Reliability of the Marx Activity Rating Scale (MARS) for Patients with Knee Problems

Year 2024, Volume: 13 Issue: 1, 60 - 66, 20.03.2024

Elif Tuğçe Çil , Ebru Akbuğa Koç , Yağmur Barlas , Helin Su Arkun , Gülce Şevval Bağcıbaşı , Gökhan Meriç

https://doi.org/10.53424/balikesirsbd.1354175

Abstract

Objective: The Marx Activity Rating Scale (MARS) is a recently developed in English to assess patients’ who have knee problems activity level. However, there is no Turkish validation for it. Materials and Methods: MARS was translated into Turkish language according to the recommended stages by Beaton et al. 100 Patients (mean age, 30.9 ± 10.5) with various types of the knee problems were included. Each participant completed the MARS twice at fourteen day intervals to determine the test-retest reliability using the interrater correlation coefficient and Cronbach's alpha evaluating internal-consistency. Spearman's “rank correlation” coefficient was done to measure construct validity between the MARS, the EUROQoL General Quality of Life Scale (EQ-5D), the International Knee Documentation Committee (IKDC) Scale. Results: A total of 100 patients (37 females, 63 males) completed the Turkish-language MARS. The reliability of the test-retest was 0.9, with Cronbach's alpha of 0.8 at the initial and 0.7 for the retest. High correlations were found between the IKDC and MARS (r =0.2). MARS also strongly correlated with the EQ5D-VAS component score (r =0.2). Floor or ceiling effects were not found for the overall MARS score. Conclusion: In conclusion, the MARS was found to be valid and reliable. It is considered to be a preferable scale for patients with knee problems.

Keywords

Validity and Reliability, Knee, Activity, Daily Living, MARS

Ethical Statement

The study was approved by the ethical committee at the Faculty of Health Sciences of Marmara University. (IRB study protocol:118).

Supporting Institution

yok

Thanks

yok

References

• Aicale, R., Tarantino, D., & Maffulli, N. (2018). Overuse injuries in sport: a comprehensive overview. Journal of orthopaedic surgery and research, 13(1), 1-11. https://doi.org/10.1186/s13018-018-1017-5
• Balestroni, G., & Bertolotti, G. (2012). EuroQol-5D (EQ-5D): an instrument for measuring quality of life. Monaldi Archives for Chest Disease, 78(3). https://doi.org/10.4081/monaldi.2012.121
• Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191.
• Cameron, K. L., Peck, K. Y., Thompson, B. S., Svoboda, S. J., Owens, B. D., & Marshall, S. W. (2015). Reference values for the Marx Activity Rating Scale in a young athletic population: history of knee ligament injury is associated with higher scores. Sports Health, 7(5), 403-408. https://doi.org/10.1177/1941738115576121
• Celik, D., Coşkunsu, D., & Kılıçoğlu, Ö. (2013). Translation and cultural adaptation of the Turkish Lysholm knee scale: ease of use, validity, and reliability. Clinical Orthopaedics and Related Research, 471, 2602-2610. https://doi.org/10.1007/s11999-013-3046-z
• Çelik, D., Coşkunsu, D., Kılıçoğlu, Ö., Ergönül, Ö., & Irrgang, J. J. (2014). Translation and cross-cultural adaptation of the international knee documentation committee subjective knee form into Turkish. Journal of orthopaedic & sports physical therapy, 44(11), 899-909. https://www.jospt.org/doi/10.2519/jospt.2014.4865
• da Silva, M. V., & Pereira, B. (2017). Biomechanics of Lower Limb Injuries. In J. Espregueira-Mendes, C. Niek van Dijk, P. Neyret, M. Cohen, S.D. Villa, H. Pereira, J.M. Oliveira. (Eds.) Injuries and Health Problems in Football: What Everyone Should Know (pp. 53-64). Springer Nature.
• Flosadottir, V., Roos, E. M., & Ageberg, E. (2017). Translation, cross-cultural adaptation, and validation of the activity rating scale for disorders of the knee. Orthopaedic Journal of Sports Medicine, 5(9), 2325967117729361. https://doi.org/10.1177/2325967117729361
• Greco, N. J., Anderson, A. F., Mann, B. J., Cole, B. J., Farr, J., Nissen, C. W., & Irrgang, J. J. (2010). Responsiveness of the International Knee Documentation Committee subjective knee form in comparison to the Western Ontario and McMaster Universities Osteoarthritis Index, modified Cincinnati Knee Rating System, and Short Form 36 in patients with focal articular cartilage defects. The American journal of sports medicine, 38(5), 891-902. https://doi.org/10.1177/0363546509354163
• Hopper, M. A., & Grainger, A. J. (2010). Knee injuries. In P. Robinson (Ed.), Essential Radiology for Sports Medicine, (pp. 1-28). Springer Nature.
• Kahyaoğlu Süt, H., & Ünsar, S. (2011). Is EQ-5D a valid quality of life instrument in patients with acute coronary syndrome? Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi, 11(2). https://doi.org/10.5152/akd.2011.037
• Kanakamedala, A. C., Anderson, A. F., & Irrgang, J. J. (2016). IKDC Subjective Knee Form and Marx Activity Rating Scale are suitable to evaluate all orthopaedic sports medicine knee conditions: a systematic review. Journal of ISAKOS, 1(1), 25-31. https://doi.org/10.1136/jisakos-2015-000014
• Koh, J. L., Parikh, S., Stein, B. S., & JUPITER Group. (2019). Conducting a multicenter trial: learning from the JUPITER (Justifying Patellar Instability Treatment by Early Results) experience. In V. Musahl, J. Karlsson, M.T. Hirschmann, O.R. Ayeni, · R.G. Marx, J. L. Koh, N. Nakamura (Eds.), Basic methods handbook for clinical orthopaedic research: A practical guide and case based research approach, (pp. 415-425). Springer Nature.
• Kuru, T., Dereli, E. E., & Yaliman, A. (2010). Validity of the Turkish version of the Kujala patellofemoral score in patellofemoral pain syndrome. Acta Orthopaedica et Traumatologica Turcica, 44(2), 152-6. https://doi.org/10.3944/AOTT.2010.2252
• Lindanger, L., Strand, T., Mølster, A. O., Solheim, E., & Inderhaug, E. (2019). Return to play and long-term participation in pivoting sports after anterior cruciate ligament reconstruction. The American journal of sports medicine, 47(14), 3339-3346. https://doi.org/10.1177/0363546519878159
• Lysholm, J., & Tegner, Y. (2007). Knee injury rating scales. Acta orthopaedica, 78(4), 445-453. https://doi.org/10.1080/17453670710014068
• Marx, R. G. (2003). Knee rating scales. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 19(10), 1103-1108. https://doi.org/10.1016/j.arthro.2003.10.029
• Marx, R. G., Stump, T. J., Jones, E. C., Wickiewicz, T. L., & Warren, R. F. (2001). Development and evaluation of an activity rating scale for disorders of the knee. The American journal of sports medicine, 29(2), 213-218. https://doi.org/10.1177/03635465010290021601
• Mokkink, L. B., Terwee, C. B., Knol, D. L., Stratford, P. W., Alonso, J., Patrick, D. L., et al. (2010). The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC medical research methodology, 10(1), 1-8. https://doi.org/10.1186/1471-2288-10-22
• Negahban, H., Mostafaee, N., Sohani, S. M., Mazaheri, M., Goharpey, S., Salavati, M., et al. (2011). Reliability and validity of the Tegner and Marx activity rating scales in Iranian patients with anterior cruciate ligament injury. Disability and rehabilitation, 33(22-23), 2305-2310. https://doi.org/10.3109/09638288.2011.570409
• Nishitani, K., Nakamura, S., & Kuriyama, S. (2023). Clinical evaluation of knee joint diseases. Journal of Joint Surgery and Research, 1(1), 9-17. https://doi.org/10.1016/j.jjoisr.2022.12.003
• Patel, D. R., & Villalobos, A. (2017). Evaluation and management of knee pain in young athletes: overuse injuries of the knee. Translational Pediatrics, 6(3), 190. https://doi.org/10.21037/tp.2017.04.05
• Suciu, O., Prejbeanu, R., Haragus, H., Faur, C., Onofrei, R. R., & Todor, A. (2020). Cross-cultural adaptation and validation of the Romanian Marx activity rating scale for anterior cruciate ligament reconstruction. In Healthcare, 8(3), 318. https://doi.org/10.3390/healthcare8030318
• Timpka, T., Alonso, J. M., Jacobsson, J., Junge, A., Branco, P., Clarsen, B., et al. (2014). Injury and illness definitions and data collection procedures for use in epidemiological studies in Athletics (track and field): consensus statement. British journal of sports medicine, 48(7), 483-490. http://dx.doi.org/10.1136/bjsports-2013-093241
• Webster, K. E., & Hewett, T. E. (2019). What is the evidence for and validity of return-to-sport testing after anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis. Sports Medicine, 49, 917-929. https://doi.org/10.1007/s40279-019-01093-x
• Whittaker, J. L., Toomey, C. M., Nettel-Aguirre, A., Jaremko, J. L., Doyle-Baker, P. K., Woodhouse, L. J., et al. (2019). Health-related Outcomes after a Youth Sport-related Knee Injury. Medicine and science in sports and exercise, 51(2), 255-263. https://doi.org/10.1249/mss.0000000000001787
• Zelle, B. A., Herzka, A. S., Harner, C. D., & Irrgang, J. J. (2005). Evaluation of clinical outcomes in anterior cruciate ligament surgery. Operative Techniques in Orthopaedics, 15(1), 76-84. https://doi.org/10.1053/j.oto.2004.11.013