Prospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2018; 9(1): 1-6
Published online Jan 18, 2018. doi: 10.5312/wjo.v9.i1.1
Dutch version of the Victorian Institute of Sports Assessment-Achilles questionnaire for Achilles tendinopathy: Reliability, validity and applicability to non-athletes
Inger Sierevelt, Maayke van Sterkenburg, Hans Tol, Bella van Dalen, Niek van Dijk, Daniel Haverkamp
Inger Sierevelt, Daniel Haverkamp, Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam 1066 EC, The Netherlands
Maayke van Sterkenburg, Niek van Dijk, Department of Orthopedic Surgery, Academic Medical Center, Amsterdam 1105 AZ, The Netherlands
Hans Tol, Academic Center for Evidence Based Sports Medicine, Academic Medical Center Amsterdam, Amsterdam 1105 AZ, The Netherlands
Bella van Dalen, Bergmanclinics te Naarden, Naarden 1411 GE, The Netherlands
Author contributions: All the authors contributed to this manuscript.
Institutional review board statement: The local accredited ethics committee (Dutch acronym: METC) reviewed this study in an expedited manner and determined, based on the Dutch Medical Research Involving Human Subjects Act (Dutch acronym: WMO), that the research activities described meet the requirements for exemption from METC review under the WMO.
Informed consent statement: All patients received a patient information brochure.
Conflict-of-interest statement: The authors do not report a conflict of interest.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Daniel Haverkamp, MD, PhD, Department of Orthopaedic Surgery, Slotervaart Hospital, Louwesweg 6, Amsterdam 1066 EC, The Netherlands.
Telephone: +31-6-45628276
Received: January 24, 2017
Peer-review started: February 2, 2017
First decision: June 26, 2017
Revised: November 30, 2017
Accepted: December 1, 2017
Article in press: December 1, 2017
Published online: January 18, 2018

Achilles tendinopathy is a major cause of chronic pain and disability. Many studies have been published on a multitude of treatments for Achilles tendinopathy, but prospective series on the outcome are lacking. The Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire was created in 2001 to assess clinical severity for patients with Achilles tendinopathy. It is a self-administered questionnaire evaluating symptoms and their effect on physical activity, and displayed reliability and construct validity.

Research frontiers

The VISA-A has been translated into Swedish, Italian, and German and proved to be able to determine the clinical severity and provide information about the effect of the management of patients with Achilles tendinopathy who speak these languages.

Innovations and breakthroughs

This work translated the VISA-A questionnaire into the Dutch language (VISA-A-NL), assessed its validity and reliability, and provided a valid questionnaire for the Dutch population. The questionnaire seems to be designed only for athletes as 40% of the points account for activity. As approximately 30% of patients with complaints of Achilles tendinopathy have a sedentary lifestyle, applicability to non-athletes was also evaluated.


Psychometric properties of the VISA-A-NL, without questions 7 and 8, are satisfactory for both athletes and non-athletes. It is therefore proposed that the modified VISA-A-NL questionnaire is considered for a mixed population of patients with Achilles tendinopathy.