Date Published: April 15, 2019
Publisher: Public Library of Science
Author(s): Yasuharu Nagano, Keisuke Kobayashi-Yamakawa, Ayako Higashihara, Hiroko Yako-Suketomo, Dalton Müller Pessôa Filho.
The purpose of the present study was to translate and modify the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire into Japanese and validate it among Japanese athletes through a longitudinal survey. A modified back-translation method was used to translate the questionnaire from English to Japanese. The longitudinal survey was performed in 29 female college swimmers who were followed up for more than 24 consecutive weeks. The response rate to the 24 weekly questionnaires was 88.8% (95% confidence interval [CI]: 85.2–92.3). Internal consistency was measured by using Cronbach’s alpha (0.73 (0.69–0.77)). The anatomical areas most frequently affected by overuse injuries were the lower back (average weekly prevalence: 27.6%, 95% CI: 25.1–30.1), shoulder (16.0%, 95% CI: 13.7–18.2), knee (9.9%, 95% CI: 7.7–12.0), and ankle (9.0%, 7.6–10.5). The severity score showed that knee (22.5, range: 6–65), ankle (21.5, range: 6–67), and lower back (20.7, range: 6–80) injuries had the greatest impact. The Japanese version of the modified OSTRC overuse injury questionnaire demonstrated reliability and validity based on the results of internal consistency and trend of injury of the swimmers. The participants in the present study did not have substantial injuries or time-loss injuries and continued practicing and competing, despite these minor injuries. Although knee and ankle injuries do not occur as often as lower back and shoulder injuries, these injuries often had a greater impact on swimmers when they did occur.
Recently, injury surveillance has been conducted to better understand sporting injury incidence during activities and to examine prevention methods. However, the results of these injury incidences have changed greatly according to the definition of injury. There are three different definitions of injury: ‘any physical complaint’, ‘medical attention injury’, and ‘time-loss injury’.[1, 2] The definition of injury will influence the rates of injury that are reported in studies because players will not always seek medical attention for physical complaints, and even fewer athletes will experience time-loss injuries. The ‘time-loss’ injury is the definition most frequently used  and is suitable for many sports in which acute injuries lead to time loss during games and practice. However, in some sports such as swimming, which require endurance or technical skill, a time-loss injury is rare and therefore the ‘time-loss’ definition is not appropriate. For example, Yang et al. reported the epidemiology of overuse and acute injuries among college athletes according to the ‘time-loss’ definition. Female swimmers demonstrated a comparable rate when overuse and acute injuries were evaluated (9.7/10000 AEs and 8.5/10000 AEs, respectively). Kerr et al. reported the epidemiology of injuries in college athletes in swimming according to the ‘medical attention’ definition. Female swimmer overuse injuries (63.7%) were shown to be higher than that of the other types of injuries. If the definition of ‘any physical complaint’ is applied, the number and rate of overuse injuries are likely to be higher. However, these data according to the definition of ‘any physical complaint’ have not been reported. Additionally, overuse injuries generally occur gradually, whereas acute injuries occur suddenly thereby directly influencing performance or participation. Therefore, detecting overuse injury in the early stages is important to prevent worsening of the condition and “time-loss” injury.
The first purpose of the present study was to translate and modify the OSTRC overuse injury questionnaire that was designed to examine overuse injuries related to sporting activities, into the Japanese language. There is currently no questionnaire in the Japanese language that can be used to survey overuse injuries based on the ‘any physical complaint’ definition. We translated the original OSTRC overuse injury questionnaire from English into Japanese using a back-translation process and completed the translation process after an expert committee meeting. We changed the method of reporting the anatomical area of injury, according to the expert committee’s suggestion. Therefore, the questionnaire of the present study was different from the original version of OSTRC questionnaire of overuse injuries, which examines the occurrence and impact of injuries in particular anatomical areas. As a result, the Japanese version resembled closely the questionnaire of health problems.  We reconstructed this modified questionnaire and confirmed its usability. The responders did not have problems while answering the questionnaire, and the response time was short. Using an internet-based form, we could conduct the survey continuously, with a small burden on the athletes. In Japan, it might be effective to use the modified questionnaire, which combined the questionnaires of overuse injuries and health problems, to examine the all the overuse injuries based on the ‘any physical complaint’ definition.