A Reliability and Validity Study of the Urdu Version of the Lysholm Knee Scoring Scale in Patients with Anterior Cruciate Ligament Injuries

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Published: 2026-05-21
DOI: https://doi.org/10.61919/8ca8rc35
Keywords:
Lysholm Knee Scoring Scale; Urdu translation; reliability; validity; anterior cruciate ligament; patient-reported outcome measure

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Saad Ullah
Doctor of Physical Therapy, Riphah College of Rehabilitation and Allied Health Sciences, Faisalabad Campus, Riphah International University, Faisalabad, Pakistan
Muhammad Usman
Doctor of Physical Therapy, Riphah College of Rehabilitation and Allied Health Sciences, Faisalabad Campus, Riphah International University, Faisalabad, Pakistan
Hafiz Shoaib Abbas
Doctor of Physical Therapy, Riphah College of Rehabilitation and Allied Health Sciences, Faisalabad Campus, Riphah International University, Faisalabad, Pakistan
Muhammad Junaid Ilyas
Johar Child and Polyclinic, Johar Town, Lahore, Pakistan

Abstract

Background: The Lysholm Knee Scoring Scale is widely used to assess knee symptoms and functional limitation in patients with anterior cruciate ligament-related injuries, but its direct use in Urdu-speaking Pakistani patients may be limited by language and cultural differences. Objective: To translate, culturally adapt, and evaluate the reliability and validity of the Urdu version of the Lysholm Knee Scoring Scale in patients with ACL-related knee conditions. Methods: This cross-sectional psychometric validation study with repeated reliability assessment included 100 Urdu-speaking Pakistani patients with ACL injury or ACL-related knee conditions. The scale was translated through forward translation, synthesis, back-translation, expert committee review, and pre-final testing. Internal consistency was assessed using Cronbach’s alpha, while intra-rater, inter-rater, and test–retest reliability were assessed using intraclass correlation coefficients. Structural validity was examined through exploratory factor analysis, and concurrent validity was evaluated through correlations with the Kujala Anterior Knee Pain Scale and International Knee Documentation Committee questionnaire. Results: Cronbach’s alpha was 0.848. Intra-rater and inter-rater reliability were 0.848 and 0.996, respectively. Item-level test–retest ICCs ranged from 0.928 to 0.993, and the total score ICC was 0.992. Factor analysis supported a single-factor structure explaining 61.62% of variance. The Urdu Lysholm score showed very strong positive correlations with the Kujala scale and IKDC questionnaire. Conclusion: The Urdu Lysholm Knee Scoring Scale is a reliable and valid patient-reported outcome measure for Urdu-speaking Pakistani patients with ACL-related knee conditions.

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Vol. 4 No. 10 (2026): Volume 4, Issue 10 (May 2026)

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1.
Saad Ullah, Muhammad Usman, Hafiz Shoaib Abbas, Muhammad Junaid Ilyas. A Reliability and Validity Study of the Urdu Version of the Lysholm Knee Scoring Scale in Patients with Anterior Cruciate Ligament Injuries. JHWCR [Internet]. 2026 May 21 [cited 2026 May 22];4(10):1-14. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1404

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