Wisconsin Running Injury and Recovery Index

NewsBot · Aug 4, 2019

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Development of the University of Wisconsin Running Injury and Recovery Index
Journal of Orthopaedic & Sports Physical Therapy, 2019 Volume:0 Issue:0 Pages:1–33 DOI: 10.2519/jospt.2019.8868

Background
Runners experience a high proportion of overuse injuries with extended recovery periods involving a gradual, progressive, return to pre-injury status. A running-specific patient-reported outcome (PRO) measure does not exist, and a questionnaire assessing critical elements of runners’ recovery process may have superior psychometric properties.

Objectives
The purpose of this study was to develop a valid, reliable, and responsive evaluative PRO measure to assess longitudinal change in running ability after running-related injury (RRI) for clinical practice and research applications.

Methods
Self-identified runners and selected experts participated in an iterative, 6-step development process creating the University of Wisconsin Running Injury and Recovery Index (UWRI). Content-related validity was assessed using open comments. Reproducibility was assessed using Cronbach’s alpha (α), intraclass correlation coefficient (ICC(agreement)), and standard error of measurement (SEMagreement). An anchor-based, construct validity assessment measured the association between the change in the UWRI score and global rating of change (GROC). Responsiveness assessments included floor and ceiling effects.

Results
The 9-item UWRI assesses running ability following RRI with the maximum score of 36 indicating a return to pre-injury running ability. The UWRI demonstrated acceptable internal consistency (α = 0.82), test-retest reliability (ICC(agreement) = 0.934), and SEMagreement = 1.47. Change in the UWRI score was moderately correlated with the GROC (r = 0.58, 95% CI [0.37, 0.74]). Floor and ceiling effects were absent. Completion required 3 minutes 15 seconds.

Conclusion
The UWRI is a reliable PRO measure responsive to changes in running function following RRI with minimal administrative burden
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NewsBot · Oct 30, 2020

Construct Validity and Responsiveness of the University of Wisconsin Running Injury and Recovery Index
Journal of Orthopaedic & Sports Physical Therapy: October 28, 2020Volume0Issue0Pages1-40

Objectives
The University of Wisconsin Running Injury and Recovery Index (UWRI) is the first running-specific patient-reported outcome measure (PRO). The UWRI evaluates the key elements runners use to self-assess running ability during recovery. This study evaluated the construct-related validity and responsiveness of the UWRI as an evaluative PRO of running ability following running-related injury (RRI).

Design
Prospective longitudinal study.

Methods
Runners seeking care from a physical therapist for a RRI (n=396) completed PROs at baseline and 12 weeks later. UWRI change was validated against the global rating of change (GROC), VR-12 change, and change in body region-specific PROs. Responsiveness was evaluated using anchor-based and distribution-based techniques.

Results
UWRI change (mean±SD 7.7±8.9) was correlated with GROC (r=0.67), as well as the changes in VR-12 physical component score (PCS) (r=0.54) and mental component score (MCS) (r=0.31). UWRI change was correlated with changes in the Foot and Ankle Ability Measure sport subscale (r=0.75), 12-item international hip outcome tool (r=0.75), and anterior knee pain scale (r=0.48), but not associated with the Oswestry Disability Index 2.0 (r=0.05). UWRI change was significantly different in runners reporting significant improvement (12.2±5.9), slight improvement (7.1±6.6), no change (0.0±9.1), and worsening (-14.6±7.4) on the GROC anchor-based responsiveness assessment. The UWRI minimal important change and minimal clinical important difference was 5 and 8 points, respectively.

Conclusion
The UWRI is a valid clinical tool for evaluating running ability following RRI; it demonstrated longitudinal (GROC), convergent (PCS and body region-specific PROs), divergent validity (MCS), and responsiveness to changes in patient-perceived running ability
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NewsBot · Sep 7, 2021

Comprehensive Return to Competitive Distance Running: A Clinical Commentary
Eric J. Hegedus, Lindsey Ickes, Franziska Jakobs, Kevin R. Ford & James M. Smoliga
Sports Medicine (2021)

Running injuries are very common, and there are well-established protocols for clinicians to manage specific musculoskeletal conditions in runners. However, competitive and elite runners may experience different injuries than the average recreational runner, due to differences in training load, biomechanics, and running experience. Additionally, injury-specific rehabilitation protocols do not consider the broader goal of return to competitive running, including the unique psychosocial and cardiorespiratory fitness needs of elite athletes. This review aims to suggest a guideline for running-specific progression as part of a comprehensive rehabilitation program for injured competitive runners. Tools to evaluate an athlete’s psychosocial preparedness to return to competition are presented. Recommendations are also provided for monitoring cardiorespiratory fitness of injured runners, including the nuances of interpreting these data. Finally, a six-phase training paradigm is proposed to guide clinicians as they help competitive runners transition from the early stages of injury through a full return to competition.
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NewsBot · Sep 23, 2021

Running-related injury: How long does it take? Feasibility, preliminary evaluation, and German translation of the University of Wisconsin running and recovery index
TimHoenigaEvan O.NelsonbKaren L.TroycBerndWolfarthdBryan C.HeiderscheiteKarstenHollanderf
Physical Therapy in Sport; 23 September 2021

Highlights
•The UWRI provides information on the recovery from a running-related injury.
•This patient-reported outcome measure can be successfully translated and culturally adapted.
•This study indicates its feasibility and validity in a clinical setting.
•Usage of the UWRI may hold promise for better rehabilitation surveillance.
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Objective
The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed as an evaluative patient-reported outcome measure of perceived running ability and recovery after running-related injuries. To date, the questionnaire was not translated into German language and studies on its clinical feasibility and validity are sparse.

Design
Prospective cohort study.

Setting
Outpatient sports medicine clinic.

Participants
The UWRI questionnaire was translated to German language using a state-of-the art back-translation method including three translators and two back-translators. Clinical feasibility and validation were assessed in 14 injured runners.

Main outcome measures
UWRI total score, running volume.

Results
The translation process was completed without major discrepancies. Feasibility and preliminary evaluation were demonstrated in a cohort of 14 injured runners. The UWRI total score significantly improved throughout 12 weeks of recovering from running-related injuries (p < 0.001). Relative running volume significantly correlated with UWRI score (p < 0.001).

Conclusion
The University of Wisconsin Running Injury and Recovery Index was successfully translated into the German language. Its usage may hold promise for better rehabilitation surveillance following running-related injuries.
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NewsBot · Jun 17, 2022

Cross-cultural adaptation and evaluation of the psychometric properties of the University of Wisconsin Running Injury and Recovery Index questionnaire in Spanish (UWRI-S)
JosefinaBunsteraMaría JesúsMartínezbManuel V.Mauri-SteccaabJaimeLeppeabEvan O.NelsoncBryanHeiderscheitdManuelaBesomiabe
Physical Therapy in Sport; Volume 55, May 2022, Pages 289-295

Highlights
•UWRI-S is a valid and reliable measure of perceived running ability.
•This study provides evidence of its validity in a clinical setting.
•UWRI-S can be used to inform the clinical decision-making process.
•UWRI-S may improve running injury surveillance and return to sport.
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Objective
To cross-culturally adapt and evaluate the psychometric properties of the University of Wisconsin Running Injury and Recovery Index questionnaire in Spanish (UWRI-S) in Chilean runners with a running-related injury.

Design
Cross-cultural adaptation and validation study, following the Consensus-based Standards for selecting health Measurement Instruments (COSMIN) recommendations.

Setting
Outpatient sports medicine clinic and running clubs.

Participants
UWRI was forward and backward translated, and culturally adapted. Thirty-one runners participated in the content validity of the UWRI-S; and fifty-seven in the assessment of psychometric properties.

Main outcome measures
Runners seeking care from a physiotherapist completed the UWRI-S (baseline and after 48–72 h for reliability), Lower Extremity Functional Scale (LEFS), Patient Specific Functional Scale (PSFS), Global Rating of Change scale (GROC), and Numeric Pain Rating Scale (NPRS).

Results
Suggestions about accuracy of wording and understanding of items were incorporated. UWRI-S showed a positive moderate correlation with LEFS (r = 0.6; p < 0.05), positive fair with GROC (r = 0.5, p < 0.05), negative fair with NPRS (r = −0.4; p < 0.05) and no correlation with PSFS (r = 0.3; p = 0.1). UWRI-S demonstrated acceptable internal consistency (α = 0.87) and test-retest reliability (ICC = 0.87).

Conclusion
UWRI-S is a valid and reliable measure to evaluate running ability of Chilean runners during recovery from a running-related injury.
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NewsBot · May 11, 2023

Cross-Cultural Adaptation of the University of Wisconsin Running Injury and Recovery Index in Turkish Runners
Elif Turgut et al
J Sport Rehabil. 2023 May 9;1-6

Context: The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed to evaluate the key elements that runners use to self-assess their own running ability following common running-related injuries. The aim of this study was to translate and culturally adapt the UWRI and to evaluate the psychometric properties of its Turkish version (UWRI-Tr) in runners.

Design: Prospective cohort study.

Methods: The study included 129 runners. The UWRI-Tr, the Lower Extremity Functional Scale, the Oswestry Disability Index, the Hip Outcome Score, the International Knee Documentation Committee Subjective Knee Evaluation Form, and the Foot and Ankle Ability Measure were applied for the validation purposes. Internal consistency, reliability, construct validity, and discriminant validity of the UWRI-Tr were tested.

Results: The test-retest reliability of the UWRI-Tr was excellent with an intraclass correlation coefficient of .85 and a Cronbach α value of .84. There was a small to strong correlation among the UWRI-Tr and Lower Extremity Functional Scale (r = .278), Oswestry Disability Index (r = -.744), Hip Outcome Score (r = .684), The International Knee Documentation Committee Subjective Knee Evaluation Form (r = .758), and Foot and Ankle Ability Measure (r = .498 and .767), indicating that its construct validity was appropriate for use with Turkish runners.

Conclusions: The UWRI-Tr was shown to be a valid and reliable tool to use in clinical and research settings as a sport-specific measurement tool.
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