# Translation, cross-cultural adaptation, and validation of the Chinese version of the 4 domain sports prom

## TL;DR

This study translated and validated a sports injury questionnaire for Chinese-speaking patients, ensuring it is clear and reliable for assessing treatment outcomes.

## Contribution

The study provides a validated Chinese version of the 4-Domain Sport PROM questionnaire suitable for sports injury rehabilitation assessments.

## Key findings

- 97% of experts found the Chinese translation of the questionnaire understandable.
- The questionnaire showed high content validity and reliability with a Cronbach's alpha of 0.72.
- The adapted questionnaire is reproducible and suitable for assessing sports injury outcomes in Chinese-speaking patients.

## Abstract

This work evaluated and validated the translation and cross-cultural adaptation of 4-Domain Sport PROM (4-DSP) into Chinese, assessing its understandability and reproducibility in all questionnaire domains for Chinese-speaking patients.

Cross-sectional study, level of evidence II. Twenty patients with sports injuries who underwent surgical treatment and postoperative rehabilitation in the Sports Medicine Surgery Department of Huashan Hospital were selected to evaluate whether the translation was understandable. Then, the 4-DSP was applied to 120 patients who had undergone trauma surgical procedures. The translation and cross-cultural adaptation of 4-DSP involved 6 steps: (1) Translation, (2) Synthesis of translation, (3) Back Translation, (4) Testing of the Prefinal Version—Expert committee review, (5) Prefinal testing among the patients, and Reliability and Consistency Testing. The questionnaire was self-administered by 120 patients (53 males and 67 females; mean age: 30.41 ± 6.8 years.) who had undergone arthroscopic surgery or conservative therapy from a sports physical therapist and had 3-month to 1-year follow-up. All patients filled in the 4-DSP questionnaire without direct supervision of their trainer/coach or researcher. All data were collected and processed anonymously.

97% of the experts (n = 10) considered the translation accuracy understandable; each item and overall content validity showed 96% agreement, and the bilingual translation accuracy was rated as 98.5%, presenting a global Cronbach's alpha of 0.72.

The Chinese cross-cultural adaptation and validation of the original English version of the 4-DSP questionnaire proved reproducible and properly understandable in all four domains. It can safely and reliably assess treatment outcomes for sports injuries in Chinese-speaking patients and is a helpful tool to collect and assess athletic population data.

The online version contains supplementary material available at 10.1186/s13018-025-05882-1.