# The Brazilian version of the High-Activity Arthroplasty Score: psychometric property evaluation in hip replacement patients

## TL;DR

The paper evaluates the reliability and validity of a Brazilian version of a questionnaire measuring physical activity after hip replacement surgery.

## Contribution

The study provides psychometric validation of the Brazilian version of the High-Activity Arthroplasty Score (HAAS-Brazil) for hip arthroplasty patients.

## Key findings

- HAAS-Brazil showed strong content and structural validity with a CVC > 0.9 and AISP = 1.
- The questionnaire demonstrated good reliability (ICC = 0.840) and acceptable internal consistency (Mokken ρ = 0.707).
- Construct validity was supported with correlations ranging from 0.338 to 0.696 with other health status measures.

## Abstract

The High-Activity Arthroplasty Score (HAAS) is a reliable and valid self-administered questionnaire that was developed in British English and was designed to determine the level of physical activity in patients after lower limb arthroplasty (hip and/or knee). The Brazilian version (HAAS-Brazil) was developed after a cross-cultural adaptation in 2023.

To evaluate the psychometric properties of HAAS-Brazil in patients after hip arthroplasty.

A cross-sectional quantitative and qualitative study was conducted in an orthopedic outpatient setting.

Evidence for the validity of HAAS-Brazil was assessed via psychometric testing, which followed the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN).

A total of 112 patients with a mean age of 56 years were included as participants; of these patients, 50.9% were female, with 44.6% being overweight and 85.7% being engaged in physical activity. HAAS-Brazil provided satisfactory evidence of content validity (CVC > 0.9), structural validity (AISP = 1; Hi > 0.3; VIMon = 0; VIIIO = 0), construct validity (ρ
HOS-SP = 0.696; ρ
SF-12 PSC = 0.554; ρ
SF-1 MSC = 0.338), no ceiling or floor effect, acceptable internal consistency (Mokken ρ = 0.707; Cronbach α = 0.663), and good reliability (ICC(3,K) = 0.840 ; P < 0.001).

The HAAS-Brazil provided satisfactory validation evidence in patients who underwent hip arthroplasty.