# Cross-cultural adaptation and validation of the simplified Chinese version of the functional assessment scale for acute hamstring injuries (FASH) questionnaire

## TL;DR

This study adapts and validates a Chinese version of a questionnaire to assess hamstring injuries, showing it is reliable and valid for use in Mainland China.

## Contribution

The study provides a validated Simplified Chinese version of the FASH questionnaire for assessing acute hamstring injuries.

## Key findings

- The SC-FASH demonstrated high reliability with Cronbach's alpha of 0.88 and ICC of 0.97.
- Good correlations were found between SC-FASH and other measures like EILP and VAS.
- The questionnaire is suitable for evaluating hamstring injuries' impact on physical function in Chinese speakers.

## Abstract

The Functional Assessment Scale for Acute Hamstring Injuries (FASH) Questionnaire is a tool to assess the severity of symptoms and their impact on function and sports ability in patients with acute hamstring injuries. The study was to cross-culturally adapt and psychometrically validate a Simplified Chinese version of the FASH (SC-FASH).

Cross-cultural adaptation was performed in accordance with the internationally recognised guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. The FASH is a 10-item questionnaire. The sample size should be 5 to 10 times the total number of items on the scale. 150 participants with acute hamstring injuries were included in this study. Cronbach's α and the intra-class correlation coefficient (ICC) were used to assess reliability, and correlations between the SC-FASH and the Exercise-Induced Leg Pain Questionnaire (EILP), the Visual Analogue Scale (VAS) and the Short Form (36) Health Survey (SF-36) were used to assess construct validity.

Between February and May 2025, 150 literate native Chinese speakers with hamstring injuries were recruited for a study. All the 10 items had an answer rate of 100%. The FASH was successfully adapted and translated into Simplified Chinese. Each item was appropriately correlated with the total items. Good reliabilities were observed in SC-FASH, evidenced by Cronbach's alpha of 0.88, an ICC 0.97 (95% CI, 0.96–0.98). The elimination of any one item did not result in a Cronbach's α < 0.80. Standard Error of the Mean (SEM) was 4.41. Good correlations were observed with EILP (0.68, p < 0.01), VAS (-0.62, p < 0.01), and physical function of SF-36 (0.62, p < 0.01). Moderate correlations were observed with role physical (0.46, p < 0.01), bodily pain (0.50, p < 0.01), and general health (0.44, p < 0.01). Fair to poor correlations were observed with vitality, social function, role emotional, and mental health domains of SF-36.

SC-FASH is recommended to evaluate the severity of hamstring muscle injuries and their impact on physical function and sports ability in Mainland China due to its good reliability, and validity.