Development of the University of Wisconsin Running Injury and Recovery Index

Abstract

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

Objectives: 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 of the University of Wisconsin Running Injury and Recovery Index (UWRI) in this longitudinal clinical measurement study. Content-related validity was assessed using open comments. Reproducibility was assessed using Cronbach's alpha, the intraclass correlation coefficient (ICC), and standard error of measurement (SEM). An anchor-based construct validity assessment measured the association between the change in UWRI score and global rating of change (GROC). Responsiveness assessments included floor and ceiling effects.

Results: The 9-item UWRI assesses running ability following an RRI, with the maximum score of 36 indicating a return to preinjury running ability. The UWRI demonstrated acceptable internal consistency (α = .82), test-retest reliability (ICC = 0.93), and SEM (1.47 points). Change in UWRI score was moderately correlated with the GROC (r = 0.61; 95% confidence interval: 0.4, 0.76). Floor and ceiling effects were absent. Completion required 3 minutes 15 seconds.

Conclusion: The UWRI is a reliable PRO measure and is responsive to changes in running function following an RRI, with minimal administrative burden.

Level of evidence: Therapy, level 2c. J Orthop Sports Phys Ther 2019;49(10):751-760. Epub 3 Aug 2019. doi:10.2519/jospt.2019.8868.

Keywords: patient-reported outcome measure; psychometric assessment; running injury.

Figures

FIGURE.

Participant flow diagram. Abbreviations: GROC, global rating of change; LEFS, Lower Extremity Functional Scale; PRO, patient-reported outcome; UWRI, University of Wisconsin Running Injury and Recovery Index.