Anterior Knee Pain Scale (AKPS): structural and criterion validity in Brazilian population with patellofemoral pain

To identify the best internal structure of the Brazilian version of the Anterior Knee Pain Scale (AKPS), comparing different instrument structures (structural validity) and correlating the scores of the versions (criterion validity).

We included Brazilian volunteers, aged ≥ 18 years, with patellofemoral pain (PFP) for at least 3 months. We used the confirmatory factor analysis and considered the following fit indices: chi-square/degrees of freedom (DF), comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA). We considered the structure with the lowest values of the Akaike information criterion (AIC), sample size adjusted Bayesian information criterion (SABIC), and assessed criterion validity using Pearson correlation coefficient (r) to correlate the long and short versions.

The study included 101 participants, mostly women (65.3%), young adults (~ 31 years old), overweight (BMI > 25 kg/m²), incomplete higher education (37.6%), and physically active (64.4%). The original 1-domain, 13-item structure showed adequate fit indices (chi-square/GL < 3.00, TLI and CFI > 0.90, and RMSEA < 0, 08). However, items 11 and 12 had a factorial load of less than 0.23. Therefore, we excluded items 11 and 12 and found adequate fit indices (chi-square/GL < 3.00, TLI and CFI > 0.90, and RMSEA < 0, 08) and lower AIC and SABIC values. We observed a correlation coefficient above the acceptable cutoff of 0.70 (r = 0.966, p-value < 0.001) between the versions.

The 11-item AKPS (without items 11 and 12) is the version with the most adequate internal structure and correlates satisfactorily with the long version of the instrument.