Artist score

Abstract

The Tegner Activity Scale, often referred to simply as the Tegner score, is a concise, single-item patient-reported outcome measure (PROM) utilized primarily in orthopedic and sports medicine contexts. It is designed to assess the subjective severity and demand of a patient’s work and sports activities. The scale is hierarchical, ranging from 0 to 10, where the patient identifies the level that best reflects their current or pre-injury physical participation. A score of 10 represents the highest level of strenuous activity, while 0 indicates disability or sick leave, thus providing a quantitative measure of the patient’s functional activity level.

Keywords

Tegner Activity Scale, Activity level, Lower extremity, Musculoskeletal system, Orthopedics, Knee injury, PROM, Self-report.

Authors

Tegner Y

Purpose

The primary purpose of the Tegner Activity Scale is to provide a standardized, yet simple, method for quantifying an individual’s physical activity level. This is particularly crucial for tracking recovery and determining functional outcomes following injuries or surgical interventions affecting the lower extremity, such as ligament reconstruction or joint replacement. It allows clinicians to benchmark a patient’s current activity against their pre-injury status, providing essential data for rehabilitation planning.

The scale is highly valuable in clinical trials and research, where it serves as a measure of treatment efficacy regarding return-to-sport or high-demand occupational activities. By translating complex physical participation into a single numerical value, the Tegner score aids in making objective comparisons across patient cohorts and facilitates transparent communication regarding recovery milestones.

Construct

The central construct measured by the Tegner score is Physical Activity Level and Exertion Demand. This construct is operationalized through a predefined, ordinal ranking of activities, ranging from sedentary occupations to competitive, high-impact sports. The scale implicitly assumes that participation in higher-level activities requires greater functional capacity and resilience within the musculoskeletal system.

As a self-report instrument, it captures the patient’s perception of their ability to engage in these activities, encompassing both the physical demands of their work environment and their recreational or athletic pursuits. This focus on participation, rather than just isolated physical performance tests, provides a holistic view of the patient’s functional outcome.

Validity

The Tegner Activity Scale demonstrates strong construct validity, consistently correlating positively with other established, multi-item knee outcome measures, such as the Lysholm Knee Score and the International Knee Documentation Committee (IKDC) Subjective Knee Form. This correlation confirms that the single-item scale effectively captures the variance associated with overall functional status and activity participation in orthopedic populations.

Furthermore, the scale exhibits known-groups validity, reliably differentiating between patient groups with varying degrees of injury severity or post-operative success. Its straightforward, hierarchical structure lends itself to high face validity, making it a credible and intuitive tool for both patients and medical professionals assessing recovery outcomes related to the musculoskeletal system.

Reliability

The reliability of the Tegner Activity Scale is generally considered acceptable for clinical use, particularly in measuring stable states (e.g., pre-injury status or long-term post-operative status). Studies evaluating test-retest reliability have shown moderate to substantial agreement, indicating that patients generally provide consistent scores when tested at different time points, provided their actual activity level has not changed.

Since the scale is a self-administered, single-item measure based on standardized activity descriptions, inter-rater reliability is inherently high. However, its reliance on the patient’s subjective interpretation of the descriptive categories means that clarity in administration is essential to minimize potential measurement error.

Factor Analysis

As the Tegner Activity Scale consists of only one item (with ten graded levels), traditional factor analysis techniques (exploratory or confirmatory) are not applicable. The scale is conceptually designed to measure a single underlying factor: the intensity of Physical Activity.

The hierarchical arrangement of the scores (0 to 10) serves as an implicit factor structure, where each ascending level represents a greater loading on the latent construct of exertion and functional demand on the lower extremity. Validation studies, therefore, focus on its criterion validity against external measures rather than internal factor structure.

Instrument

Test Type: Patient-Reported Outcome Measure (PROM) / Self-report Activity Scale.

Format: Single-item ordinal scale ranging from 0 to 10.

Language Available: Swedish (Original), widely translated into English and numerous other languages for international orthopedic research.

Population Group: Adults (Volwassenen).

Age Group: Applicable to adults and older adolescents who participate in structured physical activities.

Population Details: Primarily used for patients with injuries or conditions affecting the locomotor system, especially the knee (e.g., ACL tears, meniscal injuries), to assess their functional activity level.

Test Methodology: Patients evaluate the list of activity descriptions (which combine occupational and sports demands) and select the single activity level (score 0-10) that most accurately reflects their current or desired level of physical participation.

Keywords

Orthopedic assessment, ACL reconstruction, Functional status, Self-assessment, Sports medicine, Rehabilitation, Single-item scale.

Authors

Author ORCID Identifier: Not specified in the source.

Affiliation Email addresses: Not specified in the source.

Correspondence Address: Not specified in the source.

Permissions & Fee and Test Year

The Tegner Activity Scale is generally considered a non-proprietary instrument and is widely used in clinical and academic settings without the requirement of a formal license or fee. Its simplicity and integration into standard orthopedic assessment batteries contribute to its free availability.

The scale was developed by Y. Tegner and J. Lysholm and was first published in 1985, often used in conjunction with the Lysholm Knee Scoring Scale.

Reference’s

The primary reference detailing the scale’s development is:

• Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985 Sep;(198):43-9.

The original PDF documentation for the scale and its explanation form are available here:

• The original Explanation Form (Toelichtingsformulier) can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/Tegner-form.pdf
• The original Instrument (Meetinstrument) can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/Tegner-meetinstr.pdf

Items of the Tegner score

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

De Tegner activiteitenschaal bevat 1 item, waarbij de patiënt zelf de zwaarte van zijn/haar werk- en sportactiviteiten aangeeft. De scoring varieert van 0 tot 10. Een hoge score komt overeen met een hoog activiteitenniveau