Key facts
- Score direction
- Higher is better
- Meaningful change
- The minimal clinically important difference (MCID) for the VISA-H has been established at 22 points. Because VISA-H (normalised) calculates the total score in the same direction as VISA-H, the same threshold can be used for interpreting meaningful change.
- Scoring
- The form comprises eight questions with a maximum total score of 100 points. Question 1 (sit/drive duration) is labelled 0 mins through to 100+ mins and contributes directly (more minutes = higher score). Questions 2-6 u…
- Time to complete
- 5 min
- Questions
- 8
- Licensing
- Available free of charge; Patient Watch charges only for platform services
About the VISA-H (normalised)
VISA-H (normalised) is an improved presentation of the Victorian Institute of Sport Assessment-Hamstring questionnaire, designed for patient ease of use. It keeps the same clinical content and score interpretation as VISA-H, but presents questions 2 to 6 with conventional pain-scale direction where 0/10 is best and 10/10 is worst. This matches typical VAS and NRS pain scoring that patients already understand, reducing confusion from the original scale where higher numbers meant less pain. Question 1 asks sitting/driving duration in natural order from 0 mins to 100+ mins. The calculated total remains equivalent to the original VISA-H, so clinicians can compare results and apply the same thresholds.
Medical Specialties
Anatomic Areas
Clinical Indications
Developer Information
Based on the VISA-H developed by Angelo Cacchio and colleagues (2014). Normalised presentation adapted for patient ease of use while preserving score equivalence.
Copyright & Licensing
Copyright © 2014 Cacchio et al. Published in British Journal of Sports Medicine. The VISA-H questionnaire is freely available for clinical and research use without licensing fees.
Administration Instructions
In this questionnaire, the term "pain" refers specifically to pain in the buttock region. Question 1 asks how many minutes you can sit or drive pain free (0 mins to 100+ mins). For questions 2 to 6, 0/10 is best and 10/10 is worst - the same direction most people use when rating pain. The final score is calculated in the same direction as the original VISA-H.
Scoring Methodology
The form comprises eight questions with a maximum total score of 100 points. Question 1 (sit/drive duration) is labelled 0 mins through to 100+ mins and contributes directly (more minutes = higher score). Questions 2-6 use a patient-friendly normalised direction, where 0 represents the best state and 10 represents the worst pain or limitation; for scoring they are reverse-transformed using 10 minus the selected response so item contributions match the original VISA-H. Question 7 retains the original VISA-H categorical options (0, 4, 7, 10). Question 8 is completed as either A, B or C only with the original duration bands and scores. Item scores are summed to produce a total score ranging from 0 (worst symptoms) to 100 (asymptomatic). Higher scores indicate better function and fewer symptoms.
Meaningful Change Threshold
The minimal clinically important difference (MCID) for the VISA-H has been established at 22 points. Because VISA-H (normalised) calculates the total score in the same direction as VISA-H, the same threshold can be used for interpreting meaningful change.
Score Interpretation
Understanding what your score means
severe
0 - 39Severe symptoms with significant functional limitations. Patients in this range typically experience substantial pain during daily activities and are unable to participate in most sports or training activities.
moderate
40 - 69Moderate symptoms with noticeable limitations in daily activities and sports participation. Patients can perform some activities but experience regular pain and reduced performance.
mild
70 - 89Mild symptoms with minimal impact on daily activities. Patients can participate in most activities but may experience occasional discomfort during demanding tasks or sports.
minimal
90 - 100Minimal to no symptoms with full or near-full participation in all activities including sports.
Clinical Limitations & Considerations
VISA-H (normalised) improves patient ease of use by changing the response direction for questions 1 to 6, but keeps the calculated score equivalent to VISA-H. Clinicians should avoid mixing raw item responses from the original and normalised forms without accounting for this display-direction change.
Frequently asked questions
What does a mild VISA-H (normalised) score mean?
A VISA-H (normalised) score of 70 to 89 is classified as mild. Mild symptoms with minimal impact on daily activities. Patients can participate in most activities but may experience occasional discomfort during demanding tasks or sports.
What does a severe VISA-H (normalised) score mean?
A VISA-H (normalised) score of 0 to 39 is classified as severe. Severe symptoms with significant functional limitations. Patients in this range typically experience substantial pain during daily activities and are unable to participate in most sports or training activities.
What does a minimal VISA-H (normalised) score mean?
A VISA-H (normalised) score of 90 to 100 is classified as minimal. Minimal to no symptoms with full or near-full participation in all activities including sports.
What does a moderate VISA-H (normalised) score mean?
A VISA-H (normalised) score of 40 to 69 is classified as moderate. Moderate symptoms with noticeable limitations in daily activities and sports participation. Patients can perform some activities but experience regular pain and reduced performance.
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This questionnaire is provided free of charge. Patient Watch charges only for platform services (data storage, automated reminders, analytics) - not for use of clinical instruments. This non-commercial model supports academic and clinical use.View full licensing disclosure