Acessibilidade / Reportar erro

The Brazilian version of Shoulder Pain and Disability Index: translation, cultural adaptation and reliability

Abstracts

OBJECTIVES: To translate and culturally adapt the Shoulder Pain and Disability Index (SPADI) into Brazilian-Portuguese and to assess its reliability. METHODS: The first step was the translation, synthesis, back-translation, revision by the committee, pre-testing and evaluation of documents by the committee and the author of the SPADI. The revised version by the committee was applied to 90 subjects with shoulder dysfunction, aged over 18 years from different education and sociocultural levels. The items misunderstood by 20% or more of patients were reformulated and reapplied until they reach values lower than 20%. The second stage consisted of two applications of SPADI to 32 patients with shoulder dysfunction in a interval ranging from 2 to 7 days. The data from the translation were analyzed descriptively, the test-retest reliability by Intraclass Correlation Coefficient (ICC) and the internal consistency by Cronbach's Alpha. RESULTS: Some expressions have been adapted to the Brazilian population and the items in the pain and disability subscales were changed for an easier reading in Portuguese Language. The pre-test revealed a need to change only one item of the pain domain and to administer the questionnaire by interview, since it was repeated three times and in the first two applications with self-reported questionnaire the patients had not been reporting their symptoms with regards to the past week and also they have not been properly used the item "Not Applicable". The test-retest reliability ranged from 0.90 to 0.94 and the internal consistency ranged from 0.87 to 0.89. CONCLUSION: After the translation and cultural adaptation, it was obtained a reliable version of SPADI-Brazil.

quality of life; questionnaires; translations; shoulder


OBJETIVOS: Traduzir e adaptar culturalmente o questionário Shoulder Pain and Disability Index (SPADI) para a Língua Portuguesa do Brasil e avaliar sua confiabilidade. MÉTODOS: A primeira etapa consistiu na tradução, síntese, retro-tradução, revisão pelo Comitê, pré-teste e avaliação dos documentos pelo comitê e pelo autor do SPADI. A versão revisada pelo Comitê foi aplicada a 90 indivíduos com disfunção no ombro, com faixa etária acima de 18 anos e níveis educacional e sociocultural variados. Os itens não compreendidos por 20% ou mais dos pacientes foram reformulados e reaplicados até alcançarem valores menores que esse. A segunda etapa consistiu de duas aplicações do SPADI a 32 pacientes com disfunção de ombro, no intervalo de 2 a 7 dias. Os dados de tradução foram analisados descritivamente, a confiabilidade teste-reteste, pelo Coeficiente de Correlação Intraclasse (ICC) e a consistência interna, pelo Alpha de Cronbach. RESULTADOS: Algumas expressões foram adaptadas à população brasileira, e os itens da escala de dor e incapacidade foram alterados para maior facilidade de leitura na Língua Portuguesa. O pré-teste revelou a necessidade de se alterar apenas um item de dor e de se aplicar o questionário por entrevista, pois ele se repetiu três vezes e, nas duas primeiras aplicações, com o questionário autoaplicado, os pacientes não realizaram o relato referente à "semana passada" e utilizaram inadequadamente o item "Não se aplica". A confiabilidade teste-reteste variou de 0,90 a 0,94, e a consistência interna de 0,87 a 0,89. CONCLUSÃO: Após a tradução e adaptação cultural, foi obtida uma versão confiável do SPADI-Brasil.

qualidade de vida; questionários; tradução (produto); ombro


METHODOLOGICAL ARTICLE

The Brazilian version of Shoulder Pain and Disability Index - translation, cultural adaptation and reliability*

Jaqueline MartinsI,II; Barbara V. NapolesI,III; Carla B. HoffmanI,III; Anamaria S. OliveiraI,II

ILaboratory for the Analysis of Human Posture and Movement, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil

IIDepartment of Biomechanics, Medicine and Rehabilitation from the Locomotor System, USP

IIIPhysical Therapy Course, Faculty of Medicine of Ribeirão Preto, USP

Correspondence to

ABSTRACT

OBJECTIVES: To translate and culturally adapt the Shoulder Pain and Disability Index (SPADI) into Brazilian-Portuguese and to assess its reliability.

METHODS: The first step was the translation, synthesis, back-translation, revision by the committee, pre-testing and evaluation of documents by the committee and the author of the SPADI. The revised version by the committee was applied to 90 subjects with shoulder dysfunction, aged over 18 years from different education and sociocultural levels. The items misunderstood by 20% or more of patients were reformulated and reapplied until they reach values lower than 20%. The second stage consisted of two applications of SPADI to 32 patients with shoulder dysfunction in a interval ranging from 2 to 7 days. The data from the translation were analyzed descriptively, the test-retest reliability by Intraclass Correlation Coefficient (ICC) and the internal consistency by Cronbach's Alpha.

RESULTS: Some expressions have been adapted to the Brazilian population and the items in the pain and disability subscales were changed for an easier reading in Portuguese Language. The pre-test revealed a need to change only one item of the pain domain and to administer the questionnaire by interview, since it was repeated three times and in the first two applications with self-reported questionnaire the patients had not been reporting their symptoms with regards to the past week and also they have not been properly used the item "Not Applicable". The test-retest reliability ranged from 0.90 to 0.94 and the internal consistency ranged from 0.87 to 0.89. Conclusion: After the translation and cultural adaptation, it was obtained a reliable version of SPADI-Brazil.

Key words: quality of life; questionnaires; translations; shoulder.

Introduction

The instruments for assessing the health-related quality of life have been considered essential to determine the impact of disease on person's life1, since there is a need to understand the consequences of the disease, and not being exclusively restricted to clinical diagnosis2. Within this new approach of patients assessment, the questionnaires related to the functional assessment is highlighted3, since they can offer to the therapists information with regards to patient's level of function, contributing for clinical decision-making process.

Shoulder dysfunctions are among the most common causes of musculoskeletal pain, and its prevalence may reach about 20% to 33% of the general population4.

Several self-report measures have been developed in English for measuring shoulder's functionality5-15 and it has been encouraged the translation, cross-cultural adaptation and validation of these tools rather than creating a new instruments16,17, which avoids the indiscriminate proliferation of assessment tools18.

Some self-report questionnaires focused on the shoulder and upper extremity have already been translated and adapted for Brazilian-Portuguese language, such as the commonly used questionnaires: The Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)19, the Modified-University of California at Los Angeles Shoulder Rating Scale (modified – UCLA)20 and the Western Ontario Rotator Cuff Index (WORC)21. However, the DASH is a less specific questionnaire since it involves all joints from the upper extremity; the Brazilian version of the modified-UCLA scale have not been tested for its psychometric properties; and the WORC is a questionnaire developed exclusively for the assessment of subjects with with rotator cuff dysfunctions.

The Shoulder Pain and Disability Index (SPADI) is a quality of life questionnaire developed to assess pain and disability associated with shoulder disorders6. Initially, the SPADI was proposed in Visual Analogue Scale (VAS)6, and subsequently validated on Numeric Rating Scale (NRS)22 and cross-culturally adapted and validated for German23 and Slovak24 languages. Several studies have supported the use of SPADI on clinical practice and research25-28, since it is a specific questionnaire for the shoulder joint; has all the psychometric properties evaluated; has short questions with answers in NRS format that facilitate its completion, requiring about 3 to 10 minutes to be completed22,25,26.

Highlighted among the six highest-quality questionnaires26, the SPADI in the numeric version consists of 13 items distributed in the pain domain (five items) and disability domain (eight items), being each item scored in a NRS ranging from 0 to 10 points. The total score of the questionnaire, as well as the score of each domain separately is converted in percentages ranging from 0 to 100, with the higher scores indicating a worst condition of shoulder dysfunction.

The objectives of this study were to translate and culturally adapt the SPADI questionnaire into Brazilian-Portuguese and to analyze its reliability in different musculoskeletal pain conditions specific to the shoulder joint complex.

Methods

Participants

Participated in the phase of cultural adaptation of the SPADI (phase I) 90 patients with clinical diagnosis of different shoulder conditions and 32 patients in the phase of testing the reliability of the SPADI–Brazil (phase II). Patients were consecutively recruited from the Rehabilitation Center (CER) and from the Hand and Microsurgery Outpatient Clinic (OMR) from a public university tertiary care hospital, from São Paulo state/Brazil. In the phase II, patients were recruited only from the CER. The mean age was of 48 years (SD=14 years, range=18 to 75 years) and 50 years old (SD=17 years, range=19 to 83 years) in phases I and II, respectively. The predominant clinical diagnosis was shoulder impingement syndrome and rotator cuff injury, both in phase I (52.2%) and in phase II (53.1%), being the humeral fracture and the shoulder instability, respectively, the second and third most common diagnoses. In phase I, which might be influenced by the education level, were observed predominantly patients with a primary school certificate (49%), followed by 34% with a high school certificate , and 17% with an university degree. Patients with cognitive impairment and neurological and rheumatologic disease were excluded from the study. Illiterate patients or those with visual impairment for reading were also excluded in the first and second pre-tests, since the questionnaire was self-reported. The third pre-test and the phase II, conducted through interviews, also included illiterate participants.

This study had been approved by the Ethics Research Committee of the Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, from the University of São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil (process number 10534/2007). All patients who agreed to participate in the study signed the consent form.

Procedures

This study was conducted in two phases, being the phase I consisted in obtaining the Brazilian-Portuguese version of SPADI, and the phase II in the analysis of its test-retest reliability and internal consistency.

The cultural adaptation of the SPADI for the Brazilian population was based on the methods proposed by Beaton et al.17, consisting of six stages documented by a written report: translation, synthesis, back-translation, revision by a Committee of experts, pre-test and submission of the documents to the authors of SPADI and to the Committee of experts for approval of the process.

Initially, the author of the SPADI was contacted and authorized the study to be conducted, ensuring that concurrent studies would not be performed in parallel to this study.

The SPADI translation was performed by two foreign language teachers, whom have the Brazilian-Portuguese as a mother tongue and also have fluency in English, being only one of them aware of the concepts examined in the questionnaire. Only the T1 and T2 versions from the questionnaire were produced, which were analyzed for comparison between them and to the original version. This comparison was performed by the translators and investigators to obtain the synthesis version T12 in Brazilian-Portuguese.

The version T12 was translated from Brazilian-Portuguese into English (back-translation) by two translators that had the English as their mother language and were fluent in Portuguese. They did not know the original version of the questionnaire and were not professionals from the health field. The versions BT1 and BT2 were, then, created. All the versions from the questionnaire (original, T1, T2, T12, BT1 and BT2) were reviewed by a multidisciplinary committee of experts composed of one orthopedic surgeon, specialized in the upper extremity; by five physical therapists, of whom three are researchers on physical therapy assessment of musculoskeletal impairments of the shoulder complex, and by the translators involved in the process, which resulted in the development of the pre-final version of the SPADI – Brazil.

The pre-final version of the SPADI-Brazil was administered to 30 individuals with shoulder dysfunctions diagnosed during the pre-test, being necessary to repeat this stage three times until every item from the questionnaire was understood by more than 80% from the patients in the last application, in other words, for more than 25 of the 30 patients. Only the items misunderstood by 20% or more than the patients (six or more patients) at each application, were reformulated19,29,30. However, this new item was not administered isolated, since the complete questionnaire was applied in each pre-test. The patients were asked about their comprehension of each item and they reported if they had understood or not and, for the items related to function, they demonstrated the activity. Questions with regards to each of the items were performed after administration of the questionnaire, in order to guarantee the self-report administration of the SPADI-Brazil and to avoid interrupting the patients constantly.

The first pre-test identified the items which needed to be reformulated in a meeting of the researchers' committee, and a new version of the SPADI – Brazil was, then, administered in its totality to other 30 patients, with the same purpose and observing the methods of the first application. Some structural aspects of the questionnaire remained with values above 20% with regards to the misunderstanding and the researchers' committee decided that such problems would be probably solved in a third application performed by interview. In order to do this, before the third application, the Committee informed the author from the original version about the adaptation of the questionnaire for application through interview and prepared a material with orientations for the examiners in order to conduct it adequately. The principal investigator, guided by the material, read aloud all the items, gave explanations about the questionnaire completion and, whenever necessary, demonstrated the adequate interpretation of each item for the patient. During the interview, the examiner verified if the patient had understood each item or if additional explanation was necessary. The final version of the SPADI-Brazil was obtained after the third pretest, which was performed in two phases. The questionnaire was administered to five patients through an interview. After this test's analysis, some modifications were performed, and the pre-final version of the SPADI was administered to 25 patients, ending the process of cultural adaptation.

The pre-test phase was concluded by the remittance of the questionnaire SPADI-Brazil in English to the author of the original version, and she conceded approval for the Brazilian version of SPADI, based in the monitoring of the complete process of cultural adaptation.

The second phase of this study consisted in the application of SPADI-Brazil in two interviews, with an interval period that ranged from 2 to 7 days, according to the next day of patient's attendance in the rehabilitation setting19,21. It was used a scale for the assessment of the global changes in order to identify the patients who remained stable, without clinical changes31.

The analysis of the cultural adaptation was descriptive, performed by mean, standard deviation and relative and absolute frequencies. Test-retest reliability was performed using the Intraclass Correlation Coefficient (ICC)32, and the reliability of internal consistency by the coefficient Cronbach's Alpha33, whose values were accepted between 0.70 and 0.9026.

Results

The translation phase resulted in the creation of instructions about the completion of the numerical version of SPADI and on the inclusion, in the response options, of the item "Not Applicable" (NA), with the consent of the original author. The versions T1 and T2 presented few divergences, which were solved in the synthesis version T12 (Table 1). At this phase, all the items from the scale of pain and disability were grammatically changed to ease its comprehension.

The back-translations BT1 and BT2 revealed an important similarity between them and an equivalence with the original numerical version of the SPADI, which demonstrated that the synthesis version T12 was satisfactory to obtain the pre-final version of the SPADI. The Committee only considered necessary to complement the initial question to the scales of pain and disability with the phrase "During the past week" to reinforce, for the patients, the idea that all items referred to the pain and difficulty perceived in the past week.

The Brazilian version of the SPADI (Appendix 1) was obtained after three repetitions of the pre-test (Table 2). In the first administration of the questionnaire, more than 20% of patients had shown difficult to understand the first item from the scale of pain and the answer option NA; in the second administration of the questionnaire, the answer item NA remained misunderstood, and patients did not perform their report in relation to the past week. These problems were solved only through interview, during the third administration, once the researcher was responsible to explain the use of the item NA and to remember the patient to perform their report with regards to the "past week". In addition, to solve the problem concerning the choice for the item NA, it was asked for the patient to estimate which number he/she would give to their difficulty or pain, in the case they did not have the opportunity to perform one of the activities during the past week.

The internal consistency had shown, for each domain and for the total SPADI-Brazil, acceptable values of 0.70 to 0.90, as shown on Table 3. Test-retest reliability was performed only for the stable patient whom returned for the second interview, in other words, 32 of the 49 patients, showing excellent values of ICC equal or higher to 0.90 for the pain and disability domains and for the SPADI – Brazil. The items presented ICCs that ranged from 0.64 to 0.92, with reliability values higher than 0.70 for eight items (Table 3).

Discussion

The conduction of the process of cultural adaptation from the SPADI through a constant contact with the author of the original version and of a rigorous methodology guaranteed to the SPADI – Brazil a format and language of easy comprehension and idiomatic and cultural equivalence to the Brazilian population. In addition, the quality of the Brazilian version of the SPADI can be confirmed since it is verified that many problems from SPADI were identified for the first time in this transcultural adaptation, and all the suggestions for changes proposed by this study were accepted by the author of the original scale.

The cultural adaptation of the SPADI-Brazil presented difficulties only at the pre-test stage, and the reliability analysis was performed easily, however, with loss of some patients. The inclusion of patients with greater difficult to complete the questionnaire, such as older adults or subjects with lower levels of education, probably contributed to the development of a Brazilian version of easiest comprehension, which was proved by the fact that all items were understood when the questionnaire were self reported.

The stages of translation, synthesis and back-translation of this study, in opposition to the pre-test phase, were performed easily and quickly and were mainly characterized by grammatical modifications that would be more applicable to the Brazilian Portuguese language as well as by modifications aiming to achieve cultural equivalence with the study population, such as the preference of the expression "t-shirt" instead of "sweater", since this is the garment most frequently used in Brazil. The use of the word "t-shirt" needed to be followed by the expression "over your head" to maintain a meaningful equivalence with the original version, since sweaters and shirts are generally dressed with the elevation of the arms. It was also choose the expression "dress shirt", for the item I4, since all of them have buttons, maintaining the concept of the original version.

As on the translation of the SPADI for German Language23, the weight expression "10 pounds" was replaced for "5 kg", since it is the unit of the metric system adopted in Brazil, and its rounding allowed the patients to relate this weight to some familiar object. It is important to mention that no item from the SPADI needed to be changed in relation to the activity questioned, since all of them explore the activities of daily living (ADL) familiar to the Brazilian population.

The pre-test stage was the most difficult to be performed and also the one that collaborated more to the development of the final version of SPADI – Brazil, since its administration highlighted problems not yet perceived on previous stages and revealed others still not observed by the author from the original version. The pre-final version of SPADI-Brazil was assessed in relation to its structure and format, as well as in relation to the easiness of comprehension of the items and the answering options, and to the ability of the patients to perform their report adequately regarding "past week". Thus, it was possible to rescue the instructions contained in the original version which were not published in its numerical version22 and clarified the purpose of SPADI to assess the patients' level of disability in the performance of activities performed with the harmed upper extremity; so, different from the Brazilian DASH19, which assesses the global capacity of an individual to perform the activity, independently of the upper extremity used.

The first item referring to the pain was easily understood in the second pretesting since it was written in a more complete form and in a single phrase. The major difficulties found in the pretesting were the comprehension of the answer option "NA" without any help and the perception that they should do they report based in the "past week". The participants did not perceive the item "NA" due to their desire to score their pain or disability. Therefore, in order to facilitate its perception, the item NA was modified to "I have not performed this during the last week" and positioned in front of the numerical scale. However, this change was also not satisfactory, since the patients who have ceased to perform one activity in the previous week because they did not receive help from another person, got confused in relation to the choice between the answers "I have not performed this during the last week" or the score 10 of the NRS that indicates "So difficult that help was needed". Trying to solve the problem, the score 10 of the NRS was changed to "Unable to perform", as performed by the study of Angst et al.23, and questionnaire was administered by an interview, asking the examiner to explain for the patient simply and clearly when is necessary to choose the item NA and to remember he/she to complete the report with regards to "last week".

The phase I of the third pretesting still revealed problems with the item NA, since it should be marked only when the subject did not do the activity because it does not make part of her/his lifestyle. However, it was observed a lack of answer option for those subjects who did not do the activity past week by chance, even when it was common in their daily life. Thus, the patients were oriented to estimate their answer about the pain and disability in case they had not performed the activity, as in the Brazilian questionnaires DASH19 and WORC21.

The analysis of several questionnaires for the upper extremity evidenced that few offer the patient the possibility to answer "Not applicable" for all the items, as performed by the SPADI – Brazil and by the Brazilian version recently obtained of the Penn Shoulder Score (PSS – Brazil)34. Often, the questionnaires do not use this response option, being all the activities scored in a grade of difficulty or pain10,13,14,22,35, they use them selectively, only for the items referent to activities with effort or sports activities, normally not characterized as ADL12,36, or as the Brazilian questionnaires DASH19 and WORC21, which ask the patients to estimate the level of difficulty they would have if they were to perform the activity. Thus, the initiative from the present study to include the item NA and the effort to guarantee its adequate marking represent a positive aspect for the version SPADI-Brazil, since it was aware with the identification of the activities that did not take part of patients' life context.

The transformation of the Brazilian version of SPADI in a questionnaire administered by interview was supported by the author from the original version and followed the trend of several questionnaires translated to Brazil34,37-41. The interview was able to solve the remaining problems of the previous pretesting and contributed to the decrease of missing data of the questionnaire. Other instruments translated to the Brazilian-Portuguese were also transformed from self-administered to a tool applied by interview, such as the questionnaires PSS-Brazil34, Brazil Roland-Morris29 and the Brazilian DASH19. It is also observed that some questionnaires were administered both as an interview and self-administered, whenever possible30, or even in the self-administered format added by the provision of instructions of how to complete the questionnaire42.

The reliability and internal consistency of the global SPADI – Brazil and for each domain were excellent, agreeing with studies by the literature (Table 4). The reliability of the total SPADI-Brazil and its domains was higher than that obtained by the majority of studies6,43-48 and similar to others23,24. The reliability of the pain items was higher than the disability items, with a lower value for the item 5 of disability "Wearing a shirt with buttons in front?" (ICC=0.50), as also observed by Angst et al.23 (ICC=0.68). Other three items concerning disability had values relatively low for reliability, ranging from 0.64 to 0.67, which suggests that subjects had a better perception of their pain compared to their functional limitation. According to Bot et al.26, the ICC of a scale shall be above 0.90 for the individual assessment of patients, which suggests that SPADI-Brazil shall be used only as a function of their domains or total score, being the isolated use of an item discouraged.

The SPADI-Brazil presented an acceptable internal consistency26 and consistent to other studies (Table 4), showing the homogeneity of the items in presenting a common variation.

The cultural adaptation of SPADI for the Brazilian Portuguese Language revealed few problems related to the items, being important to be alert to the structural aspects of the questionnaire that present the most important points of difficulty for comprehension. The initial analysis of the psychometric properties of the questionnaire showed that SPADI – Brazil is a reliable tool for the assessment of patients with shoulder dysfunction. However, this study presents limitations to ensure the use of the questionnaire in clinical settings and researches, once their remaining psychometric properties have not been tested yet.

The clinical and research relevance of this study consists in contributing for the availability of more than an option of instrument for the assessment of quality of life of patients with diverse shoulder dysfunctions. The SPADI – Brazil questionnaire offers to the therapist and researcher more information about patients' functionality with their affected arm, which may help clinical decision making in relation to continue, interrupt or modify an intervention, as well as targeting treatment to the actual limitations from the patients.

Conclusion

After the translation and cultural adaptation of the questionnaire, the Brazilian version of the SPADI was obtained, and showed to be a reliable tool for the assessment of quality of life of patients with diverse shoulder dysfunctions.

Aknowledgements

To the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), for the financial support, and to Helga Tatiana Tucci, for the collaboration as a member of the Committee of specialists.

References

3. Michener LA, Snyder AR. Evaluation of health-related quality of life in patients with shoulder pain: are we doing the best we can? Clin Sports Med. 2008;27(3):491-505, x.

5. Amstutz HC, Sew Hoy AL, Clarke IC. UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res. 1981;(155):7-20.

23. Angst F, Goldhahn J, Pap G, Mannion AF, Roach KE, Siebertz D, et al. Cross-cultural adaptation, reliability and validity of the German Shoulder Pain and Disability Index (SPADI). Rheumatology (Oxford). 2007;46(1):87-92. Epub 2006 May 23.

  • 1. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med. 1996;334(13):835-40.
  • 2. Farias N, Buchalla CM. A classificação internacional de funcionalidade, incapacidade e Saúde da Organização Mundial da Saúde: conceitos, usos e perspectivas. Rev Bras Epidemiol. 2005;8(2):187-93.
  • 4. McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2007;21(3):403-25.
  • 6. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991;4(4):143-9.
  • 7. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602-8.
  • 8. Dawson J, Fitzpatrick R, Carr A. Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg Br. 1996;78(4):593-600.
  • 9. L'Insalata JC, Warren RF, Cohen SB, Altchek DW, Peterson MG. A self-administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Joint Surg Am. 1997;79(5):738-48.
  • 10. Kirkley A, Griffin S, McLintock H, Ng L. The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability: The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med. 1998;26(6):764-72.
  • 11. Dawson J, Fitzpatrick R, Carr A. The assessment of shoulder instability. The development and validation of a questionnaire. J Bone Joint Surg Br. 1999;81(3):420-6.
  • 12. Hollinshead RM, Mohtadi NG, Vande Guchte RA, Wadey VM. Two 6-year follow-up studies of large and massive rotator cuff tears: comparison of outcome measures. J Shoulder Elbow Surg. 2000;9(5):373-81.
  • 13. Lo IK, Griffin S, Kirkley A. The development of a disease-specific quality of life measurement tool for osteoarthritis of the shoulder: The Western Ontario Osteoarthritis of the Shoulder (WOOS) index. Osteoarthritis Cartilage. 2001;9(8):771-8.
  • 14. Kirkley A, Alvarez C, Griffin S. The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: The Western Ontario Rotator Cuff Index. Clin J Sport Med. 2003;13(2):84-92.
  • 15. Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR Jr. The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006;36(3):138-51.
  • 16. Guillemin F, Bombardier C, Beaton D. Cross-Cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993;46(12):1417-32.
  • 17. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-91.
  • 18. Skutek M, Fremerey RW, Zeichen J, Bosch U. Outcome analysis following open rotator cuff repair. Early effectiveness validated using four different shoulder assessment scales. Arch Orthop Trauma Surg. 2000;120(7-8):432-6.
  • 19. Orfale AG, Araújo PMP, Ferraz MB, Natour J. Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of The Disabilities of the Arm, Shoulder and Hand questionnaire. Braz J Med Biol Res. 2005;38(2):293-302.
  • 20. Oku EC, Andrade AP, Stadiniky SP, Carrera EF, Tellini GG. Translation and cultural adaptation of the Modified-University of California at Los Angeles Shoulder Rating Scale to portuguese language. Rev Bras Reumatol. 2006;46(4):246-52.
  • 21. Lopes AD, Stadniky SP, Masiero D, Carrera EF, Ciconelli RM, Griffin S. Tradução e adaptação cultural do WORC: um questionário de qualidade de vida para alterações do manguito rotador. Rev Bras Fisioter. 2006;10(3):309-15.
  • 22. Williams JW Jr, Holleman DR Jr, Simel DL. Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol. 1995;22(4):727-32.
  • 24. Jamnik H, Spevak MK. Shoulder Pain and Disability Index: validation of Slovene version. Int J Rehabil Res. 2008;31(4):337-41.
  • 25. MacDermid JC, Solomon P, Prkachin K. The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity. BMC Musculoskelet Disord. 2006;7:12.
  • 26. Bot SD, Terwee CB, van der Windt DA, Bouter LM, Dekker J, de Vet HC. Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature. Ann Rheum Dis. 2004;63(4):335-41.
  • 27. Cloke DJ, Lynn SE, Watson H, Steen IN, Purdy S, Williams JR. A comparison of functional, patient-based scores in subacromial impingement. J Shoulder Elbow Surg. 2005;14(4):380-4.
  • 28. Paul A, Lewis M, Shadforth MF, Croft PR, Van Der Windt DA, Hay EM. A comparison of four shoulder-specific questionnaires in primary care. Ann Rheum Dis. 2004;63(10):1293-9.
  • 29. Nusbaum L, Natour J, Ferraz MB, Goldenberg J. Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris. Braz J Med Biol Res. 2001;34(2):203-10.
  • 30. Kosminsky M, Lucena LBS, Siqueira JTT, Pereira Jr FJ, Góes PSA. Adaptação cultural do questionário "Research Diagnostic Criteria for Temporomandibular Disorders: Axis II" para o português. JBC J Bras Clin Odontol Integr. 2004;8(43):51-61.
  • 31. Michener LA, McClure PW, Sennett BJ. American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg. 2002;11(6):587-94.
  • 32. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231-40.
  • 33. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3): 297-334.
  • 34. Napoles BV, Hoffman CB, Martins J, Oliveira AS. Tradução e adaptação cultural do Penn Shoulder Score para a Língua Portuguesa: PSS-Brasil. Rev Bras Rheumatol. 2010;50(4):389-407.
  • 35. Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3(6):347-52.
  • 36. Sallay PI, Reed L. The measurement of normative American Shoulder and Elbow Surgeons scores. J Shoulder Elbow Surg. 2003;12(6):622-7.
  • 37. Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol. 1999;39(3):143-50.
  • 38. Ferraz MB, Oliveira LM, Araújo PM, Atra E, Tugwell P. Crosscultural reliability of the physical ability dimension of the health assessment questionnaire. J Rheumatol. 1990;17(6):813-7.
  • 39. Luft CDB, Sanches SO, Mazo GZ, Andrade A. Versão brasileira da Escala de Estresse Percebido: tradução e validação para idosos. Rev Saúde Pública. 2007;41(4):606-15.
  • 40. Marx FC, Oliveira LM, Bellini CG, Ribeiro MCC. Tradução e validação cultural do questionário Algofuncional de Lequesne para osteoartrite de joelhos e quadris para a língua portuguesa. Rev Bras Reumatol. 2006;46(4):253-60.
  • 41. Pimenta CAM, Teixeira MJ. Questionário de dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enferm USP. 1996;30(3):473-83.
  • 42. Varoli FK, Pedrazzi V. Adapted version of the McGill pain questionnaire to Brazilian Portuguese. Braz Dent J. 2006;17(4):328-35.
  • 43. Beaton D, Richards RR. Assessing the reliability and responsiveness of 5 shoulder questionnaires. J Shoulder Elbow Surg. 1998;7(6):565-72.
  • 44. Roddey TS, Olson SL, Cook KF, Gartsman GM, Hanten W. Comparison of the University of California-Los Angeles Shoulder Scale and the Simple Shoulder Test with the shoulder pain and disability index: single-administration reliability and validity. Phys Ther. 2000;80(8):759-68.
  • 45. Cook KF, Roddey TS, Olson SL, Gartsman GM, Valenzuela FF, Hanten WP. Reliability by surgical status of self-reported outcomes in patients who have shoulder pathologies. J Orthop Sports Phys Ther. 2002;32(7):336-46.
  • 46. Schmitt JS, Di Fabio RP. Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria. J Clin Epidemiol. 2004;57(10):1008-18.
  • 47. Ekeberg OM, Bautz-Holter E, Tveitå EK, Keller A, Juel NG, Brox JI. Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease. BMC Musculoskelet Disord. 2008;9:68.
  • 48. Simmen BR, Angst F, Schwyzer HK, Herren DB, Pap G, Aeschlimann A, et al. A concept for comprehensively measuring health, function and quality of life following orthopaedic interventions of the upper extremity. Arch Orthop Trauma Surg. 2009;129(1):113-8.
  • Correspondência para:
    Anamaria Siriani de Oliveira
    Avenida dos Bandeirantes, 3900
    CEP 14049-900, Ribeirão Preto, SP, Brasil
    e-mail:
  • *
    Hoffman CB, Nápoles BV, Martins J, Oliveira AS. Obtenção dos questionários brasileiros SPADI e PSS aplicados por entrevista. In: XVIII Congresso Brasileiro de Fisioterapia – COBRAF, 2009, Rio de Janeiro-RJ.
  • Publication Dates

    • Publication in this collection
      04 Feb 2011
    • Date of issue
      Dec 2010

    History

    • Accepted
      09 Sept 2010
    • Reviewed
      05 Apr 2010
    • Received
      07 Oct 2009
    Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia Rod. Washington Luís, Km 235, Caixa Postal 676, CEP 13565-905 - São Carlos, SP - Brasil, Tel./Fax: 55 16 3351 8755 - São Carlos - SP - Brazil
    E-mail: contato@rbf-bjpt.org.br