A comparison of the Oxford shoulder score and shoulder pain and disability index: factor structure in the context of a large randomized controlled trial

Dawson, Jill; Harris, Kristina; Doll, Helen; Fitzpatrick, Ray; Carr, Andrew

doi:10.2147/prom.s115488

Cited by 22 publications

(14 citation statements)

References 28 publications

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“…This concurs with findings from several factor analyses that have indicated that the SPADI has at least two dimensions (9,12). Recently, data on the SPADI and Oxford Shoulder Score collected in a large randomized controlled trial comparing shoulder surgery with rest and exercise were analysed using exploratory and confirmatory factor analysis (8). The fit of both one-and two-factor hypothesised models were assessed and the authors conclude that both a single factor 13-item structure and two-factor pain and disability structure are supported and that the SPADI pain and disability subscales are suitable as primary endpoints.…”

Section: Discussionsupporting

confidence: 83%

“…The SPADI is short, easy to complete and score and has been widely adopted and recommended for clinical practice and research (6,8,9). It has been studied in multiple contexts for its validity, reliability and responsiveness (6)(7)(8)(9)(10)(11)(12)(13); using classical test theory (CTT). However, recent developments in the field of psychometrics and the scientific requirements for use of PROMs in clinical trials have highlighted that ordinal rating scales often do not meet the criteria for true interval-level measurement (14,15).…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of the structural validity of the shoulder pain and disability index (SPADI) using the Rasch model

et al. 2017

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Rasch Model analysis of the SPADI has identified some strengths and limitations not previously observed using CTT methods. The SPADI should be treated as two separate subscales. The SPADI is a widely used outcome measure in clinical practice and research; however, the scores derived from it must be interpreted with caution. The pain subscale fits the Rasch model expectations well. The disability subscale does not fit the Rasch model and its current format does not meet the criteria for true interval-level measurement required for use as a primary endpoint in clinical trials. Clinicians should therefore exercise caution when interpreting score changes on the disability subscale and attempt to compare their scores to age- and sex-stratified data.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

An evaluation of the structural validity of the shoulder pain and disability index (SPADI) using the Rasch model

et al. 2017

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“…This is the likely reason why previous studies have reported more of a unidimensional structure for the SPADI, especially where the pain construct is very high in conditions such as in adhesive capsulitis [25, 26]. A recent large randomised control trial and a multi-centre cohort study have provided further evidence of a two-factor structure for the SPADI, but even these studies suggest that the two factors of pain and disability are not well delineated with some items cross-loading [27, 28] and misfit of the disability items when the Rasch model is used [28].…”

Section: Discussionmentioning

confidence: 99%

Nepali translation, cross-cultural adaptation and measurement properties of the Shoulder Pain and Disability Index (SPADI)

Sharma

Ginn

et al. 2019

J Orthop Surg Res

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Background The Shoulder Pain and Disability Index (SPADI) is a 13-item shoulder-specific patient-reported outcome measure (PROM). The English version is easy to use and has demonstrated excellent measurement properties for both clinical and research settings. The availability of the SPADI in Nepali would facilitate shoulder research and enhance management of patients with shoulder pain in Nepal. Therefore, the purpose of this study was to translate and cross-culturally adapt the SPADI into Nepali (SPADI-NP) and evaluate its measurement properties. Methods The translation and adaptation process followed international guidelines. Participants completed SPADI-NP on two assessments ( N = 150 at initial and 119 at follow-up assessment). A Nepali version of the Global Rating of Change score was completed at follow-up. Assessment of measurement properties included analysis of internal consistency (Cronbach’s α), minimal detectable change (MDC) with standard error of measurement (SEM), test-retest reliability (intraclass correlation coefficient; ICC), validity (factor structure, construct using Pearson’s correlation with the Disability of Arm and Hand [DASH]) and responsiveness (area under the curve; AUC) with minimal important change (MIC). Results Minor changes were integrated in the adaptation process to improve cultural relevance such as dress items. Items were largely loaded under two factors (pain and disability), internal consistencies were good for the pain construct ( α = 0.82) and disability ( α = 0.88) and test-retest reliability was excellent (pain = 0.89, disability = 0.96). MDC was 5.7 (out of 100) with SEM = 2.1. Strong associations with the DASH ( r = 0.63 pain, r = 0.81 disability) demonstrated its construct validity. The AUC was 0.68 and MIC was 12.3 (out of 100). Conclusion The Nepali version of the SPADI demonstrated excellent reliability and validity. It can be used for the assessment of shoulder pain and disability in patients with shoulder pain in Nepal in both clinical practice and research.

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“…We chose a patient-reported outcome [40] which directly measures the participants' shoulder complaints. The OSS has been translated and cross-culturally adapted to Danish [19] and is a valid, reliable, and responsive shoulder-specific measure [17,[41][42][43][44]. It is one of the recommended first choice instruments in patients with shoulder disorders [45].…”

Section: Primary Outcomesmentioning

confidence: 99%

Reducing shoulder complaints in employees with high occupational shoulder exposures: study protocol for a cluster-randomised controlled study (The Shoulder-Café Study)

Trøstrup

Mikkelsen

Frost

et al. 2019

Preprint

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Background: In Denmark, exercise therapy in combination with work modifications is the first choice treatment for persons with shoulder complaints and high occupational shoulder exposures. To obtain this treatment they must visit several healthcare providers, which makes usual care fragmented and uncoordinated. Therefore, we developed a new intervention which unifies the expertise that is needed. The main hypotheses are that a group-based Shoulder-Café intervention will reduce (I) shoulder complaints and (II) occupational shoulder exposures more effectively than an individual-based Shoulder-Guidance intervention (active control – enhanced usual care). Methods: A cluster-randomised trial is conducted including 120 employees with high occupational shoulder exposures. Companies (clusters) are randomised to either Shoulder-Café or Shoulder-Guidance with a 1:1 allocation ratio. Participants are 18–65 years old and have an Oxford Shoulder Score (OSS) ≤ 40. Both interventions include a home-based shoulder exercise programme, assessment of shoulder exposures by technical measurements and self-report, and general information on how to reduce shoulder exposures. The Shoulder-Café course also includes three café meetings with physiotherapist-supervised exercises, clinical shoulder evaluation, education on shoulder anatomy, workplace-oriented counselling, and an opportunity for a workplace visit by a health and safety consultant. The primary outcomes are the OSS at 6 month follow-up (hypothesis I), and the mean number of minutes/day with the arm elevated > 60° shortly after end of intervention (hypothesis II). We will use mixed model analysis that allows for company clustering, and data will be analysed according to the intention-to-treat principle. Discussion: Persons with shoulder complaints and high occupational shoulder exposures are an obvious target group for secondary prevention efforts. We developed the Shoulder-Café to reduce shoulder complaints and shoulder exposures while unifying the expertise that is needed to evaluate and treat shoulder complaints. If the intervention is effective, it would warrant widespread implementation. Trial registration: The trial was registered at Clinicaltrials.gov on 18 May 2017 (ID: NCT03159910). Keywords: Exercise, Intervention, Mechanical exposure, Occupation, Randomised controlled trial, Shoulder, Training programme.

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A comparison of the Oxford shoulder score and shoulder pain and disability index: factor structure in the context of a large randomized controlled trial

Cited by 22 publications

References 28 publications

An evaluation of the structural validity of the shoulder pain and disability index (SPADI) using the Rasch model

An evaluation of the structural validity of the shoulder pain and disability index (SPADI) using the Rasch model

Nepali translation, cross-cultural adaptation and measurement properties of the Shoulder Pain and Disability Index (SPADI)

Reducing shoulder complaints in employees with high occupational shoulder exposures: study protocol for a cluster-randomised controlled study (The Shoulder-Café Study)

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