Clinimetric Testing Supports the Use of 5 Questionnaires Adapted Into Brazilian Portuguese for Patients With Shoulder Disorders

Abstract

isorders of the shoulder region cause pain and limitation in movement and can affect functional abilities, professional and sports activities, as well as activities of daily living, and can ultimately affect quality of life.7 Studies conducted in Europe and North America estimated that roughly half of the population has at least 1 episode of shoulder pain a year, which results in high cost of treatment. 7,39,47 Current practice standards suggest that standard clinical measurements of muscle strength and joint mobility should be supplemented by the use of self-report questionnaires to measure pain, disability, and quality of life in these patients. 11,22,30 In the last decade, a large number of questionnaires have been developed to assess function and clinical changes in individuals with shoulder disorders. 6,17,42 A systematic review 17 identified 38 questionnaires for upper-limb disorders, including self-assessment instruments used in isolation or in conjunction with objective measures. Another review, 6 limited to self-report instruments, identified 16 questionnaires. Together with a recent systematic review on 4 questionnaires that measure function in patients with shoulder pain, 42 these reviews provide evidence that there is no single, ideal instrument for patients with shoulder disorders. The choice of a questionnaire to use in clinical practice or research must be based on the type of patients, the intended construct/outcome to measure, practical considerations (ease and time of application), measurement properties of the instrument, and whether the instrument has been translated and cross-culturally adapted for the targeted population. 6,17,18 Two of the most frequently cited questionnaires in the literature are the T T STUDY DESIGN: Clinical measurement. T T OBJECTIVES:To cross-culturally adapt the Shoulder Pain and Disability Index (SPADI) into Brazilian Portuguese and to test the measurement properties of the Brazilian Portuguese versions of the SPADI, the short form of the Disabilities of the Arm, Shoulder and Hand, the Patient-Specific Functional Scale, a numeric pain rating scale, and the Global Perceived Effect scale in patients with shoulder disorders. T T BACKGROUND:Most instruments for shoulder disorders were developed in English. For their use in Brazil, translation into Brazilian Portuguese, cross-cultural adaptation, and testing of measurement properties of these instruments are required. T T METHODS:The SPADI was translated and cross-culturally adapted according to current guidelines. Measurement properties of internal consistency, reproducibility, construct validity, ceiling and floor effects, and responsiveness of all instruments were tested in 100 patients with shoulder disorders. The patients filled out the questionnaires on 3 occasions: at baseline, 24 to 48 hours after baseline, and 4 weeks after baseline. T T RESULTS:The instruments showed adequate internal consistency (Cronbach alpha between .78 and .93) and a good level of agreement, as reflected by low standard errors of measureme...

Minimal Clinically Important Difference of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH) and Its Shortened Version (QuickDASH)

“…2 Likewise, our MDC 90 for the QuickDASH was 12.85 points, compared to values ranging from 11 to 15.7 points in the literature, 1,14,23,27,30,31 whereas the MDC 95 reported on the DASH website ranges from 16 to 20 points. 20 It is important to recognize that (a) the MDC values reflect the specific ICC and standard deviation values in each particular study, and therefore different groups of patients would be expected to generate different values; (b) changes below the MDC threshold could be interpreted at an individual level as random fluctuations in score rather than actual change 39 ; and (c) the lower the reliability coefficient, the greater the SEM and the higher the MDC will be.…”

Evaluative Measurement Properties of the Patient-Specific Functional Scale for Primary Shoulder Complaints in Physical Therapy Practice

“…Recently, a study in patients with shoulder complaints, including specific pathology and postoperative shoulder patients, concluded that the PSFS was a reproducible, valid, and responsive instrument for measuring disability. 42 In general, the PSFS scored positively on agreement, test-retest reliability, construct validity, and responsiveness. 2,26 Overall, PSFS scales were more responsive than various musculoskeletal condition-specific questionnaires.…”

“…The test-retest reliability, construct validity, and responsiveness of the NPRS for measuring shoulder pain have been supported in various studies. 34,42 We instructed patients to choose the number that corresponded best with their current pain intensity level and their worst and least amount of pain in the last 24 hours. To best determine the amount of pain over the last 24 hours, the average of these 3 measures was used.…”

Estilo de vida e nível de atividade física de indivíduos com dor no ombro atendidos em um serviço público

“…A queixa de dor no ombro foi considerada quando a pontuação no questionário Shoulder Pain and Disability Index (SPADI) 17 foi igual ou maior a 30 pontos. Considerando que o SPADI não apresenta uma classificação da pontuação em níveis de severidade da disfunção, este ponto de corte foi estabelecido com base no estudo de Puga et al 18 …”

“…O questionário SPADI representa uma das ferramentas mais recomendadas para avaliação das disfunções de ombro e a versão brasileira é confiável, válida e responsiva 17,18 . O questionário apresenta um domínio de dor com cinco itens e outro domínio de incapacidade, com oito itens, pontuados em uma escala de avaliação numérica de 10 pontos, de modo que zero indica sem dificuldade ou sem dor e dez indica não conseguiu fazer ou pior dor.…”