Cross-cultural Adaptation and Validation of the European Portuguese Version of the Western Ontario Shoulder Instability Index (WOSI)

Abstract

Introduction: The Western Ontario Shoulder Instability Index (WOSI) is a self-administered questionnaire specifically used to determine the impact of shoulder instability on quality of life. The aim of this study was to translate the WOSI into European Portuguese and analyze its validity and reliability in a population with shoulder instability.Material and Methods: The WOSI was translated and culturally adapted from its original version into European Portuguese (WOSIPT). Internal consistency and test-retest analyses were conducted to determine the level of reliability of the scale. WOSI-PT, Quick-DASH, and SF-12 questionnaires were applied to 81 patients with symptomatic shoulder instability to assess validity, and reliability was tested by randomly selecting 50 patients within 72 hours using a test-retest design.Results: The reliability of the WOSI-PT was very high, with Cronbach´s alpha equal to 0.97 and an intraclass correlation coefficient of 0.98. Regarding the construct validity, the correlation between the WOSI-PT and QuickDASH was high and negative (-0.79). The correlations between WOSI-PT and SF-12 were positive, respectively, moderate with physical (0.66) and low with mental (0.34) health.Conclusion: WOSI-PT is a reliable and valid instrument for assessing the functional impact of shoulder joint instability on quality of life.

Reliability, Validity and Responsiveness of the Polish Version of the Western Ontario Shoulder Instability Index (WOSI-PL) in Patients after Arthroscopic Repair for Shoulder Instability

“…The majority of the hypotheses specified in the methodology were proven. The findings show that the psychometric properties of the WOSI-PL correspond to those reported for the original version of the tool and WOSI adaptations developed in other countries [ 3 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. A summary of the psychometric properties of all language versions of the WOSI questionnaire is shown in Table S1 .…”

“…The WOSI is one of most frequently used questionnaires for shoulder instability with very good psychometric properties [ 6 , 8 ]. It has been validated in twelve languages and in fourteen cultures so far [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. Bejer et al, (2019) published the results of the translation and cultural adaptation of the WOSI into Polish [ 26 ].…”

“…It also exceeds 0.90, which is the recommended threshold when a questionnaire is used in a clinical setting [ 40 ]; not exceeding 0.95 which may indicate item redundancy [ 34 ]. The Cronbach’s alpha coefficient in other language versions of the WOSI ranged from 0.84 ( n = 85) in the Japanese version [ 12 ] to 0.97 ( n = 81) in the European Portuguese versions [ 25 ]. The original research of the WOSI does not report this coefficient [ 3 ].…”

“…These values are similar to those reported in the case of the original WOSI (ICC at 2 weeks was 0.95) [ 3 ] and are consistent with other studies reporting repeatability of this tool using a similar time interval. In the Turkish version, the ICC was 0.97 [ 21 ], and in the European Portuguese version the ICC was 0.97 [ 25 ]. In both of these cases, the time interval was 72 h [ 21 , 25 ].…”

“…Whittle et al, in their systematic review, also strongly recommend using WOSI for patients with shoulder instability [ 6 ]. To our knowledge, the WOSI has been translated to Swedish [ 9 ], German [ 10 , 11 ], Japanese [ 12 ], Italian [ 13 ], Brazilian, Portuguese [ 14 ], Dutch [ 15 , 16 ], French—validated on a Canadian and Swiss population [ 17 ], Spanish [ 18 ], Danish [ 19 ], French—validated on a French population [ 20 ], Turkish [ 21 ], Hebrew [ 22 ], Arabic [ 23 , 24 ] and European Portuguese [ 25 ]. In Poland, translation and cultural adaptation of the WOSI was conducted by Bejer et al, in 2019 [ 26 ].…”