Norwegian translation, cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaire

Abstract

The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, with 10 items and a total score ranging from zero to 100, provides more clinically relevant information about overhead athletes than other shoulder or upper limb patient-reported outcomes.ObjectivesTo translate, cultural adapt and evaluate the measurement properties of the Norwegian version of KJOC shoulder and elbow questionnaire.Methods33 overhead athletes (age 18.6±4.2, 10 men/23 women) were included in the analysis of face validity and known-group validity, of whom 15 went through cognitive interviews. An electronic version was developed, and six handball players were interviewed to ensure measurement equivalence between the paper-based and electronic version of the questionnaire. Test–retest reproducibility (1-week interval) and concurrent validity with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was investigated in 36 handball players (age 20.7±3.8, 17 men/19 women).ResultsThe translation was conducted, and smaller consensus-based adjustments were made. Athletes found the questionnaire easy to understand, with no differences between paper and electronic based version, and preferred the electronic version. The Norwegian electronic version of the KJOC showed excellent internal consistency (Cronbach's α=0.952) and relative test–retest reliability (Intraclass correlation coefficient, ICC=0.967). SEM, minimal detectable change (MDC) and limits of agreement were 3.1, 8.5 and −9.2 to 7.7, respectively. The concurrent validity versus DASH was moderate (Spearman’s rho=−0.642). However, KJOC had a wider range in scores than DASH, distinguished better between players playing with and without pain and was more sensitive to capture players playing with pain.ConclusionThis study suggests that the Norwegian version of the KJOC is a reliable and acceptable tool for evaluating shoulder and elbow-related problems in overhead athletes (handball players).

Cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score in Finnish-speaking overhead athletes

“…Detected correlations with DASH, DASH-SM and ASES corresponded the early hypothesis of moderate to strong correlations and the results were in line with previous studies (6, 17,18,19,20,21,22). In subgroup analysis, correlations resulted higher within symptomatic subjects.…”

“…Internal consistency was evaluated as excellent, and is in line with previous studies (17,18,19,20,21).…”

“…Compared to earlier publications, ICC resulted lower (0.77 vs. 0.82-0.99) and consequently, the measures of absolute reliability were of a higher level (SEM 5.5 vs. 0.81-8.54; MDC 15.1 vs. 2.42-8.5) (6, 17,19,20,21,22). The variation in repeatability results might be due to the characteristics of study subjects.…”

“…In general, low mean age (18.1), high participation of asymptomatic athletes (83.3%), and athletes' semiprofessional level of competition (79.8%) might have resulted in the increased variability in the test-retest data. Previously, it has been argued that older and higher-level athletes might give more precise answers related to their athletic performance (20). Older and higher-level athletes might possess a broader range of symptoms and observe themselves in a closer manner, leading to differences in the accuracy of reporting.…”

“…Detection of functional changes may aid in planning the sports training, rehabilitation, and return to sports after injury. The KJOC score is a valid and reliable tool in English speaking overhead athletes (6, 15,16), and it has recently been validated to several other languages (17,18,19,20,21,22). However, the validity, reliability, and responsiveness of the Finnish version of KJOC have not been previously reported.…”