Spanish cultural adaptation and validation of the shoulder pain and disability index, and the oxford shoulder score after breast cancer surgery

Abstract

BackgroundThe Oxford Shoulder Score (OSS) and the Shoulder Pain and Disability Index (SPADI) are patient-based outcome scores with valid psychometric properties which are widely used for shoulder interventions.ObjectiveThe purpose of the study is to adapt both questionnaires cross-culturally to Spanish, and to test their reliability, validity, responsiveness, and feasibility.DesignCultural adaptation and psychometric validation study.MethodsConsecutive patients who had undergone breast cancer surgery referred to an outpatient clinic at the University of Alcalá de Henares, Spain. One hundred and twenty women who had undergone breast cancer surgery, with pain and shoulder dysfunction. Cross-cultural adaptation was performed according to the international guidelines. Reliability was analysed by test-retest reliability and internal consistency. Content and convergent construct validity were measured by the Expert Committee’s and Spearman coefficient respectively. Responsiveness, feasibility, floor and ceiling effects were also tested.ResultsOne hundred and twenty women aged 54.2 (±11) years took part in the study. The reliability was excellent; test-retest reliability was 0.974 (p < 0.001) for OSS, and 0.992 (p < 0.001) for SPADI; and Cronbach’s alpha value was 0.947 for OSS, and 0.965 for SPADI. High construct validity was found between the OSS and SPADI questionnaires (r = −0.674). The effect size (ES) and standardized response mean (SRM) was moderate in OSS (ES = 0.50 and SRM = 0.70 (p < 0.001)), and moderate to good in SPADI (ES = 0.59 and SRM = 0.82 (p < 0.001)).LimitationsThis study has some limitations, such as the group of participants is composed only of women following breast cancer treatment; the measurement took place in a single centre; and all the questionnaires administered were always provided to the participants in the same order.ConclusionsThe OSS and SPADI Spanish versions are applicable, reliable, valid, and responsive to assess shoulder symptoms and quality of life in Spanish women with shoulder pain and disability after breast cancer treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-015-0256-y) contains supplementary material, which is available to authorized users.

Electromyographic Analysis of Shoulder Neuromuscular Activity in Women Following Breast Cancer Treatment: A Cross-Sectional Descriptive Study

“…Surface electromyography (sEMG) was used to measure the onset and amplitude of muscle activity for five different muscles of the shoulder, performing the three movements that are more affected in women after breast cancer (abduction, forward flexion, and external rotation) [ 29 ]. In all the movements that were evaluated, the upper trapezius muscle, lower trapezius muscle, and especially the serratus anterior muscle was established as representatives for the upward scapular rotator muscles.…”

Measures of Adult Shoulder Function

“…There is evidence for high internal consistency, with high Cronbach’s α scores for the total SPADI scale and the individual subscales in various settings, including shoulder disorders in outpatients (Cronbach’s α : total SPADI = 0.96, disability = 0.95, and pain = 0.89) (29), population‐based individuals with shoulder pain (Cronbach’s α : total SPADI = 0.92, disability = 0.90, and pain = 0.85) (8), and Spanish patients with shoulder pain/dysfunction after surgery for breast cancer (Cronbach’s α = 0.965) (30).…”

“…Test‐retest reliability was moderate in the original development study (intraclass correlation coefficient [ICC] = 0.66; 95% confidence interval [CI] 0.42‐0.81), although only 37 subjects with shoulder pain were included (5). Higher ICCs have been reported in subsequent studies in various populations, including patients with general shoulder pain (ICC = 0.91) (31), adhesive capsulitis (ICC = 0.89 [95% CI 0.82‐0.93], pain subscale ICC = 0.85 [95% CI 0.76‐0.91], disability subscale ICC = 0.86 [95% CI 0.78‐0.92]) (32), and Spanish patients with shoulder pain/dysfunction after surgery for breast cancer (ICC = 0.992) (30).…”

“…Rotator cuff surgery or total shoulder arthroplasty: SRM = 1.23 (31); this was better than the SRQ (SRM = 0.65) and comparable with the SST (SRM = 1.05). Occupational or physical therapy for various upper extremity disorders: ES = 1.21 and SRM = 1.08; this was similar to the DASH (ES =1.06, SRM = 1.08) and SF‐36 PCS (ES = 1.20, SRM = 1.07) (45). Spanish patients with shoulder pain/dysfunction after surgery for breast cancer: ES = 0.59 and SRM = 0.82 (30). …”

Cultural Adaptation and Psychometric Validation of the Standardised Nordic Questionnaire Spanish Version in Musicians

“…The Shoulder Pain and Disability Index is a self-reporting questionnaire that measures shoulder pain and disability. It is validated in Spanish [31]. Higher scores in each subscale imply greater pain intensity and greater disability [28].…”