Psychometric Properties of Full and Shortened Persian-version of Western Ontario Rotator Cuff Index Questionnaires in Persian-speaking Patients with Shoulder Pain

Cross-cultural adaptation, validation and responsiveness of the Persian version of Western Ontario shoulder instability index questionnaire in Persian patients with shoulder instability

INTRODUCTION

To translate, cross-culturally adapt, and psychometric testing the Western Ontario Shoulder Instability index (WOSI) into Persian.

METHODS

Seventy-two patients diagnosed with shoulder instability participated in reliability, construct validity, and responsiveness analysis. All the patients filled out the WOSI with an interval of two weeks to assess reliability. The shortened Disability of Arm, Shoulder and Hand (Quick-DASH), Shoulder Pain and Disability Index (SPADI), and the 36-Item Short-Form Survey (SF-36) were assessed to evaluate construct validity. In order to assess responsiveness patients filled out WOSI before and after the physiotherapy and global rating of change scale at last session of physiotherapy. Reliability was assessed by intra-class correlation coefficient (ICC (1,2)), construct validity by two tailed Pearson (r), and responsiveness by longitudinal validity and receiver operating characteristics (ROC) curve analysis.

RESULTS

The ICC (1,2) was 0.90 and correlation analysis revealed high level of correlation with: Quick-DASH (r = 0.82); SPADI (r = 0.72); physical SF-36 (r = -0.52); and mental SF-36 (r = -0.48). Responsiveness analysis demonstrated the area under curve was 0.90, with minimal clinical important difference 46.87.

CONCLUSION

We found the Persian-WOSI as a valid, reliable, and responsive questionnaire to evaluate quality of life of patients with shoulder instability.

Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Quebec Back Pain Disability Scale: Responsiveness and Minimal Clinically Important Changes in Iranian People with Lumbar Disc Herniation Following Physiotherapy

Objectives

The present study aimed to investigate the responsiveness of the Persian version of the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Quebec Back Pain Disability Scale (QBPDS) and detect minimal clinically important changes (MCICs) of these questionnaires in people with lumbar disc herniation.

Methods

Ninety-two patients with lumbar herniated disc completed the Persianversion of the ODI, RMDQ, and QBPDS before and after the physiotherapy intervention. Additionally, they completed a global rating of change scale after the final physiotherapy session to give an account of non-improved and improved outcomes. The responsiveness of these three disability questionnaires was represented by Receiver Operating Characteristic (ROC) and correlation analyses. The MCIC was defined as the best cut-off when sensitivity and specificity were optimally balanced.

Results

Area under the ROC curves are in the acceptable range for ODI and QBPDS (0.78 and 0.70, respectively). Moreover, ODI, RMDQ, and QBPDS have significant positive fair to moderate correlation with the external anchor (P<0.001). The MCIC values for ODI, RMDQ, and QBPDS were 13, 5.5, and 14.5 points, respectively.

Conclusion

Our results revealed that the ODI and QBPDS questionnaires have adequate responsiveness to detect improvements in the functional status of lumbar herniated disc patients following a physiotherapy treatment. Therefore, the ODI and QBPDS seem to be superior to the RMDQ for use in randomized clinical trials and clinical settings in patients with herniated lumbar discs. The MCIC scores of 13 and 14.5 obtained for the ODI and QBPDS can help to identify important changes in the clinical status of an individual patient and treatment efficacy.