A Self-Administered Questionnaire for Assessment of Symptoms and Function of the Shoulder*

A self-administered questionnaire was designed to assess the severity of symptoms related to and the functional status of the shoulder. It includes domains of global assessment, pain, daily activities, recreational and athletic activities, work, satisfaction, and areas for improvement. Each domain is graded separately and is weighted to arrive at the total score. The over-all scale and each domain were prospectively tested for validity, reliability, and responsiveness to clinical change. One hundred patients who were seen for evaluation of the shoulder were enrolled in the study. The validity of the scale was demonstrated by moderate-to-high correlation of the domains and individual questions of the Shoulder Rating Questionnaire with those of the Arthritis Impact Measurement Scales 2. Validity was supported further by significant correlation of the scores in each domain with the level of satisfaction in that domain and by significantly lower scores in domains that patients selected as areas important for improvement. The over-all scale and each domain were internally consistent (Cronbach alpha, 0.71 to 0.90). Reproducibility was evaluated by repeated administration of the questionnaire after a mean of three days to forty patients whose condition was clinically stable. Reproducibility of the over-all questionnaire and individual domains was excellent (Spearman-Brown index, 0.94 to 0.98). Individual questions were reproducible, with a weighted kappa value of more than 0.7 for each. Responsiveness was evaluated by comparison of the preoperative and postoperative scores of thirty patients who had a satisfactory result one year after an operation on the shoulder. The over-all Shoulder Rating Questionnaire and each domain were responsive to clinical change as demonstrated by favorable standardized response means (range, 1.1 to 1.9) and indices of responsiveness (range, 1.1 to 2.0). Similar analysis performed for individual diagnostic groups supported the validity, reliability, and responsiveness of the questionnaire in each group. The self-administered shoulder questionnaire was found to be valid, reliable, and responsive to clinical change. These qualities should make it a useful instrument for the prospective assessment of the outcome of treatment of disorders related to the shoulder.

[1]  Freddie H. Fu,et al.  The Shoulder: A Balance of Mobility and Stability , 1993 .

[2]  M. Guttadauria,et al.  Outcome assessment in clinical trials. Evidence for the sensitivity of a health status measure. , 1984, Arthritis and rheumatism.

[3]  L. Koran,et al.  The reliability of clinical methods, data and judgments (second of two parts). , 1975, The New England journal of medicine.

[4]  A A Sapega,et al.  Muscle performance evaluation in orthopaedic practice. , 1990, The Journal of bone and joint surgery. American volume.

[5]  R. Lirette,et al.  The difficulties in assessment of results of anterior acromioplasty. , 1992, Clinical orthopaedics and related research.

[6]  J. Callaghan,et al.  Assessing the results of hip replacement. A comparison of five different rating systems. , 1990, The Journal of bone and joint surgery. British volume.

[7]  J. Katz,et al.  A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. , 1993, The Journal of bone and joint surgery. American volume.

[8]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[9]  Jacob Cohen,et al.  Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. , 1968 .

[10]  V C Mow,et al.  A standardized method for the assessment of shoulder function. , 1994, Journal of shoulder and elbow surgery.

[11]  A. Burstein,et al.  Measurements in the conduct of research. , 1993, The Journal of bone and joint surgery. American volume.

[12]  A M Epstein,et al.  The outcomes movement--will it get us where we want to go? , 1990, The New England journal of medicine.

[13]  B. Bach,et al.  Scoring Systems for Shoulder Conditions , 1996, The American journal of sports medicine.

[14]  J J Gartland,et al.  Orthopaedic clinical research. Deficiencies in experimental design and determinations of outcome. , 1988, The Journal of bone and joint surgery. American volume.

[15]  J. J. Gerhardt,et al.  Range-of-motion measurements. , 1995, The Journal of bone and joint surgery. American volume.

[16]  L. Kazis,et al.  AIMS2. The content and properties of a revised and expanded Arthritis Impact Measurement Scales Health Status Questionnaire. , 1992, Arthritis and rheumatism.

[17]  M. Liang,et al.  Comparisons of Five Health Status Instruments for Orthopedic Evaluation , 1990, Medical care.

[18]  D. Beaton,et al.  Measuring Function of the Shoulder. A Cross-Sectional Comparison of Five Questionnaires* , 1996, The Journal of bone and joint surgery. American volume.

[19]  L. Cronbach.  Coefficient alpha and the internal structure of tests , 1951 .

[20]  G. Guyatt,et al.  Measuring change over time: assessing the usefulness of evaluative instruments. , 1987, Journal of chronic diseases.

[21]  C. Ranawat,et al.  A self-administered hip-rating questionnaire for the assessment of outcome after total hip replacement. , 1992, The Journal of bone and joint surgery. American volume.