The reliability and validity of the Turkish version of the oxford shoulder instability score

Linguistic validation and cultural adaptation of Tamil version of oxford shoulder score

Background

The Oxford Shoulder Score (OSS) is a well-established and extensively utilized shoulder score translated into Western and Asian languages for use in respective countries. Our study aimed to translate, cross-culturally adapt, and psychometrically validate the OSS in the Tamil language community.

Methods

The translation and cross-cultural adaptation were conducted according to previously established standards. We recruited 61 patients with degenerative or inflammatory shoulder pain presenting to a tertiary care hospital between January-August 2021. Patients were evaluated using the Tamil-OSS (OSS-T) and Constant-Murley scores (CMS). We assessed the understanding, acceptability, reproducibility, and reliability of the OSS-T. In addition, we evaluated the intra-observer and inter-observer reproducibility. We also evaluated the correlation of the OSS-T with another validated score namely the CMS.

Results

The mean age of the patient included in the study was 43 (±12) years. Patients took an average of 8 (±2) minutes to complete the OSS form. Internal Consistency of the OSS-T was strong (Cronbach's alpha = 0.98). The intraclass coefficient was 0.963 (95 % CI 0.93-0.98, p < 0.001). We noted significant interobserver reliability (r = 0.963, p < 0.001). The Tamil OSS showed a strong significant correlation with the CMS (r = 0.82, p < 0.001) and original OSS (r = 0.98, p < 0.001). The OSS-T has a high level of convergent validity with CMS (p < 0.001). The 12 included translated questions in the OSS-T scored more than 0.95 from the subject experts for inclusion based on the three-point Likert scale.

Conclusion

This study indicated that the Tamil version of the OSS is a reliable and valid, self-reported questionnaire, which can be applied to patients with shoulder disorders. Furthermore, the very good psychometric properties of the OSS-T score would allow for its use in clinical practice in national and international research projects concerning Tamil-speaking patients.

Level of evidence

4.

Oxford Shoulder Instability Score: cross-cultural adaptation into Spanish and analysis of its methodological quality

BACKGROUND

Oxford Shoulder Instability Score (OSIS) is a patient reported outcome measure designed specifically to assess functional difficulties resulting from shoulder instability. The main aim of this study was to cross-culturally adapt the OSIS to Spanish. Secondary, it aimed to analyse its methodological quality.

METHODS

A cross-cultural adaptation to Spanish has been carried out following the recommendations of COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) with a sample of 167 cases of shoulder instability. Inclusion criteria were: subjects with instability symptoms in at least one shoulder with or without clinical diagnosis; aged between 18 and 60. The following psychometric properties were evaluated: validity (construct, internal and external), reliability (internal consistency, test-retest and measurement error), discriminant ability and feasibility. The methodological quality was addressed with Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and COSMIN Risk of Bias checklist (COSMIN RoB).

RESULTS

The construct validity obtained an OSIS correlation with the Simple Shoulder Test of r = 0.636 and with the Western Ontario Shoulder Instability of r = 0.80. The unidimensionality of the OSIS was confirmed through second-order factor analysis. Cronbach's alpha and intraclass correlation coefficient were both 0.93 (IC95%: 0.91-0.94). Standard error of measurement was 0.70, and the percentage of error and smallest detectable change were 1.46% and 1.94, respectively. No floor or ceiling effects were found. Assessing feasibility of OSIS, the participants answered all questions, had no questions and completion time was: mean 2 min 30 s; SD ± 1 min. Regarding methodological quality, the study showed low risk of bias in the areas of patient selection, index test, reference standard and flow and timing, as well as low concern regarding applicability in the domains of patient selection, index test and reference standard according to QUADAS-2. In relation to COSMIN RoB, all psychometric properties, except for content validity, obtained very good results.

CONCLUSIONS

The Spanish version of OSIS offers valid, reliable and feasible functional outcome measures for Spanish-speaking subjects with shoulder instability, based on its psychometric properties and its methodological quality.

Validity and reliability of Turkish transcultural adaptation of the Prosthetic Limb Users Survey of Mobility

BACKGROUND

Amputee-specific, self-assessment mobility scales are essential to evaluate mobility in lower-limb amputees.

OBJECTIVES

To evaluate the validity and reliability of a Turkish translation and adaptation of the Prosthetic Limb Users Survey of Mobility.

STUDY DESIGN

This is a validation study.

METHODS

Turkish translation of the Prosthetic Limb Users Survey of Mobility (PLUS-M-T) from its original was performed following the rules of intercultural adaptation and translation methods. The PLUS-M-T and its 12-item short form were applied to '100 induviduals with limb loss twice in 3-day intervals. The structural validity analysis was determined by calculating the correlation with the Amputee Mobility Scale, which is a valid, reliable scale for assessing the functional level in amputees. The Cronbach alpha coefficient was calculated to analyze the internal consistency. The interclass correlation coefficient (ICC) and Spearman correlation coefficient (r) were calculated, and the test-retest reliability was determined.

RESULTS

A positive, high correlation was found between the first application and its repetition of both PLUS-M-T (ICC = 0.85, r = 0.94, P < 0.001) and 12-item short form (ICC = 0.92, r = 0.93, P < 0.001). The internal consistency was high for both PLUS-M-T (Cronbach alpha = 0.94) and 12-item short form (Cronbach alpha = 0.91). A positive, high correlation was found between the scores obtained from the Amputee Mobility Scale and PLUS-M-T (r = 0.84, P < 0.001) and 12 question short form (r = 0.77, P < 0.001).

CONCLUSION

Turkish translation of the PLUS-M questionnaire is a valid and reliable scale for assessing the mobility of individuals who have undergone lower-extremity amputation using a prosthesis.

How to Assess Shoulder Functionality: A Systematic Review of Existing Validated Outcome Measures

The objective of this review was to compile validated functional shoulder assessment tools and analyse the methodological quality of their validations. Secondarily, we aimed to provide a comparison of the tools, including parameter descriptions, indications/applications, languages and operating instructions, to choose the most suitable for future clinical and research approaches. A systematic review (PRISMA) was conducted using: PubMed, WoS Scopus, CINHAL, Dialnet and reference lists until 2020. The main criteria for inclusion were that papers were original studies of validated tools or validation studies. Pre-established tables showed tools, validations, items/components, etc. The QUADAS-2 and COSMIN-RB were used to assess the methodological quality of validations. Ultimately, 85 studies were selected, 32 tools and 111 validations. Risk of bias scored lower than applicability, and patient selection got the best scores (QUADAS-2). Internal consistency had the highest quality and PROMs development the lowest (COSMIN-RB). Responsiveness was the most analysed metric property. Modified UCLA and SST obtained the highest quality in shoulder instability surgery, and SPADI in pain. The most approached topic was activities of daily living (81%). We compiled 32 validated functional shoulder assessment tools, and conducted an analysis of the methodological quality of 111 validations associated with them. Modified UCLA and SST showed the highest methodological quality in instability surgery and SPADI in pain.

The efficacy of a phone assistance nursing program for functional outcomes in patients after shoulder instability surgery: A protocol for randomized controlled trial

OBJECTIVE

We conduct this research protocol for the assessment of the effect of phone-assisted care programs on functional outcomes in patients receiving shoulder instability surgery.

METHODS

This is a randomized controlled, single center trial which will be implemented from October 2020 to December 2021. This trial is conducted according to the SPIRIT Checklist of randomized researches. It was authorized via the Ethics Committee of the First People's Hospital of Xiangyang city affiliated to Hubei Medical College (XY234-026). Ninety participants who undergo shoulder instability surgery are analyzed. Patients are randomly divided into control group (standard management group, with 45 patients) and study group (the phone program group, with 45 patients). In control group, the exercises at home are not monitored. Whereas in study group, patients are asked about their at-home activities, and the extra coaching sessions are provided to patients on self-care, exercise guidance, and the importance of exercise at home, and then answers to their questions. The primary outcome is the range of motion of the shoulder joint, and the pain arcs are determined through the range of motion. The extra assessments include the shoulder functional outcome, pain, and the quality of life. All the analysis needed in this study is implemented with SPSS (IBM, Chicago, USA) for Windows Version 19.0.

RESULTS

The clinical outcome variables between groups are shown in Table.

CONCLUSION

This investigation can offer a reliable basis for the effectiveness of phone assistance nursing program in patients after shoulder instability surgery.

TRIAL REGISTRATION NUMBER

researchregistry6010.