Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2006 | Research article

The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity

Authors: Joy C MacDermid, Patty Solomon, Kenneth Prkachin

Published in: BMC Musculoskeletal Disorders | Issue 1/2006

Abstract

Background

The Shoulder Pain and Disability Index (SPADI) is a self-report measure developed to evaluate patients with shoulder pathology. While some validation has been conducted, broader analyses are indicated. This study determined aspects of cross-sectional and longitudinal validity of the SPADI.

Methods

Community volunteers (n = 129) who self-identified as having shoulder pain were enrolled. Patients were examined by a physical therapist using a standardized assessment process to insure that their pain was musculoskeletal in nature. This included examination of pain reported during active and passive shoulder motion as reported on a visual analogue pain scale. Patients completed the SPADI, the Coping Strategies Questionnaire (CSQ) and the Sickness Impact Profile (SIP) at a baseline assessment and again 3 and 6 months later. Factor analysis with varimax rotation was used to assess subscale structure. Expectations regarding convergent and divergent subscales of CSQ and SIP were determined a priori and analysed using Pearson correlations. Constructed hypotheses that patients with a specific diagnosis or on pain medication would demonstrate higher SPADI scores were tested. Correlations between the observed changes recorded across different instruments were used to assess longitudinal validity.

Results

The internal consistencies of the SPADI subscales were high (α > 0.92). Factor analysis with varimax rotation indicated that the majority of items fell into 2 factors that represent pain and disability. Two difficult functional items tended to align with pain items. Higher pain and disability was correlated to passive or negative coping strategies, i.e., praying/hoping, catastrophizing on the CSQ. The correlations between subscales of the SPADI and SIP were low with divergent subscales and low to moderate with convergent subscales. Correlations, r > 0.60, were observed between the SPADI and pain reported on a VAS pain scale during active and passive movement. The two constructed validity hypotheses (on diagnosis and use of pain medications) were both supported (p < 0.01). The SPADI demonstrated significant changes over time, but these were poorly correlated to the SIP or CSQ suggesting that these scales measure different parameters.

Conclusion

The SPADI is a valid measure to assess pain and disability in community-based patients reporting shoulder pain due to musculoskeletal pathology.

Available only for authorised users

Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y: Development of a shoulder pain and disability index. Arthritis Care Res. 1991, 4: 143-149.CrossRefPubMed

Williams JWJ, Holleman DRJ, Simel DL: Measuring shoulder function with the Shoulder Pain and Disability Index. J Rheumatol. 1995, 22: 727-732.PubMed

Cook KF, Roddey TS, Olson SL, Gartsman GM, Valenzuela FF, Hanten WP: Reliability by surgical status of self-reported outcomes in patients who have shoulder pathologies. J Orthop Sports Phys Ther. 2002, 32: 336-346.CrossRefPubMed

Di Fabio RP, Boissonnault W: Physical therapy and health-related outcomes for patients with common orthopaedic diagnoses. Journal of Orthopaedic & Sports Physical Therapy. 1998, 27: 219-230.CrossRef

Heald SL, Riddle DL, Lamb RL: The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure. Phys Ther. 1997, 77: 1079-1089.PubMed

MacDermid JC, Chesworth BM, Patterson S, Roth JH: Validity of pain and motion indicators recorded on a movement diagram of shoulder lateral rotation. Australian Journal of Physiotherapy. 1999, 45: 269-277.CrossRefPubMed

Paul A, Lewis M, Shadforth MF, Croft PR, van der Windt DA, Hay EM: A comparison of four shoulder-specific questionnaires in primary care. Ann Rheum Dis. 2004, 63: 1293-1299. 10.1136/ard.2003.012088.CrossRefPubMedPubMedCentral

Schmitt JS, Di Fabio RP: Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria. J Clin Epidemiol. 2004, 57: 1008-1018. 10.1016/j.jclinepi.2004.02.007.CrossRefPubMed

Roddey TS, Olson SL, Cook KF, Gartsman GM, Hanten W: Comparison of the University of California-Los Angeles Shoulder Scale and the Simple Shoulder Test with the shoulder pain and disability index: single-administration reliability and validity. Phys Ther. 2000, 80: 759-768.PubMed

10.

Cloke DJ, Lynn SE, Watson H, Steen IN, Purdy S, Williams JR: A comparison of functional, patient-based scores in subacromial impingement. J Shoulder Elbow Surg. 2005, 14: 380-384. 10.1016/j.jse.2004.08.008.CrossRefPubMed

11.

Ostor AJ, Richards CA, Prevost AT, Speed CA, Hazleman BL: Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology (Oxford). 2005

12.

Beaton D, Richards RR: Assessing the reliability and responsiveness of 5 shoulder questionnaires. J Shoulder Elbow Surg. 1998, 7: 565-572. 10.1016/S1058-2746(98)90002-7.CrossRefPubMed

13.

Beaton DE, Richards RR: Measuring function of the shoulder. A cross-sectional comparison of five questionnaires. J Bone Joint Surg Am. 1996, 78: 882-890.PubMed

14.

Angst F, Pap G, Mannion AF, Herren DB, Aeschlimann A, Schwyzer HK, Simmen BR: Comprehensive assessment of clinical outcome and quality of life after total shoulder arthroplasty: usefulness and validity of subjective outcome measures. Arthritis Rheum. 2004, 51: 819-828. 10.1002/art.20688.CrossRefPubMed

15.

Michener LA, Leggin BG: A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther. 2001, 14: 68-76.CrossRefPubMed

16.

Bot SD, Terwee CB, van der Windt DA, Bouter LM, Dekker J, de Vet HC: Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature. Ann Rheum Dis. 2004, 63: 335-341. 10.1136/ard.2003.007724.CrossRefPubMedPubMedCentral

17.

Rosenstiel AK, Keefe FJ: The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain. 1983, 17: 33-44. 10.1016/0304-3959(83)90125-2.CrossRefPubMed

18.

Bergner M, Bobbitt RA, Kressel S, Pollard WE, Gilson BS, Morris JR: The sickness impact profile: Conceptual formulation and methodology for the devlopment of a health status measure. International Journal of Health Services. 1976, 6: 393-415.CrossRefPubMed

19.

Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS: The sickness impact profile: Validation of a health measure. Med Care. 1976, 14: 57-67.CrossRefPubMed

20.

Bergner M, Bobbitt RA, Carter WB, Gilson BS: The sickness impact profile: Development and final revision of a health status measure. Med Care. 1981, 19: 787-805.CrossRefPubMed

21.

Cohen J: Statistical Power Analyses for the Behavioural Sciences. 1987, New York, N.Y, Academic Press, Harcourt Press

22.

Michlovitz SL, LaStayo PC, Alzner S, Watson E: Distal radius fractures: therapy practice patterns. J Hand Ther. 2001, 14: 249-257.CrossRefPubMed

23.

MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH: Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma. 1998, 12: 577-586. 10.1097/00005131-199811000-00009.CrossRefPubMed

24.

Norman GR, Streiner DL: Biostatistics. The Bare Essentials. 1994, St. Louis. MO, Mosby, 1: 2-260. 1

25.

Kennedy D, Stratford PW, Pagura SMC, Wessel J, Gollish JD, Woodhouse LJ: Exploring the factorial validity and clinical interpretability of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Physiother Can. 2003, 55: 160-168.CrossRef

26.

Stratford PW, Kennedy DM: Does parallel item content on WOMAC's pain and function subscales limit its ability to detect change in functional status?. BMC Musculoskelet Disord. 2004, 5: 17-10.1186/1471-2474-5-17.CrossRefPubMedPubMedCentral

27.

Bostrom C, Harms-Ringdahl K, Nordemar R: Relationships between measurements of impairment, disability, pain, and disease activity in rheumatoid arthritis patients with shoulder problems. Scand J Rheumatol. 1995, 24: 352-359.CrossRefPubMed

28.

Kirkley A, Alvarez C, Griffin S: The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: The Western Ontario Rotator Cuff Index. Clin J Sport Med. 2003, 13: 84-92. 10.1097/00042752-200303000-00004.CrossRefPubMed

29.

Beaton DE, Bombardier C, Hogg-Johnson SA: Measuring health in injured workers: a cross-sectional comparison of five generic health status instruments in workers with musculoskeletal injuries. Am J Ind Med. 1996, 29: 618-631. 10.1002/(SICI)1097-0274(199606)29:6<618::AID-AJIM6>3.0.CO;2-F.CrossRefPubMed

30.

Stucki G, Liang MH, Phillips C, Katz JN: The Short Form-36 is preferable to the SIP as a generic health status measure in patients undergoing elective total hip arthroplasty. Arth Care Res. 1995, 8: 174-181.CrossRef

31.

Beaton DE, Hogg-Johnson S, Bombardier C: Evaluating changes in health status: reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders. J Clin Epidemiol. 1997, 50: 79-93. 10.1016/S0895-4356(96)00296-X.CrossRefPubMed

32.

Katz JN, Larson MG, Phillips CB, Fossel AH, Liang MH: Comparative measurement sensitivity of short and longer health status instruments. Med Care. 1992, 30: 917-925.CrossRefPubMed

33.

MacDermid JC, Richards RS, Donner A, Bellamy N, Roth JH: Responsiveness of the short form-36, disability of the arm, shoulder, and hand questionnaire, patient-rated wrist evaluation, and physical impairment measurements in evaluating recovery after a distal radius fracture. J Hand Surg [Am ]. 2000, 25A: 330-340. 10.1053/jhsu.2000.jhsu25a0330.CrossRef

34.

Buer N, Linton SJ: Fear-avoidance beliefs and catastrophizing: occurrence and risk factor in back pain and ADL in the general population. Pain. 2002, 99: 485-491. 10.1016/S0304-3959(02)00265-8.CrossRefPubMed

35.

France CR, France JL, al'Absi M, Ring C, McIntyre D: Catastrophizing is related to pain ratings, but not nociceptive flexion reflex threshold. Pain. 2002, 99: 459-463. 10.1016/S0304-3959(02)00235-X.CrossRefPubMedPubMedCentral

36.

Jones DA, Rollman GB, White KP, Hill ML, Brooke RI: The relationship between cognitive appraisal, affect, and catastrophizing in patients with chronic pain. J Pain. 2003, 4: 267-277. 10.1016/S1526-5900(03)00630-8.CrossRefPubMed

37.

Severeijns R, Vlaeyen JW, van den Hout MA, Weber WE: Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001, 17: 165-172. 10.1097/00002508-200106000-00009.CrossRefPubMed

38.

Severeijns R, van den Hout MA, Vlaeyen JW, Picavet HS: Pain catastrophizing and general health status in a large Dutch community sample. Pain. 2002, 99: 367-376. 10.1016/S0304-3959(02)00219-1.CrossRefPubMed

39.

Severeijns R, Vlaeyen JW, van den Hout MA, Picavet HS: Pain catastrophizing is associated with health indices in musculoskeletal pain: a cross-sectional study in the Dutch community. Health Psychol. 2004, 23: 49-57. 10.1037/0278-6133.23.1.49.CrossRefPubMed

40.

Sullivan MJ, Stanish W, Waite H, Sullivan M, Tripp DA: Catastrophizing, pain, and disability in patients with soft-tissue injuries. Pain. 1998, 77: 253-260. 10.1016/S0304-3959(98)00097-9.CrossRefPubMed

41.

Jensen MP, Turner JA, Romano JM: Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment. J Consult Clin Psychol. 2001, 69: 655-662. 10.1037/0022-006X.69.4.655.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/7/12/prepub

Title: The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity
Authors: Joy C MacDermid
Patty Solomon
Kenneth Prkachin
Publication date: 01-12-2006
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2006
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-7-12

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2006

Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc herniation: a prospective randomised controlled trial [ISRCTN51857546]

Prevalence of amyloid deposition in long standing rheumatoid arthritis in Iranian patients by abdominal subcutaneous fat biopsy and assessment of clinical and laboratory characteristics

Subcutaneous rupture of the Achilles tendon and ipsilateral fracture of the medial malleolus

Responsiveness and minimal clinically important difference for pain and disability instruments in low back pain patients

The Knee Clinical Assessment Study – CAS(K). A prospective study of knee pain and knee osteoarthritis in the general population: baseline recruitment and retention at 18 months

The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series