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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2014

Open Access 01-12-2014 | Research article

Measurement properties of the Western Ontario Shoulder Instability Index in Dutch patients with shoulder instability

Authors: Just A van der Linde, W Jaap Willems, Derk A van Kampen, Loes W A H van Beers, Derek FP van Deurzen, Caroline B Terwee

Published in: BMC Musculoskeletal Disorders | Issue 1/2014

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Abstract

Background

The Western Ontario Shoulder Instability index (WOSI) is a patient-reported outcome measure for patients with shoulder instability. The purpose of this study was to validate the WOSI in a Dutch population by evaluating its structural validity, internal consistency, measurement error, reliability, and construct validity. Floor and ceiling effects were also addressed.

Methods

Two cohorts were recruited, including a total of 138 patients with shoulder instability. Confirmatory factor analysis was used to assess the structural validity and Cronbach’s α to assess internal consistency. The measurement error was calculated as the smallest detectable change (SDC). Reliability (test–retest) was estimated in a subgroup of 99 patients who completed the re-test after a mean of 13 days (5–30 days). Reliability was calculated with the intraclass correlation coefficient (ICC). Construct validity was evaluated by comparing the WOSI with the Oxford Shoulder Instability Score (OSIS), the Simple Shoulder Test, the Oxford Shoulder Score, the Disability of the Arm, Shoulder, and Hand assessment (DASH), and the Short Form-36 Health Survey. Measurement properties were evaluated for both the total WOSI score and its four domains.

Results

Factor analysis did not confirm the validity of the four domains. Best results were found for a one-factor model. Internal consistency was good, with Cronbach’s α ranging from 0.93 to 0.96. Reliability was excellent (ICC 0.88–0.92 for all subscales). The measurement error (SDC) was 23.0% for the total WOSI and 23% to 28% for the subscales (on a scale of 0–100). Regarding the construct validity, 76% of the results were in accordance with the hypotheses, including a high correlation with the OSIS (0.82) and DASH (0.81) assessments. No floor or ceiling effects were found.

Conclusion

The Dutch version of WOSI showed good reliability and validity in a cohort of patients with shoulder instability, although the factor structure remains unclear.
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Literature
1.
Simonet WT, Melton LJ, Cofield RH, Ilstrup DM: Incidence of anterior shoulder dislocation in Olmsted County, Minnesota. Clin Orthop Relat Res. 1984, 186-191. 186
2.
Nordqvist A, Petersson CJ: Incidence and causes of shoulder girdle injuries in an urban population. J Shoulder Elbow Surg. 1995, 4: 107-112.CrossRefPubMed
3.
Zacchilli MA, Owens BD: Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am. 2010, 92: 542-549.CrossRefPubMed
4.
Liavaag S, Svenningsen S, Reikeras O, Enger M, Fjalestad T, Pripp AH, Brox JI: The epidemiology of shoulder dislocations in Oslo. Scand J Med Sci Sports. 2011, 21: e334-e340.CrossRefPubMedPubMedCentral
5.
Poolman RW, Swiontkowski MF, Fairbank JC, Schemitsch EH, Sprague S, de Vet HC: Outcome instruments: rationale for their use. J Bone Joint Surg Am. 2009, 91 (Suppl 3): 41-49.CrossRefPubMedPubMedCentral
6.
7.
Kirkley A, Griffin S, McLintock H, Ng L: The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. the Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med. 1998, 26: 764-772.PubMed
8.
Park MJ, Garcia G, Malhotra A, Major N, Tjoumakaris FP, Kelly JD: The evaluation of arthroscopic remplissage by high-resolution magnetic resonance imaging. Am J Sports Med. 2012, 40: 2331-2336.CrossRefPubMed
9.
Bak K, Fogh K: Reconstruction of the chronic anterior unstable sternoclavicular joint using a tendon autograft: medium-term to long-term follow-up results. J Shoulder Elbow Surg. 2013, 23 (2): 245-250.CrossRefPubMed
10.
Ahmed I, Ashton F, Robinson CM: Arthroscopic Bankart repair and capsular shift for recurrent anterior shoulder instability: functional outcomes and identification of risk factors for recurrence. J Bone Joint Surg Am. 2012, 94: 1308-1315.CrossRefPubMed
11.
Salomonsson B, Ahlstrom S, Dalen N, Lillkrona U: The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation. Acta Orthop. 2009, 80: 233-238.CrossRefPubMedPubMedCentral
12.
Hofstaetter JG, Hanslik-Schnabel B, Hofstaetter SG, Wurnig C, Huber W: Cross-cultural adaptation and validation of the German version of the Western Ontario Shoulder Instability index. Arch Orthop Trauma Surg. 2010, 130: 787-796.CrossRefPubMed
13.
Hatta T, Shinozaki N, Omi R, Sano H, Yamamoto N, Ando A, Sugaya H, Aizawa T, Kuriyama S, Itoi E: Reliability and validity of the Western Ontario Shoulder Instability Index (WOSI) in the Japanese population. J Orthop Sci. 2011, 16: 732-736.CrossRefPubMed
14.
Drerup S, Angst F, Griffin S, Flury MP, Simmen BR, Goldhahn J: Western Ontario shoulder instability index (WOSI): translation and cross-cultural adaptation for use by German speakers. Orthopade. 2010, 39: 711-718.CrossRefPubMed
15.
Cacchio A, Paoloni M, Griffin SH, Rosa F, Properzi G, Padua L, Padua R, Carnelli F, Calvisi V, Santilli V: Cross-cultural adaptation and measurement properties of an Italian version of the Western Ontario Shoulder Instability Index (WOSI). J Orthop Sports Phys Ther. 2012, 42: 559-567.CrossRefPubMed
16.
Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P: Principles of good practice for the translation and cultural adaptation process for Patient-Reported Outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005, 8: 94-104.CrossRefPubMed
17.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HCW: International consensus on taxonomy, terminology, and definitions of measurement properties: results of the COSMIN study. J Clin Epidemiol. 2010, 63: 737-745.CrossRefPubMed
18.
Guillemin F, Bombardier C, Beaton D: Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993, 46: 1417-1432.CrossRefPubMed
19.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB: Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000, 25: 3186-3191.CrossRef
20.
Floor S, Overbeke AJ: Questionnaires on the quality of life in other than the Dutch language used in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine): the translation procedure and arguments for the choice of the questionnaire. Ned Tijdschr Geneeskd. 2006, 150: 1724-1727.PubMed
21.
Dawson J, Fitzpatrick R, Carr A: The assessment of shoulder instability. the development and validation of a questionnaire. J Bone Joint Surg Br. 1999, 81: 420-426.CrossRefPubMed
22.
Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC: Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res. 2012, 21: 651-657.CrossRefPubMed
23.
Kirshner B, Guyatt G: A methodological framework for assessing health indices. J Chronic Dis. 1985, 38: 27-36.CrossRefPubMed
24.
Kirkley A, Griffin S, Dainty K: Scoring systems for the functional assessment of the shoulder. Arthroscopy. 2003, 19: 1109-1120.CrossRefPubMed
25.
Lippitt SB: A practical tool for evaluating function: the Simple Shoulder Test. The Shoulder: A Balance of Mobility and Stability. Edited by: Matsen FAIII, Fu FH, Hawkins RJ. 1993, Rosemont (IL): American Academy of Orthopaedic Surgeons
26.
van Kampen DA, van Beers LW, Scholtes VA, Terwee CB, Willems WJ: Validation of the Dutch version of the simple shoulder test. J Shoulder Elbow Surg. 2012, 21: 808-814.CrossRefPubMed
27.
Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher M: Reliability, validity, and responsiveness of the simple shoulder test: psychometric properties by age and injury type. J Shoulder Elbow Surg. 2007, 16: 260-267.CrossRefPubMed
28.
Dawson J, Rogers K, Fitzpatrick R, Carr A: The Oxford shoulder score revisited. Arch Orthop Trauma Surg. 2009, 129: 119-123.CrossRefPubMed
29.
Dawson J, Fitzpatrick R, Carr A: Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg Br. 1996, 78: 593-600.PubMed
30.
Frich LH, Noergaard PM, Brorson S: Validation of the Danish version of Oxford Shoulder Score. Dan Med Bull. 2011, 58: A4335-PubMed
31.
Roh YH, Noh JH, Kim W, Oh JH, Gong HS, Baek GH: Cross-cultural adaptation and validation of the Korean version of the Oxford shoulder score. Arch Orthop Trauma Surg. 2012, 132: 93-99.CrossRefPubMed
32.
Tugay U, Tugay N, Gelecek N, Ozkan M: Oxford Shoulder Score: cross-cultural adaptation and validation of the Turkish version. Arch Orthop Trauma Surg. 2011, 131: 687-694.CrossRefPubMed
33.
Murena L, Vulcano E, D’Angelo F, Monti M, Cherubino P: Italian cross-cultural adaptation and validation of the Oxford Shoulder Score. J Shoulder Elbow Surg. 2010, 19: 335-341.CrossRefPubMed
34.
Huber W, Hofstaetter JG, Hanslik-Schnabel B, Posch M, Wurnig C: The German version of the Oxford Shoulder Score–cross-cultural adaptation and validation. Arch Orthop Trauma Surg. 2004, 124: 531-536.CrossRefPubMed
35.
Berendes T, Pilot P, Willems J, Verburg H, te SR: Validation of the Dutch version of the Oxford Shoulder Score. J Shoulder Elbow Surg. 2010, 19: 829-836.CrossRefPubMed
36.
Desai AS, Dramis A, Hearnden AJ: Critical appraisal of subjective outcome measures used in the assessment of shoulder disability. Ann R Coll Surg Engl. 2010, 92: 9-13.CrossRefPubMedPubMedCentral
37.
Hudak PL, Amadio PC, Bombardier C: Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996, 29: 602-608.CrossRefPubMed
38.
Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C: Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001, 14: 128-146.CrossRefPubMed
39.
Veehof MM, Sleegers EJ, van Veldhoven NH, Schuurman AH, van Meeteren NL: Psychometric qualities of the Dutch language version of the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH-DLV). J Hand Ther. 2002, 15: 347-354.CrossRefPubMed
40.
Garratt A, Schmidt L, Mackintosh A, Fitzpatrick R: Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ. 2002, 324: 1417-CrossRefPubMedPubMedCentral
41.
Salaffi F, De Angelis R, Stancati A, Grassi W: Health-related quality of life in multiple musculoskeletal conditions: a cross-sectional population based epidemiological study. II the MAPPING study. Clin Exp Rheumatol. 2005, 23: 829-839.PubMed
42.
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, 44: 800-805.CrossRef
43.
Gartsman GM, Brinker MR, Khan M, Karahan M: Self-assessment of general health status in patients with five common shoulder conditions. J Shoulder Elbow Surg. 1998, 7: 228-237.CrossRefPubMed
44.
Floyd FJ, Widaman KF: Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess. 1995, 7: 286-299.CrossRef
45.
Hu LT, Bentler PM: Cut-off criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equation Model. 1999, 6: 1-55.CrossRef
46.
Snyder CF, Aaronson NK, Choucair AK, Elliott TE, Greenhalgh J, Halyard MY, Hess R, Miller DM, Reeve BB, Santana M: Implementing patient-reported outcomes assessment in clinical practice: a review of the options and considerations. Qual Life Res. 2012, 21: 1305-1314.CrossRefPubMed
47.
de Vet HC, Terwee CB, Knol DL, Bouter LM: When to use agreement versus reliability measures. J Clin Epidemiol. 2006, 59: 1033-1039.CrossRefPubMed
48.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007, 60: 34-42.CrossRefPubMed
49.
McHorney CA, Tarlov AR: Individual-patient monitoring in clinical practice: are available health status surveys adequate?. Qual Life Res. 1995, 4: 293-307.CrossRefPubMed
50.
Lillkrona U: How should we use the Constant Score?–A commentary. J Shoulder Elbow Surg. 2008, 17: 362-363.CrossRefPubMed
51.
Jensen KU, Bongaerts G, Bruhn R, Schneider S: Not all Rowe scores are the same! which Rowe score do you use?. J Shoulder Elbow Surg. 2009, 18: 511-514.CrossRefPubMed
52.
Schunemann HJ, Akl EA, Guyatt GH: Interpreting the results of patient reported outcome measures in clinical trials: the clinician’s perspective. Health Qual Life Outcomes. 2006, 4: 62-CrossRefPubMedPubMedCentral
Metadata
Title
Measurement properties of the Western Ontario Shoulder Instability Index in Dutch patients with shoulder instability
Authors
Just A van der Linde
W Jaap Willems
Derk A van Kampen
Loes W A H van Beers
Derek FP van Deurzen
Caroline B Terwee
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2014
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-15-211

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