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Translation and validation of a Hebrew version of the Western Ontario Shoulder Instability index.

ABSTRACT: BACKGROUND:The Western Ontario Shoulder Instability index (WOSI) is a questionnaire designed to measure health-related quality of life in patients with shoulder instability. The aim of the current study was to translate the WOSI into Hebrew and assess its psychometric properties. METHODS:The WOSI was translated into Hebrew according to World Health Organization guidelines. Twenty-five patients completed the WOSI and the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire 2 weeks and 2 months after surgical shoulder stabilization. Internal consistency (Cronbach's α), criterion validity (Pearson's correlation coefficient with DASH), responsiveness, and floor and ceiling effects were assessed. RESULTS:Cronbach's α was 0.88-0.95 for total WOSI (range 0.68-0.95 for different sections). Strong correlation with DASH score (r = 0.76-0.84) indicated good criterion validity. Changes between baseline and follow-up for WOSI and DASH scores were moderately correlated (r = 0.68), suggesting moderate responsiveness. Some items demonstrated floor and ceiling effects, especially at baseline, but no floor or ceiling effects were observed for total WOSI or for the WOSI sections. CONCLUSIONS:The results of the current study demonstrate that the Hebrew version of the WOSI is a valid instrument that can be used to assess disability in patients with shoulder instability. Additional studies are warranted to assess its psychometric properties among various subpopulations. TRIAL REGISTRATION:The study was pre-registered at the ClinicalTrials.gov website, registration number NCT02978365 .

SUBMITTER: Gottlieb U

PROVIDER: S-EPMC6670116 | BioStudies | 2019-01-01

SECONDARY ACCESSION(S): NCT02978365

REPOSITORIES: biostudies

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Project description:Background:There is an important gap in knowledge about the effectiveness of nonoperative treatment (exercise) for patients with traumatic primary and recurrent anterior shoulder dislocations (ASDs). Purpose/Hypothesis:The purpose of this study was to assess the efficacy and safety of physical therapist-supervised, shoulder instability neuromuscular exercise (SINEX) versus self-managed, home-based, standard care shoulder exercise (HOMEX) in patients with traumatic ASDs. The hypothesis was that SINEX would have a larger effect and fewer adverse events compared with HOMEX. Study Design:Randomized controlled trial; Level of evidence, 2. Methods:A total of 56 participants with radiographically verified, trauma-initiated primary or recurrent ASDs and self-reported decreased shoulder function were randomized to 12 weeks of either SINEX or HOMEX. The SINEX program consisted of 7 exercises, individually progressing from basic (2 × 20 repetitions each day) to elite (2 × 10 repetitions, 3 times weekly). The HOMEX program included 5 shoulder exercises performed 3 times weekly (2 × 10 repetitions). The primary outcome was the Western Ontario Shoulder Instability Index (WOSI) score, ranging from 0 (best possible) to 2100. The between-group minimal clinically important difference at 12 weeks was 250 points. Secondary outcomes included WOSI subdomain scores, patient-reported ratings of kinesiophobia and pain, objective shoulder function, patient satisfaction, and number of adverse events. Results:The between-group mean difference in the WOSI total score at 12 weeks significantly favored SINEX over HOMEX (-228.1 [95% CI, -430.5 to -25.6]). SINEX was furthermore superior to HOMEX in most of the secondary outcomes (3/4 subdomains of the WOSI and pain level during the past 7 days as well as clinical signs of anterior shoulder instability). Also, although not statistically significant, less than half the proportion of the SINEX patients compared with the HOMEX patients (3/27 [11%] vs 6/24 [25%], respectively; P = .204) underwent or were referred for shoulder stabilizing surgery. Satisfaction with both exercise programs was high, and no serious adverse events were reported. Conclusion:Neuromuscular shoulder exercise (SINEX) was superior to standard care exercise (HOMEX) in patients with traumatic ASDs. Further long-term follow-ups on treatment effects are needed. Registration:NCT02371928 (ClinicalTrials.gov identifier).

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Translation and validation of a Hebrew version of the Western Ontario Shoulder Instability index.

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