COSMIN database

Assessment of cross-cultural adaptations and measurement properties of self-report outcome measures relevant to shoulder disability in Portuguese: a systematic review

Puga, V. O., Lopes, A. D., and Costa, L. O.
OBJECTIVES: To evaluate the quality of the adaptation procedures as well as the clinimetric testing of the shoulder disability questionnaires available in Portuguese that has occurred for each adaptation.

METHODS: Systematic literature searches on MEDLINE, EMBASE, CINAHL, SCIELO and LILACS were performed to identify relevant studies. Data on the quality of the cross-cultural adaptation procedures and clinimetric testing were extracted. All studies were evaluated according to the current guidelines for cross-cultural adaptation and measurement properties.

RESULTS: Seven different questionnaires adapted into Brazilian-Portuguese (DASH, WORC, SPADI, PSS, ASORS, ASES and UCLA) were indentified from eleven studies. Most of the studies performed the cross-cultural adaptation procedures following the recommendations from the guidelines. From a total of seven instruments, two were not tested for any measurement property (PSS and ASES) and two questionnaires (DASH and WORC) were evaluated for almost all of properties. None of the questionnaires were fully tested for their measurement properties.

CONCLUSIONS: Although most of the shoulder disability questionnaires have been properly adapted into Brazilian-Portuguese, some of them were either inadequately tested or not tested at all. It is recommended that only tested instruments can be used in clinical practice, as well as in research.
Rev Bras Fisioter
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
ASES - American Shoulder and Elbow Surgeons
ASORS - Athletic Shoulder Outcome Rating Scale
DASH - Disabilities of the Arm, Shoulder and Hand   
Modified-UCLA - Modified-University of California at Los Angeles Shoulder Rating Scale
PSS - Penn Shoulder Score [alias: Penn]
SPADI - Shoulder Pain and Disability Index   
UCLA shoulder score - University of California Los Angeles shoulder score [alias: UCLA Shoulder Rating Scale]   
WORC - Western Ontario Rotator Cuff Index