Cross-cultural Adaptation and Measurement Properties of an Italian Version of the Western Ontario Shoulder Instability Index (WOSI)

Angelo Cacchio, Marco Paoloni, Sharon H. Griffin, Francesco Rosa, Gianfranco Properzi, Luca Padua, Roberto Padua, Franco Carnelli, Vittorio Calvisi, Valter Santilli

DOI: 10.2519/jospt.2012.3827

STUDY DESIGN: Clinical measurement study. OBJECTIVES: To translate and cross-culturally adapt the Western Ontario Shoulder Instability Index (WOSI) into Italian, and to evaluate its measurement properties in patients with shoulder instability secondary to a first-time traumatic anterior dislocation. BACKGROUND: The WOSI was developed for English-speaking patients. To date, no Italian version of the WOSI exists. METHODS: The WOSI was cross-culturally adapted to Italian according to established guidelines. Sixty-four (16 women, 48 men) patients with unilateral shoulder anterior instability were prospectively recruited for the purposes of this study. Internal consistency, test-retest reliability, construct validity, and responsiveness of the WOSI were evaluated. RESULTS: The Italian version of the WOSI showed a high degree of internal consistency, with a Cronbach alpha of .93 (95% confidence interval [CI]: 0.91, 0.96). The test-retest reliability was high for both short-term (3 days, 64 patients) and medium-term (14 weeks, 20 patients) test-retest, with intraclass correlation coefficients of 0.95 (95% CI: 0.90, 0.97) and 0.92 (95% CI: 0.89, 0.95), respectively. The WOSI was more closely correlated to the Disabilities of the Arm, Shoulder and Hand questionnaire than to the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.794 and 0.113, respectively). The receiver-operating-characteristic curve analysis revealed that the WOSI was more responsive than the Disabilities of the Arm, Shoulder and Hand questionnaire (P = .03), with an area under the curve of 0.90 (95% CI: 0.78, 0.97) for the WOSI and 0.76 (95% CI: 0.61, 0.88) for the Disabilities of the Arm, Shoulder and Hand questionnaire. CONCLUSION: The Italian version of the WOSI is a valid, reliable, and responsive tool that can be used to measure function in Italian-speaking patients with shoulder instability due to a first-time traumatic anterior dislocation.

J Orthop Sports Phys Ther 2012;42(6):559-567, Epub 8 March 2012. doi:10.2519/jospt.2012.3827

KEY WORDS: outcome measures, shoulder dislocation, shoulder questionnaire

The authors aim to translate and cross-culturally adapt the Western Ontario Shoulder Instability Index (WOSI) into Italian, and to evaluate its measurement properties in patients with shoulder instability secondary to a first-time traumatic anterior dislocation.

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