title: Cross-cultural adaptation and measurement properties of an Italian version of the Western Ontario Shoulder Instability Index (WOSI).
abstract: METHODS
  Clinical measurement study.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Science, Physical and Rehabilitation Medicine, School of Medicine, University of L'Aquila, L'Aquila, Italy. angelo.cacchio@tin.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Cacchio
authors.forename: Marco
authors.initials: M
authors.lastname: Paoloni
authors.forename: Sharon H
authors.initials: SH
authors.lastname: Griffin
authors.forename: Francesco
authors.initials: F
authors.lastname: Rosa
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Properzi
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.forename: Roberto
authors.initials: R
authors.lastname: Padua
authors.forename: Franco
authors.initials: F
authors.lastname: Carnelli
authors.forename: Vittorio
authors.initials: V
authors.lastname: Calvisi
authors.forename: Valter
authors.initials: V
authors.lastname: Santilli
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis* / Q000473:pathology; D016001:Confidence Intervals; D054521:Cultural Competency; D018864:Cultural Diversity; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012783:Shoulder Dislocation / Q000175:diagnosis* / Q000473:pathology; D020069:Shoulder Pain / Q000175:diagnosis* / Q000473:pathology; D013223:Statistics as Topic; D055815:Young Adult