title: Measurement properties of the Brazilian version of the Penn Shoulder Score (PSS-Brazil): reliability, validity, and responsiveness.
abstract: METHODS
  Clinical measurement.
  
  
  OBJECTIVE
  To determine the reliability, validity, and responsiveness of the Brazilian version of the Penn Shoulder Score (PSS-Brazil) in patients with shoulder dysfunctions.
  
  
  BACKGROUND
  Several questionnaires assessing shoulder dysfunctions are available in Brazil, but the measurement properties of most of them, such as the PSS, have not yet been tested.
  
  
  METHODS
  Internal consistency, measurement error, construct validity, and floor and ceiling effects were evaluated in 62 patients, 36 of whom completed the questionnaire at baseline and after 2 to 7 days to assess test-retest reliability. Responsiveness was determined with 50 patients who completed the questionnaire at an initial visit and after 4 weeks of physical therapy.
  
  
  RESULTS
  The PSS-Brazil displayed acceptable internal consistency, with a Cronbach alpha of .92. Test-retest reliability was excellent, with an intraclass correlation coefficient of 0.95; the standard error of measurement and minimal detectable change were 12.8 and 14.4 points, respectively. A high correlation was obtained between the PSS and the Shoulder Pain and Disability Index (0.96) and the Disabilities of the Arm, Shoulder and Hand questionnaire (0.86). There was moderate correlation between the PSS and its subscales and the pain and function subscales of the Medical Outcomes Study 36-Item Short-Form Health Survey (0.40-0.68). There was high responsiveness, with an effect size of 0.95 and standardized response mean of 1.13 for patients with improvement of shoulder dysfunction, and adequate area under the curve of 0.81. No floor or ceiling effects were observed.
  
  
  CONCLUSIONS
  The PSS-Brazil is a reliable, valid, and responsive measure for assessing patients with shoulder dysfunction.
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcela Bembo
authors.initials: MB
authors.lastname: de Souza
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Martins
authors.forename: Gisele Harumi
authors.initials: GH
authors.lastname: Hotta
authors.forename: Anamaria Siriani
authors.initials: AS
authors.lastname: de Oliveira
mesh_terms: D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012782:Shoulder / Q000503:physiopathology*; D020069:Shoulder Pain / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: clinimetrics; outcome measures; shoulder