title: Spanish cultural adaptation and validation of the shoulder pain and disability index, and the oxford shoulder score after breast cancer surgery.
abstract: BACKGROUND
  The Oxford Shoulder Score (OSS) and the Shoulder Pain and Disability Index (SPADI) are patient-based outcome scores with valid psychometric properties which are widely used for shoulder interventions.
  
  
  OBJECTIVE
  The purpose of the study is to adapt both questionnaires cross-culturally to Spanish, and to test their reliability, validity, responsiveness, and feasibility.
  
  
  METHODS
  Cultural adaptation and psychometric validation study.
  
  
  METHODS
  Consecutive patients who had undergone breast cancer surgery referred to an outpatient clinic at the University of Alcalá de Henares, Spain. One hundred and twenty women who had undergone breast cancer surgery, with pain and shoulder dysfunction. Cross-cultural adaptation was performed according to the international guidelines. Reliability was analysed by test-retest reliability and internal consistency. Content and convergent construct validity were measured by the Expert Committee's and Spearman coefficient respectively. Responsiveness, feasibility, floor and ceiling effects were also tested.
  
  
  RESULTS
  One hundred and twenty women aged 54.2 (±11) years took part in the study. The reliability was excellent; test-retest reliability was 0.974 (p < 0.001) for OSS, and 0.992 (p < 0.001) for SPADI; and Cronbach's alpha value was 0.947 for OSS, and 0.965 for SPADI. High construct validity was found between the OSS and SPADI questionnaires (r = -0.674). The effect size (ES) and standardized response mean (SRM) was moderate in OSS (ES = 0.50 and SRM = 0.70 (p < 0.001)), and moderate to good in SPADI (ES = 0.59 and SRM = 0.82 (p < 0.001)).
  
  
  CONCLUSIONS
  This study has some limitations, such as the group of participants is composed only of women following breast cancer treatment; the measurement took place in a single centre; and all the questionnaires administered were always provided to the participants in the same order.
  
  
  CONCLUSIONS
  The OSS and SPADI Spanish versions are applicable, reliable, valid, and responsive to assess shoulder symptoms and quality of life in Spanish women with shoulder pain and disability after breast cancer treatment.
authors.affiliation: Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. maria.torres@uah.es.|Faculty of Medicine and Health Sciences-University of Alcalá, Campus Externo, Ctra. Madrid-Barcelona km 33.600, Alcalá de Henares, Madrid, 28071, Spain. maria.torres@uah.es.
authors.forename: María
authors.initials: M
authors.lastname: Torres-Lacomba
authors.affiliation: Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. beatriz.sanchez@uah.es.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Sánchez-Sánchez
authors.affiliation: Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. virginia.prieto88@gmail.com.
authors.forename: Virginia
authors.initials: V
authors.lastname: Prieto-Gómez
authors.affiliation: Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. soraya.pacheco@uah.es.
authors.forename: Soraya
authors.initials: S
authors.lastname: Pacheco-da-Costa
authors.affiliation: Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. marijo.yuste@uah.es.
authors.forename: María José
authors.initials: MJ
authors.lastname: Yuste-Sánchez
authors.affiliation: Physiotherapy Department, Physiotherapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain. b.navarrobrazalez@gmail.com.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Navarro-Brazález
authors.affiliation: Department of Epidemiology, Medical Statistics Unit, Central de la Defensa Hospital, Madrid, Madrid, Spain. kargut13@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gutiérrez-Ortega
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001943:Breast Neoplasms / Q000601:surgery*; D003431:Cross-Cultural Comparison; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020069:Shoulder Pain / Q000175:diagnosis* / Q000209:etiology; D013030:Spain; D011795:Surveys and Questionnaires