title: Translation, cross-cultural adaptation and validation of the Italian version of the Nottingham Clavicle Score (NCS).
abstract: BACKGROUND
  The Nottingham Clavicle Score (NCS) is a specific Patient Reported Outcome Measure of injuries to the clavicle, acromio-clavicular joint (ACJ) and sterno-clavicular joint. The purpose of this study was to translate the NCS into Italian and establish its cultural adaptiveness and validity.
  
  
  METHODS
  The original version of the NCS was translated into Italian in accordance with the cross-cultural adaptation guidelines described by Guillemin. Sixty-six patients [average age 45.7 years (SD 11.3)] who had received surgical treatment for injuries of the ACJ and the clavicle were included in the study. The study population completed the NCS twice within 5 days, the Oxford Shoulder Score (OSS), the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and the short-form 36 (SF-36). Statistical tests assessed the construct validity, discriminant validity, internal consistency, reliability and feasibility of the NCS.
  
  
  RESULTS
  The translation and adaptation of the NCS for an Italian context required no major cultural adaptation. Internal consistency was high (Cronbach's α, 0.86). Test-retest reproducibility was excellent (ρ = 0.981, p < 0.00001). Administration time was 45 s (range 1 min 32 s-8 min), and all items were answered. The Italian NCS showed strong correlation with the DASH (-0.87), the OSS (-0.84) and those subscales of the SF-36 (physical functioning, role physical and bodily pain) which aim to measure similar constructs.
  
  
  CONCLUSIONS
  The Italian NCS scale is a reliable, valid, consistent shoulder assessment form that can be used to assess the functional limitations of patients with injuries of clavicle or ACJ.
  
  
  METHODS
  III.
authors.affiliation: Orthopaedic and Traumatology Department, Oderzo Hospital, Via Luzzatti 33, Oderzo, 31046, Treviso, Italy. mascvoz@gmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Vascellari
authors.affiliation: Orthopaedic and Traumatology Department, Oderzo Hospital, Via Luzzatti 33, Oderzo, 31046, Treviso, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Schiavetti
authors.affiliation: Orthopaedic and Traumatology Department, Oderzo Hospital, Via Luzzatti 33, Oderzo, 31046, Treviso, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Rebuzzi
authors.affiliation: Orthopaedic and Traumatology Department, Oderzo Hospital, Via Luzzatti 33, Oderzo, 31046, Treviso, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Coletti
mesh_terms: D000328:Adult; D002968:Clavicle / Q000503:physiopathology / Q000601:surgery; D003431:Cross-Cultural Comparison; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D014177:Translations
keywords: Acromio-clavicular joint; Clavicle; Italian validation; NCS; Subjective shoulder scores