Abstract
BackgroundThe Shoulder Pain and Disability Index (SPADI) is a self-report measure developed to evaluate patients with shoulder pathology. While some validation has been conducted, broader analyses are indicated. This study determined aspects of cross-sectional and longitudinal validity of the SPADI.MethodsCommunity volunteers (n = 129) who self-identified as having shoulder pain were enrolled. Patients were examined by a physical therapist using a standardized assessment process to insure that their pain was musculoskeletal in nature. This included examination of pain reported during active and passive shoulder motion as reported on a visual analogue pain scale. Patients completed the SPADI, the Coping Strategies Questionnaire (CSQ) and the Sickness Impact Profile (SIP) at a baseline assessment and again 3 and 6 months later. Factor analysis with varimax rotation was used to assess subscale structure. Expectations regarding convergent and divergent subscales of CSQ and SIP were determined a priori and analysed using Pearson correlations. Constructed hypotheses that patients with a specific diagnosis or on pain medication would demonstrate higher SPADI scores were tested. Correlations between the observed changes recorded across different instruments were used to assess longitudinal validity.ResultsThe internal consistencies of the SPADI subscales were high (α > 0.92). Factor analysis with varimax rotation indicated that the majority of items fell into 2 factors that represent pain and disability. Two difficult functional items tended to align with pain items. Higher pain and disability was correlated to passive or negative coping strategies, i.e., praying/hoping, catastrophizing on the CSQ. The correlations between subscales of the SPADI and SIP were low with divergent subscales and low to moderate with convergent subscales. Correlations, r > 0.60, were observed between the SPADI and pain reported on a VAS pain scale during active and passive movement. The two constructed validity hypotheses (on diagnosis and use of pain medications) were both supported (p < 0.01). The SPADI demonstrated significant changes over time, but these were poorly correlated to the SIP or CSQ suggesting that these scales measure different parameters.ConclusionThe SPADI is a valid measure to assess pain and disability in community-based patients reporting shoulder pain due to musculoskeletal pathology.
Highlights
The Shoulder Pain and Disability Index (SPADI) is a self-report measure developed to evaluate patients with shoulder pathology
The correlations between subscales of the SPADI and Sickness Impact Profile (SIP) were low with divergent subscales and low to moderate with convergent subscales
The SPADI demonstrated significant changes over time, but these were poorly correlated to the SIP or Coping Strategies Questionnaire (CSQ) suggesting that these scales measure different parameters
Summary
The Shoulder Pain and Disability Index (SPADI) is a self-report measure developed to evaluate patients with shoulder pathology. The shoulder pain and disability index (SPADI) [1] is a self-report questionnaire developed to measure the pain and disability associated with shoulder pathology. The. SPADI consists of 13 items in two subscales: pain (5 items) and disability (8 items); originally items were presented in a visual analogue format. Principal components factor analysis with, and without, varimax rotation were conducted, with the former supporting the two subscales currently used; i.e., pain and disability. Validity was established by correlating SPADI total and subscale scores with shoulder range of motion (ROM). The ability to measure clinical change was indicated by high negative correlations between changes in SPADI scores and changes in shoulder ROM [1]
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