Psychometric Properties of Full and Shortened Persian-version of Western Ontario Rotator Cuff Index Questionnaires in Persian-speaking Patients with Shoulder Pain

Document Type : RESEARCH PAPER


1 Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

2 1 Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran 2 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Faculty Member, University of Lahore, Pakistan


Background: This study aimed to translate the shortened Western Ontario Rotator Cuff (Short-WORC) questionnaire 
into Persian and determine the psychometric features of WORC and Persian-Short-WORC in patients with shoulder pain.
Methods: A total of 130 patients completed Persian-WORC and -Short-WORC, Shoulder Pain And Disability Index 
(SPADI), shortened Disability of Arm, Shoulder, and Hand (Quick-DASH), WORC, as well as Short-Form health survey 
(SF-36), in the evaluation and re-evaluation sessions with an interval of 5-7 days to assess reliability and validity. To 
determine responsiveness, all patients completed questionnaires and a global rating of change scale before and after the 
4-week physiotherapy. Intra-class correlation coefficient (ICC) was used for assessing reliability, two-tailed Pearson (r) for
validity, as well as longitudinal validity, and receiver operating characteristics (ROC) curve analysis for responsiveness.
Results: The ICC was 0.95 (confidence interval: 0.93-0.96) for Short-WORC. A strong correlation was found between 
Short-WORC, SPADI (r=-0.82), Quick-DASH (r=-0.79), WORC (r=0.92), SF-36 physical (r=0.76), and SF-36 mental 
(r=0.71). Floor and ceiling effects were not detected. The responsiveness of Short-WORC and WORC was proven with 
an area under the curve of >0.90, and their minimal important change was 28.56 and 26.28 points, respectively.
Conclusion: The Persian version of WORC has good psychometric properties to measure disability and health-related 
quality of life in patients with shoulder pain. 
Level of evidence: IV


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