Psychometric Properties of the Persian Version of the Simple Shoulder Test (SST) Questionnaire

Document Type : RESEARCH PAPER


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


To validate the Persian version of the simple shoulder test in patients with shoulder joint problems.
Following Beaton`s guideline, translation and back translation was conducted. We reached to a consensus on the Persian version of SST. To test the face validity in a pilot study, the Persian SST was administered to 20 individuals with shoulder joint conditions. We enrolled 148 consecutive patients with shoulder problem to fill the Persian SST, shoulder specific measure including Oxford shoulder score (OSS) and two general measures including DASH and SF-36. To measure the test-retest reliability, 42 patients were randomly asked to fill the Persian-SST for the second time after one week. Cronbach’s alpha coefficient was used to demonstrate internal consistency over the 12 items of Persian-SST.
ICC for the total questionnaire was 0.61 showing good and acceptable test-retest reliability. ICC for individual items ranged from 0.32 to 0.79. The total Cronbach’s alpha was 0.84 showing good internal consistency over the 12 items of the Persian-SST. Validity testing showed strong correlation between SST and OSS and DASH. The correlation with OSS was positive while with DASH scores was negative. The correlation was also good to strong with all physical and most mental subscales of the SF-36. Correlation coefficient was higher with DASH and OSS in compare to SF-36.
Persian version of SST found to be valid and reliable instrument for shoulder joint pain and function assessment in Iranian population.


Main Subjects

1. Kennedy CA, Beaton DE, Smith P, Van Eerd D, Tang K,
Inrig T, et al. Measurement properties of the QuickDASH
(disabilities of the arm, shoulder and hand) outcome
measure and cross-cultural adaptations of the
QuickDASH: a systematic review. Qual Life Res. 2013;
2. Kachooei AR, Ebrahimzadeh MH, Erfani-Sayyar R,
Salehi M, Salimi E, Razi S. Short Form-McGill Pain
Questionnaire-2 (SF-MPQ-2): a cross-cultural adaptation
and validation study of the persian version in patients
with knee osteoarthritis. Arch Bone Jt Surg. 2015;
3. Ebrahimzadeh MH, Birjandinejad A, Golhasani F, Moradi
A, Vahedi E, Kachooei AR. Cross-cultural adaptation,
validation, and reliability testing of the Shoulder Pain and
Disability Index in the Persian population with shoulder
problems. Int J Rehabil Res. 2015; 38(1):84-7.
4. Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR,
Birjandinejad A. Validity and reliability of the persian
version of shortened disabilities of the arm, shoulder and
hand questionnaire (Quick-DASH). Int J Prev Med. 2015;
5. Kachooei AR, Moradi A, Janssen SJ, Ring D. The
influence of dominant limb involvement on DASH and
QuickDASH. Hand (N Y). 2015; 10(3):512-5.
6. Lippitt SB, Harryman DT, Matsen FA, Fu FH, Hawkins
RJ. A practical tool for evaluating function: the simple
shoulder test. The shoulder: a balance of mobility
and stability. Rosemont, IL: American Academy of
Orthopaedic Surgeons; 1993. P. 501-18.
7. Van Kampen DA, van Beers LW, Scholtes VA, Terwee
CB, Willems WJ. Validation of the Dutch version of the
Simple Shoulder Test. J Shoulder Elbow Surg. 2012;
8. Neto JO, Gesser RL, Steglich V, Bonilauri Ferreira AP,
Gandhi M, Vissoci JR, et al. Validation of the Simple
Shoulder Test in a Portuguese-Brazilian population.
Is the latent variable structure and validation of the
Simple Shoulder Test Stable across cultures? PloS
One. 2013; 8(5):e62890.
9. Membrilla-Mesa M, Tejero-Fernández V, Cuesta-
Vargas A, Arroyo-Morales M. Validation and reliability
of a Spanish version of Simple Shoulder Test (SST-Sp).
Qual Life Res. 2015; 24(2):411-6.
10. Marchese C, Cristalli G, Pichi B, Manciocco V, Mercante
G, Pellini R, et al. Italian cross-cultural adaptation and
validation of three different scales for the evaluation of
shoulder pain and dysfunction after neck dissection:
University of California-Los Angeles (UCLA) Shoulder
Scale, Shoulder Pain and Disability Index (SPADI) and
Simple Shoulder Test (SST). Acta Otorhinolaryngol Ital.
2012; 32(1):12-7.
11. Godfrey J, Hamman R, Lowenstein S, Briggs K, Kocher
M. Reliability, validity, and responsiveness of the simple
shoulder test: psychometric properties by age and injury
type. J Shoulder Elbow Surg. 2007; 16(3):260-7.
12. Beaton DE, Bombardier C, Guillemin F, Ferraz MB.
Guidelines for the process of cross-cultural adaptation of
self-report measures. Spine. 2000; 25(24):3186-91.
13. Mousavi SJ, Parnianpour M, Abedi M, Askary-Ashtiani
A, Karimi A, Khorsandi A, et al. Cultural adaptation and
validation of the Persian version of the Disabilities of the
Arm, Shoulder and Hand (DASH) outcome measure. Clin
Rehabil. 2008; 22(8):749-57.
14. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B.
The Short Form Health Survey (SF-36): translation
and validation study of the Iranian version. Qual Life
Res. 2005; 14(3):875-82.
15. Kilinc AS, Ebrahimzadeh MH, Lafosse L. Subacromial
internal spacer for rotator cuff tendon repair: “the
balloon technique”. Arthroscopy. 2009;25(8):921-4.