Skip to main content
SpringerLink
Log in

The German version of the Oxford shoulder score—cross-cultural adaptation and validation

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The evaluation of health-related quality of life is an established criterion for the evaluation of therapeutic measurement. Especially in the English language, a great number of different questionnaires have been developed. The original, English-language 12-item Oxford shoulder score (OSS) is a recently developed and validated patient-completed outcome measure specifically designed for the evaluation of patients suffering from shoulder pathology other than instability. Because of the lack of a comparable instrument in German, this questionnaire was translated into German and subsequently tested for validity and reliability in a cross-sectional study.

Material and methods

Translation of the OSS was done according to the guidelines in the literature. One hundred two patients completed the German version of the OSS and the SF-36. Additionally, the Constant shoulder score and the UCLA shoulder score were included into the validation process. The psychometric properties feasibility and patient-burden parameters were also tested.

Results

The patients completed all questionnaires. The mean time required for completing the OSS was 3 min, 25 s; the mean time required for evaluation of the questionnaire was 35 s. The internal consistency tested by the Cronbach’s alpha (0.94) was high. The reproducibility tested by two different methods showed no significant difference. The construct validity showed a significant correlation between the OSS and the other scores.

Conclusion

The instrument proved to be valid by demonstrating the same correlations predicted by standard clinical assessments and a generic patient-based instrument. Application and evaluation in clinical trial proved feasible and minimally time consuming. Therefore, the German translation of the Oxford shoulder score is a valid and reliable tool, applicable to outcome studies on shoulder patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Acquadro C, Jambon B, Ellis D, Marquis P (1996) Language and translation issues. In: Spilker B (ed) Quality of life and pharmacoeconomics in clinical trials, 2nd edn. Lippincott, Philadelphia, pp 575–585

  2. Amadio PC (1993) Outcomes measurements. J Bone Joint Surg Am 75:1583–1584

    CAS  PubMed  Google Scholar 

  3. Anderson RT, MacFarlane M, Naughton MJ, Shumaker SA (1996) Conceptual issues and considerations in cross-cultural validation of generic health-related quality of life instruments; quality of life and pharmacoeconomics in clinical trials, 2nd edn. Lippincott, Philadelphia, pp 605–612

  4. Beaton DE, Richards RR (1996) Measuring function of the shoulder—a cross-sectional comparison of five questionnaires. J Bone Joint Surg Am 78: 882–890

    CAS  PubMed  Google Scholar 

  5. Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C (2001) Measuring the whole or the parts? Validity, reliability and responsiveness of the Disabilities of the Arm, Shoulder and Hand Outcome Measure in different regions of the upper extremity. J Hand Ther 14:128–146

    CAS  PubMed  Google Scholar 

  6. Bergenudd H, Lindgärde F, Nilsson B, Petersson CJ (1988) Shoulder pain in middle age. A study of prevalence and relation to occupational workload and psychosocial factors. Clin Orthop 261:234–238

    Google Scholar 

  7. Bergner M, Bobbitt RA, Carter WB (1981) The Sickness Impact Profile. Development and final revision of a health status measure. Med Care 19:787–805

    CAS  PubMed  Google Scholar 

  8. Bjelle A (1989) Epidemiology of shoulder problems. Baillieres Clin Rheumatol 3:437–451

    CAS  PubMed  Google Scholar 

  9. Bongers PM (2001) The cost of shoulder pain at work. BMJ 325:64–65

    Article  Google Scholar 

  10. Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, Westlake L (1992) Validating the SF-36 health survey questionnaire: new outcome measurement for primary care. Br Med J 305:160-164

    CAS  Google Scholar 

  11. Bullinger M (1995) German translation and psychometric testing of the SF-36 health survey: Preliminary results from the IQOLA project. Soc Sci Med 41:1359–1366

    Article  CAS  PubMed  Google Scholar 

  12. Chakravarty KK, Webley M (1990) Disorders of the shoulder: an often unrecognized cause of disability in elderly people. Br Med J 300:848–849

    CAS  Google Scholar 

  13. Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop 214:160–164

    PubMed  Google Scholar 

  14. Cronbach LJ (1951) Coefficient alpha and internal structure of tests. Psychometrika 16:297–334

    Google Scholar 

  15. Dawson J, Fitzpatrick R, Carr A (1996) Questionnaire of the perceptions of patients about shoulder surgery. J Bone Joint Surg Br 78:593–600

    CAS  PubMed  Google Scholar 

  16. Dawson J, Hill G, Fitzpatrick R, Carr A (2001) The benefits of using patient-based methods of assessment—medium-term results of an observational study of shoulder surgery. J Bone Joint Surg Br 83:877–882

    Article  CAS  PubMed  Google Scholar 

  17. Deyo RA, Andersson G, Bombardier C, Cherkin DC, Keller RB, Lee CK, Liang MH, Lipscomb B, Shekelle P, Spratt KF, Weinstein JN (1994) Outcome measures for studying patients with low back pain. Spine 19 [Suppl 18 ]:2032S–2036S

  18. Ellman H (1987) Arthroscopic subacromial decompression. Analysis of one- to three-year results. Arthroscopy 3:173–181

    CAS  PubMed  Google Scholar 

  19. Freedman KB, Back S, Bernstein J (2001) Sample size and statistical power of randomized, controlled trials in orthopaedics. J Bone Joint Surg Br 83:397–402

    Article  CAS  PubMed  Google Scholar 

  20. Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46:1417–1432

    Article  CAS  PubMed  Google Scholar 

  21. Guyatt GH, Townsend M, Berman LB, Keller JL (1987) A comparison of Likert and visual analogue scales for measuring change in function. J Chron Dis 40:1129–1133

    Article  CAS  PubMed  Google Scholar 

  22. Hollinshead RM, Mohtadi NG, Vande Guchte RA, Wadey VM (2000) Two 6-year follow-up studies of large and massive rotator cuff tears: comparison of outcome measures. J Shoulder Elbow Surg 9:373–381

    CAS  PubMed  Google Scholar 

  23. Hudak PL, Amadio PC, Bombardier C and The Upper Extremity Collaborative Group (UECG) (1996) Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder and hand). Am J Ind Med. 29:602–608

    Google Scholar 

  24. Hunt SM, McEwen J (1980) The development of a subjective health indicator. Sociol Health Illn 2:231–246

    Article  CAS  PubMed  Google Scholar 

  25. Kessler S, Pfänder T, Nelitz M, Puhl W, Günther KP (2001) Pediatric Musculoskeletal Functional Health Questionnaire. Ein Funktionsfragebogen zur Erfassung von Erkrankungen des Stütz- und Bewegungsapparates bei Kindern und Jugendlichen – Erste Ergebnisse der Validierung einer deutschen Version. Z Orthop Ihre Grenzgeb 139:134–137

    Article  CAS  PubMed  Google Scholar 

  26. Kirkley A, Griffith S, McLintock H, Ng L (1998) The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability: The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med 26:764–772

    CAS  PubMed  Google Scholar 

  27. Koran LM (1975) The reliability of clinical methods, data and judgments. Part 1. N Engl J Med 293:642–646

    CAS  PubMed  Google Scholar 

  28. L’Insalata JC, Warren RF, Cohen SB, Altchek DW, Peterson MG (1997) A self-administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Joint Surg Am 79:738–748

    Article  PubMed  Google Scholar 

  29. Lippitt SB, Harryman DT, Matsen FA (1993) A practical tool for evaluation of function: the Simple Shoulder Test. In: FA Matsen, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. The American Academy of Orthopaedic Surgeons, Rosemont, IL, USA, pp 501–518

  30. Lohr KN, Aaronson NK, Alonso J, Burnam MA, Patrick DL, Perrin BE, Roberts JS (1996) Evaluating quality-of-life and health status instruments: development of scientific review criteria. Clin Ther 18:979–992

    Article  CAS  PubMed  Google Scholar 

  31. MacDermid JC, Richards RS, Donner A, Bellamy N, Roth JH (2000) Responsiveness of the SF-36, DASH, patient-rated wrist evaluation and physical impairments in evaluating recovery after a distal radius fracture. J Hand Surg [Am] 25:330–340

    Google Scholar 

  32. Michener LA, Leggin BG (2001) A review of self-report scales for the assessment of functional limitation and disability of the shoulder. J Hand Ther 14:68–76

    CAS  PubMed  Google Scholar 

  33. Najman JM, Levine S (1981) Evaluating the impact of medical care and technology on the quality of life. A review and critique. Soc Sci Med [F] 15:107–115

    Google Scholar 

  34. Nunnally JC, Bernstein ICH (1994) Psychometric theory. McGraw-Hill, New York

  35. Offenbaecher M, Ewert T, Sangha O, Stucki G (2002) Validation of a German version of the disabilities of arm, shoulder, and hand questionnaire (DASH-G). J Rheumatol 29:401–402

    PubMed  Google Scholar 

  36. Portney LG, Watkins MP (2000) Foundations of clinical research: applications to practice, 2nd edn. Prentice Hall, Upper Saddle River, NJ, USA

    Google Scholar 

  37. Pose B, Sangha O, Peters A, Wildner M (1999) Validierung des North American Spine Society Instrumentes zur Erfassung des Gesundheitszustandes bei Patienten mit chronischen Rückenbeschwerden. Z Orthop Ihre Grenzgeb 137:437–441

    CAS  PubMed  Google Scholar 

  38. Pynsent PB (2001) Choosing an outcome measure. J Bone Joint Surg Br 83:792–794

    Article  CAS  PubMed  Google Scholar 

  39. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y (1991) Development of a shoulder pain and disability index. Arthritis Care Res 4:143–149

    CAS  PubMed  Google Scholar 

  40. Rosales RS Delgado EB, Diez de la Lastra-Bosch I (2002) Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: Cross-cultural adaptation process and reliability. J Hand Surg [Am] 27:334–343

  41. Secherst L, Fay TL, Zaidi SMH (1972) Problems of translation in cross-cultural research. J Cross-Cult Psychol 3:41–56

    Google Scholar 

  42. van der Heijden GJ (1999) Shoulder disorders: a state-of-the-art review. Baillieres Best Pract Res Clin Rheumatol 13:287–307

    Article  PubMed  Google Scholar 

  43. Ware JE, Sherbourne CD (1992) The MOS 36-item short form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483

    PubMed  Google Scholar 

  44. Wiesinger GF, Nuhr M, Quittan M, Ebenbichler G, Wolfl G, Fialka-Moser V (1999) Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain. Spine 24:1099–1103

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Orthopaedic Surgery, University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria

    Wolfgang Huber, Jochen G. Hofstaetter, Beatrice Hanslik-Schnabel & Christian Wurnig

  2. Department of Medical Statistics, University of Vienna, Austria

    Martin Posch

  3. F. Schillerstr. 45, 2340 Mödling, Austria

    Wolfgang Huber

Authors
  1. Wolfgang Huber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jochen G. Hofstaetter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beatrice Hanslik-Schnabel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin Posch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Wurnig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wolfgang Huber.

Appendix: German version of the Oxford shoulder score

Appendix: German version of the Oxford shoulder score

The 12 questions of the Oxford shoulder score were translated into German

OXFORD—SCHULTERFRAGEBOGEN

ZU BEACHTEN: Alle Fragen beziehen sich auf die letzten 4 Wochen !!!!

1. Wie würden Sie den schlimmsten Schmerz in ihrer Schulter beschreiben ?

O kein

O stark

O leicht

O untragbar

O mäßig

2. Gab es wegen Ihrer Schulter Probleme beim Anziehen?

O gar keine

O extreme Schwierigkeiten

O leichte Schwierigkeiten

O unmöglich

O mäßige Schwierigkeiten

3. Hatten Sie aufgrund Ihrer Schulter Schwierigkeiten ins Auto ein- oder auszusteigen, oder öffentliche Verkehrsmittel zu benützen ?( Je nachdem welches Transportmittel Sie benützen)

O gar keine

O extreme Schwierigkeiten

O sehr leichte Schwierigkeiten

O unmöglich

O mäßige Schwierigkeiten

4. Konnten Sie Messer und Gabel gleichzeitig verwenden?

O ja, leicht

O mit extremen Schwierigkeiten

O mit leichten Schwierigkeiten

O unmöglich

O mit mäßigen Schwierigkeiten

5. Konnten Sie Ihre Haushaltseinkäufe selbstständig erledigen?

O ja, leicht

O mit extremen Schwierigkeiten

O mit leichten Schwierigkeiten

O unmöglich

O mit mäßigen Schwierigkeiten

6. Konnten Sie ein Tablett mit einem Teller Essen durchs Zimmer tragen?

O ja, leicht

O mit extremen Schwierigkeiten

O mit leichten Schwierigkeiten

O unmöglich

O mit mäßigen Schwierigkeiten

7. Konnten Sie Ihr Haar mit dem betroffenen Arm kämmen?

O ja, leicht

O mit extremen Schwierigkeiten

O mit leichten Schwierigkeiten

O unmöglich

O mit mäßigen Schwierigkeiten

8. Wie würden Sie den Schmerz beschreiben, den Sie gewöhnlich in Ihrer Schulter hatten?

O kein

O mäßig

O sehr leicht

O stark

O leicht

9. Konnten Sie Ihre Kleider mit Ihrem betroffenen Arm in einer Garderobe aufhängen?

O ja, leicht

O mit großen Schwierigkeiten

O mit leichten Schwierigkeiten

O unmöglich

O mit mäßigen Schwierigkeiten

10. Konnten Sie sich selbst unter beiden Armen waschen und abtrocknen?

O ja, leicht

O mit großen Schwierigkeiten

O mit leichten Schwierigkeiten

O unmöglich

O mit mäßigen Schwierigkeiten

11. Wie sehr hat Ihr Schulterschmerz Ihre tägliche Arbeit behindert? (Hausarbeit mit eingeschlossen)

O gar nicht

O stark

O ein wenig

O extrem

O mäßig

12. Wurden Sie nachts im Bett von Schmerzen in der Schulter geplagt?

O nie

O die meisten Nächte

O nur 1 oder 2 Nächte

O jede Nacht

O einige Nächte

                

.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huber, W., Hofstaetter, J.G., Hanslik-Schnabel, B. et al. The German version of the Oxford shoulder score—cross-cultural adaptation and validation. Arch Orthop Trauma Surg 124, 531–536 (2004). https://doi.org/10.1007/s00402-004-0716-z

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-004-0716-z

Keywords

Search

Navigation