Cross-cultural adaptation and measurement properties of the Malay Shoulder Pain and Disability Index

Abstract

Objective The purpose of this study is to cross-culturally adapt the Shoulder Pain and Disability Index from English to Malay, and to evaluate the measurement properties of the Malay version among Malay speakers with shoulder pain. Methods Cross-cultural adaptation of the Malay version of Shoulder Pain and Disability Index (M-SPADI) was conducted according to international guidelines. 260 participants (Shoulder pain = 130, No shoulder pain = 130) completed the M-SPADI, the Numerical Rating Scale (NRS), and measurement of shoulder active range of motion (AROM). 54 participants repeated M-SPADI within a mean of 9.2 days. Results Cross-cultural adaptation of M-SPADI had no major issues. The M-SPADI had good face validity; item and scale content validity indexes (I-CVI, S-CVI) were >0.79 except for Disability Item 3 (I-CVI = 0.75), and exploratory factor analysis showed that M-SPADI had a bidimensional structure. There was a strong positive correlation between M-SPADI and NRS (rPain = 0.845, rDisability = 0.722, rTotal = 0.795, p <0.001) and a negative correlation between M-SPADI and shoulder AROM with the following correlation ranges (rPain = -0.316 to -0.637, rDisability = -0.419 to -0.708, rTotal = -0404 to -0.697, p<0.001). M-SPADI’s total score was higher in participants with shoulder pain (Mdn: 33.8, IQR = 37.3) compared to no shoulder pain (Mdn:0, IQR = 0.8) and the difference was statistically significant (U = 238.5, z = -13.89, p<0.001). M-SPADI had no floor or ceiling effects (floor/ceiling <15%), high internal consistency (Cronbach’s αPain = 0.914, Cronbach’s αDisability = 0.945) and good to excellent test-retest reliability (ICCPain = 0.922, ICCDisability = 0.859, ICCTotal = 0.895). Conclusion M-SPADI has a bi-dimensional structure with no floor or ceiling effects, established face, content and construct validity, internal consistency, and test-retest reliability. M-SPADI is a reliable and valid tool for assessing Malay-speaking individuals with shoulder pain in clinical and research settings.