Shoulder pain and disability index: its effectiveness and reliability in an outpatient setting in Indian population


  • Sukumar Nayak P. T. Department of Physiotherapy, Garden City University, Karnataka
  • Manjunatha A. Department of Orthopaedics, Kodagu Institute of Medical Sciences, Karnataka



SPADI, Shoulder pain, OSS


Background: One of the most common joints to be treated in the clinic is the shoulder joint. An orthopedic surgeon and physical therapists should be knowledgeable about the proper assessment of the shoulder joint to effectively evaluate and design a treatment program in shoulder pathologies. Shoulder pain and disability index (SPADI) is a questionnaire designed to measure pain and disability associated with shoulder pathologies in a clinical setting. SPADI’s effectiveness as a tool needed to be validated in Indian population hence this study. The objectives of this study were to measure effectiveness of SPADI in our setting and to measure the reliability and acceptability of SPADI in Indian population.

Methods: 60 patients with shoulder pain between the age of 25-50 years who attended the orthopaedic OPD during the time period of April 2017 to April 2018 were included. The subjects were evaluated with SPADI and oxford shoulder score (OSS) questionnaires. The data was analyzed by paired sample T test and alpha coefficient level.

Results: The data statistically analysed revealed that the scales are reliable as the Cronbach's alpha was high (>0.7) and was effective to measure the pain and disability of the shoulder joint in our clinical set up.

Conclusions: It can be concluded from our statistical analysis that both SPADI and OSS are equally effective tools in measuring pain and disability in our clinical set up, the only difference being that SPADI is operationally very simple and lucid for our population.

Author Biography

Manjunatha A., Department of Orthopaedics, Kodagu Institute of Medical Sciences, Karnataka

department of orthopaedics

assistant professor


Weevers HJA, Beek VAJ, Anema JR, Wal VG, Mechelen VW. Work related disease in general practice: A systematic review. Family Practice. 2005;22:197-204.

Roach KE, Budiman ME, Songsiridej N, Lertratanakul Y. Development of a shoulder pain and disability index. Arthritis Care Res. 1991;4:143-9.

Lippitt SB, Harryman DT, Matsen FA. A practical tool for evaluating function: the simple shoulder test. In: Matsen III FA, Fu FH, Hawkins RJ, eds. The shoulder:a balance of mobility and stability. Rosemont, Illinois: Am Acad Orthop Surgeons; 1993: 501-518.

Croft P, Pope D, Zonca M, Neill OT, Silman A. Measurement of shoulder related disability: results of a validation study. Ann Rheum Dis. 1994;53:525-8.

Richards RR, Ank N, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3:347-52.

Dawson J, Fitzpatrick R, Carr A. Questionnaire on the perceptions of patients about shoulder surgery. J Bone Joint Surg Br. 1996;78:593-600.

Kohn D, Geyer M. The subjective shoulder rating system. Arch Orthop Trauma Surg. 1997;116:324-8.

Insalata LJC, Warren RF, Cohen SB, Altchek DW, Peterson MG. A self- administered questionnaire for assessment of symptoms and function of the shoulder. J Bone Joint Surg Am. 1997;79:738-48.

Windt DAWM, Heijden GJ, Winter AF, Koes BW, Deville W, Bouter LM. The responsiveness of the Shoulder Disability Questionnaire. Ann Rheum Dis. 1998;57:82-7.

Heijden GJ, Leffers P, Bouter LM. Shoulder disability questionnaire design and responsiveness of a functional status measure. J Clin Epidemiol. 2005;53:29-38.

Paul A, Lewis M, Shadforth MF, Croft PR, Windt DAWM, Hay EM. A comparison of four shoulder-specific questionnaires in primary care. Ann Rheum Dis. 2004;63:1293-9.

Deyo RA, Andersson G, Bombardier C. Outcome measures for studying patients with low back pain. Spine. 1994;19(18):2032-6.

Beaton DE, Richards RR. Measuring function of the shoulder. A cross- sectional comparison of five questionnaires. J Bone Joint Surg Am. 1996;78(6):882-90.

Dermid MJC, Solomon P, Prkachin K. Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity. BMC Musculoskeletal Disord. 2006;7:12.

Williams JW, Holleman DR, SImel DL. measuring shoulder function with the Shoulder Pain and Diability Index. J Rheumatol. 1995;22(40):727-32.

Angst F, Goldhahn J, Drerup S, Aeschlimann A, Schwayzer HK, Simmen BR. Responsiveness of six outcome assessment instruments in total shoulder arthroplasty. Arthritis Rheum. 2008;59(3):391-8.

Headl SL, Riddle DL, Lamb RL. The shoulder pain and disability index: the construct validity and responsiveness of a region-specific disability measure. Phyd Ther. 1997;77(10):1079-89.

Schmitt JS, Fabio DRP. Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparison using individual threshold criteria. J Clin Epidemiol. 2004;57(10):1008-18.

Staples MP, Forbes A, Green S, Buchbinder R. Shoulder-specific disability measures showed acceptable construct validity and responsiveness. J Clin Epidemiol. 2010;63(2):163-70.

Tevita EK, Ekeberg OM, Juel NG, Holter BE. Responsiveness of the shoulder pain and disability index in patients with adhesive capsulitis. BMC Musculoskeletal Disord. 2008;9:161.

Jamnik H, Spevak MK. Shoulder Pain and Disability Index: validation of Slovene version. Int J Rehabil Res. 2008;31:337-41.

Bumin G, Tuzun EH, Tonga E. The shoulder pain and disability index (SPADI): Cross-cultural adaptation, reliability and validity of the Turkish version. J Back Musculoskeletal Rehab. 2008;21:57-62.

Fries JF, Spitz P, Kraines RG. Measurements of patient outcome in arthritis. Arthritis Rheum. 1980;23:137-45.

Bot SD, Terwee CB, Windt VDA, Bouter LM, Dekker J, Vet HC. Clinicometric evaluation of shoulder disability questionnaires: a systemic review of literature. Ann Rheum Dis. 2004;63(4):335-41.

Roy JS, Dermid MJC, Woodehouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009;61(5):623-32.

Streiner DL, Norman GR. Health measurement scales, a practical guide to their development and use. Oxford: Oxford university press; 21995.

Catherine LH, Susan L, Anne WT, Shanahan ME, Gill TK. Factor structure and validity of the shoulder pain and disability index in a population-based study of people with shoulder symptoms. BMC Musculoskeletal Disorder. 2011;12:8.

Bicer A, Ankarali H. Shoulder Pain and Disability Index: a validation study in Turkish women. Singapore Med J. 2010;51:865.

Maria TL, Beatriz S, Virginia PG, Soraya PDC. Spanish cultural adaptation and validation of the shoulder pain and disability index, and the oxford shoulder score after breast cancer surgery. Health Quality Life Outcomes. 2015;13:63.

Tveita EK, Sandvik L, Ekeberg OM, Juel NG, Holter BE. Factor structure of the Shoulder Pain and Disability Index in patients with adhesive capsulitis. BMC Musculoskelet Disord. 2008;9:103.

Roddey TS, Olson SL, Cook KF, Gartsman GM, Hanten W. Comparison of the University of California-Los Angeles Shoulder Scale and the Simple Shoulder Test with the shoulder pain and disability index: single- administration reliability and validity. Phys Ther. 2000;80(8):759-68.

Dawson J, Kristina KH, Helen D, Ray F, Carr A. A comparison of the Oxford shoulder score and shoulder pain and disability index: factor structure in the context of a large randomized controlled trail. Patient Related Outcome Measures. 2016;7:195-203.

Artaban JJ, Antony LA, Appaswami GD, Roach KE. Cross-cultural adaption, reliability and validity of an Indian (Tamil) version for the Shoulder Pain and Disability Index. Hong Kong Physiotherapy J. 2012;30:99-104.

Gupta R. Reliability and validity of shoulder pain and disability index (SPADI) in sweepers of Surat city. Int J Yogic Human Movement Sports Sci. 2019;4(1):1231-6.






Original Research Articles