The original version used to have a visual analogue scale VAS just like that in the BASFI score but the second version, the one based on a numerical rating scale NRS has settled better as it oversteps the clinician interpretation during scoring and therefore proves to be a lot faster and more straightforward. The original study researched a male population in ambulatory care for shoulder pain. Score interpretation Given that the two components have 5 and respectively 8 items, the preliminary results range between 0 to 50 and 0 to 80, the overall result ranging from 0 to The original SPADI research and the subsequent validations do not provide specific cut off points to separate the results into limited, medium, high or extreme disability. It is considered that the higher the score in each scale, the higher the impairment to the shoulder function. A 10 point change is usually said to be clinically relevant in distinguishing between relevant improvements after treatment in patients with shoulder conditions.

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J Physiother. The SPADI contains 13 items that assess two domains; a 5-item subscale that measures pain and an 8-item subscale that measures disability.

The latter version was developed to make the tool easier to administer and score Williams et al Both versions take less than five minutes to complete Beaton et al , Williams et al The questionnaire was developed and initially tested in a mixed diagnosis group of male patients presenting to ambulatory care reporting shoulder pain Roach et al The SPADI has since been used in both primary care on mixed diagnosis Beaton et al , MacDermaid et al and surgical patient populations including rotator cuff disease Ekeberg et al , osteoarthritis, and rheumatoid arthritis Christie et al , adhesive capsulitis Staples et al , Tveita et al , joint replacement surgery Angst et al , and in a large population-based study of shoulder symptoms Hill et al Each subscale is summed and transformed to a score out of A mean is taken of the two subscales to give a total score out of , higher score indicating greater impairment or disability.

In the NRS version Williams et al the VAS is replaced by a scale and the patient is asked to circle the number that best describes the pain or disability. The total score is derived in exactly the same manner as the VAS version. In each subscale patients may mark one item only as not applicable and the item is omitted from the total score. If a patient marks more than two items as non applicable, no score is calculated Roach et al The SPADI demonstrates good construct validity, correlating well with other region-specific shoulder questionnaires Paul et al , Bot et al , Roy et al It has been shown to be responsive to change over time, in a variety of patient populations and is able to discriminate adequately between patients with improving and deteriorating conditions Beaton et al , Williams et al , Roy et al The minimal clinically important difference has been reported to be 8 points; this represents the smallest detectable change that is important to the patient Paul et al Thus some caution is advised with regard to repeated use of the instrument on the same patient.

A change score of less than this value could be attributed to measurement error. Published by.. All rights reserved.


Shoulder Pain and Disability Index (SPADI).






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