Comparison of the responsiveness of the Brazilian version of the Western Ontario Rotator Cuff Index (WORC) with DASH, UCLA and SF-36 in patients with rotator cuff disorders.

OBJECTIVE: To investigate the responsiveness of the Brazilian version of the Western Ontario Rotator Cuff Index (WORC) and compare it with the Disabilities of Arm, Shoulder and Hand questionnaire (DASH), the University of California Los Angeles Shoulder Rating Scale (UCLA), and the Short-Form 36 questionnaire (SF-36) in patients with rotator cuff disorders. METHODS: The four questionnaires were administered to 30 patients at baseline and 3 months after treatment (physiotherapy or surgery). The patients were divided into two groups: those who improved after treatment (n=20) and those who did not (n=10) based on an anchor-based strategy to distinguish between the two groups and assess responsiveness. The t-test, the t-value of the paired t-test, the effect size (ES), and the standardized response mean (SRM) were calculated. RESULTS: All four questionnaires registered statistically significant changes (p<0.05) in the "improved" group between baseline and 3 months after treatment, and no changes in patients who did not improve. All four instruments showed higher ES and SRM values for the patients who improved than those who did not. WORC registered moderate to high ES and SRM values for the "improved" group, as did the UCLA and DASH. The ES and SRM values measured by the SF-36 ranged from small to large, the physical subscales being more responsive than the other subscales. CONCLUSION: The Brazilian version of the WORC (like UCLA, DASH and SF-36 physical subscales) proved responsive to change and suitable for use in the short-term follow-up of patients after rotator cuff interventions.

Tradução e adaptação cultural do WORC: um questionário de qualidade de vida para alterações do manguito rotador / Translation and cultural adaptation of WORC: a quality-of-life questionnaire for rotator cuff disorders

OBJETIVO: Realizar a tradução e a adaptação cultural do questionário WORC (The Western Ontario Rotator Cuff Index) para a língua portuguesa para ulterior validação no Brasil. MÉTODOS: O protocolo aplicado consistiu em: 1) Preparação, 2) Tradução, 3) Tradução de volta à língua original (retro-tradução), 4) Interrogatório Cognitivo e 5) Relato de Informações. Ao serem concluídas as etapas de tradução e retro-tradução, as versões foram enviadas para os autores do WORC original, que as aprovaram para continuação do estudo. A versão em Português foi aplicada a 35 pacientes com disfunções do manguito rotador para verificar o nível de compreensão do instrumento. A idade média foi 57 anos (DP=13), 63 por cento eram do sexo feminino e 74 por cento tinham nível de escolaridade de primeiro grau incompleto. A versão brasileira final do WORC foi definida após se conseguir menos que 15 por cento de "não compreensão" em cada item. Para análise das variáveis, foi utilizada estatística descritiva. RESULTADOS: Realizaram-se mudanças e substituições de termos e expressões para obter equivalência cultural do WORC. Alteraram-se também os termos "não compreendidos" pelos pacientes de acordo com as sugestões feitas por eles. CONCLUSÃO: Após a tradução e adaptação cultural do questionário, foi concluída a versão em Português do WORC que está em processo de validação para ser utilizada no Brasil.

OBJECTIVE: To accomplish the translation of WORC (The Western Ontario Rotator Cuff Index) into Portuguese and its cultural adaptation, for future validation in Brazil. METHOD: The protocol applied consisted of: 1) Preparation; 2) Forward translation; 3) Back translation; 4) Cognitive Debriefing; and 5) Information report. After concluding the forward and back-translations, the versions were sent to the authors of the original questionnaire, who gave their approval for the study to be continued. The Portuguese version was applied to 35 patients with rotator cuff dysfunctions to verify the level of understanding of the instrument. The mean age of these patients was 57 years (SD = 13); 63 percent were female and 74 percent had not completed elementary school. The final Brazilian version of WORC was defined after achieving a "no comprehension" rate of less than 15 percent for each item. Descriptive statistics were used to analyze the variables. RESULTS: Some terms and expressions were changed or replaced to obtain cultural equivalence for WORC. The terms that were incomprehensible to the patients were changed in accordance with their own suggestions. CONCLUSION: After the translation and cultural adaptation of the questionnaire, the final Portuguese version of WORC was concluded and it is now undergoing validation for use in Brazil.