Translation into Arabic and validation of the ASES index in assessment of shoulder disabilities

To translate into Arabic and validate the "American Shoulder and Elbow Surgeons Evaluation Form" (ASES) for use in a Tunisian population presenting with periarticular pathologies of the shoulder.

No functional index assessing the functional capacities of the shoulder is presently available in Arabic.

The translation was achieved by means of forward/backward translation. Adaptations were carried out subsequent to a preliminary test involving 15 persons. Patients with periarticular shoulder disabilities were included. Clinical measurements evaluated pain and functional disability by means of the visual analogue scale (VAS). Interrater concordance (repeatability) was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity (convergent and discriminant validity) was investigated using the Spearman rank correlation coefficient and a factorial analysis followed by orthogonal rotation. The internal consistency of each factor was graded in terms of the Cronbach alpha coefficient.

Eighty (80) patients were included in the study. Interrater concordance was excellent (ICC=0.96). The Bland and Altman method showed a low-variability mean difference. Correlations of the index score with the pain VAS (r=-0.49) and functional disability (r=-0.58) suggested satisfactory convergent validity, and our index likewise showed good discriminant validity. Factorial analysis led to the extraction of two factors with a cumulative variance rate of 92.6% that could not be explained.

Translated into Arabic, the ASES index was found to possess high metrological qualities. While the index has been satisfactorily validated with regard to a Tunisian population, additional studies are needed to verify its applicability to other Arab populations.