Full Length Paper| Volume 35, ISSUE 4, P501-506, October 2022

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Structural validity of the Brazilian version of the Shoulder Pain and Disability Index in patients with chronic shoulder pain

Published:January 13, 2021DOI:


      • The scientific literature is not unanimous about the best structure of SPADI.
      • The original version of SPADI with 2 domains and 13 items showed a high covariance between domains.
      • The version of SPADI with a domain and 13 items presents a better structure than the two-dimensional version.



      The Shoulder Pain and Disability Index (SPADI) is a measuring instrument for pain and disability in patients with shoulder dysfunction. However, its structure is controversial (ie, 1 or 2 domains).


      To investigate the structural validity of the Brazilian version of the SPADI in patients with chronic shoulder pain.

      Study Design

      Cross-sectional study.


      Brazilian Portuguese speakers of both genders aged 18 years or older with shoulder pain for at least 90 days (chronic) were included in this study. The structure of the SPADI was assessed by means of exploratory factor analysis with the implementation of parallel analysis and by confirmatory factor analysis. For the latter, the following goodness-of-fit indices were considered: root mean square error of approximation with 90% confidence interval, comparative fit index, Tucker–Lewis index, standardized root mean square residual, and chi-square/degrees of freedom.


      A total of 103 participants were included in the study. The original version of the SPADI with 2 domains and 13 items showed high covariance between domains (0.98), suggesting one-dimensionality. After exploratory factor analysis with the implementation of parallel analysis, one-dimensionality was found in the SPADI. Comparing models with 1 and 2 domains by means of confirmatory factor analysis, both presented adequate values (chi-square/degrees of freedom < 3; comparative fit index and Tucker–Lewis index > 0.90; root mean square error of approximation and standardized root mean square residual < 0.08). However, the model with one domain is more suitable for presenting lower values of Akaike information criterion (3308.713) and Bayesian information criterion (3377.216).


      The Brazilian version of the SPADI has a one-dimensional structure with 13 items (“shoulder impairment” construct), in contrast to the version with 2 domains.


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      JHT Read for Credit

      Quiz: # 892

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The study design is
        • a.
        • b.
        • c.
        • d.
          case series
      • # 2.
        The English version of the SPADI
        • a.
          has been shown to be valid
        • b.
          has never been tested for its validity
        • c.
          failed validation analysis when converted to Spanish
        • d.
          has been rejected by the APTA and ASHT quality control committees
      • # 3.
        Which was used to assess compatibility of the English and Portuguese versions
        • a.
          an ANOVA
        • b.
          two different ICCs
        • c.
          perpendicular analysis
        • d.
          parallel analysis
      • # 4.
        The two-dimensional SPADI includes these domains
        • a.
          glenohumeral motion and function
        • b.
          function and sensation
        • c.
          disability and pain
        • d.
          pain and ROM
      • # 5.
        The Brazilian version of the SPADI is one-dimensional with 13 items, whereas the original English version has two domains
        • a.
          not true
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.