Development and content validation of an ADL questionnaire for hemiplegic shoulder

OBJECTIVE: Shoulder problems can be a common secondary musculoskeletal complication after stroke. Common post-stroke shoulder problems include altered muscle tone, pain, and a frozen shoulder. The study was aimed at formulating an activities of daily living (ADL) questionnaire for stroke patients with shoulder problems. MATERIALS AND METHODS: The study was a cross-sectional content validation study conducted in a tertiary care hospital from August 2020 to March 2021. A literature review and direct patient interview were used to identify items for the scale. Before the construction of the scale, two physiotherapists with relevant field experience were interviewed to identify the items. Then, ten stroke patients were interviewed to generate new items depending on the challenges that they experienced. The scale was subsequently sent to a panel of eight experts for content evaluation. RESULTS: After the first round of Delphi, we excluded the items that failed to achieve at least a 0.8 item-level content validity index (I-CVI). In the first round, 9 items fail to achieve 0.8 I-CVI hence removed from the actual draft of the scale. Total 10 items were included in the second draft and it was sent to the 2(nd) round of Delphi survey. In this phase, all items got more than 0.8 I-CVI. The average value and universal acceptance of the scale level content validity index have been obtained at 0.96 and 0.8, respectively. It denotes that our proposed questioner got excellent level of content validity. CONCLUSION: As the ADL questioner got excellent content validity, this scale can be used to assess the ADL functions of hemiplegic shoulder.