Norwegian translation, cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaire

The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, with 10 items and a total score ranging from zero to 100, provides more clinically relevant information about overhead athletes than other shoulder or upper limb patient-reported outcomes. OBJECTIVES: To translate, cultural adapt and evaluate the measurement properties of the Norwegian version of KJOC shoulder and elbow questionnaire. METHODS: 33 overhead athletes (age 18.6±4.2, 10 men/23 women) were included in the analysis of face validity and known-group validity, of whom 15 went through cognitive interviews. An electronic version was developed, and six handball players were interviewed to ensure measurement equivalence between the paper-based and electronic version of the questionnaire. Test–retest reproducibility (1-week interval) and concurrent validity with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was investigated in 36 handball players (age 20.7±3.8, 17 men/19 women). RESULTS: The translation was conducted, and smaller consensus-based adjustments were made. Athletes found the questionnaire easy to understand, with no differences between paper and electronic based version, and preferred the electronic version. The Norwegian electronic version of the KJOC showed excellent internal consistency (Cronbach's α=0.952) and relative test–retest reliability (Intraclass correlation coefficient, ICC=0.967). SEM, minimal detectable change (MDC) and limits of agreement were 3.1, 8.5 and −9.2 to 7.7, respectively. The concurrent validity versus DASH was moderate (Spearman’s rho=−0.642). However, KJOC had a wider range in scores than DASH, distinguished better between players playing with and without pain and was more sensitive to capture players playing with pain. CONCLUSION: This study suggests that the Norwegian version of the KJOC is a reliable and acceptable tool for evaluating shoulder and elbow-related problems in overhead athletes (handball players).