Translation, cultural adaptation, validity and reliability of the Turkish ASES questionnaire

Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2184-9. doi: 10.1007/s00167-012-2183-3. Epub 2012 Aug 30.


Purpose: The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) is a standard shoulder assessment form, which is comprised of objective and subjective sections and prepared by shoulder and elbow surgeons. The purpose of this study was to translate the subjective part of the ASES into Turkish and establish its cultural adaptiveness and validity.

Methods: The original version of the ASES was translated into Turkish in accordance with the stages recommended by Guillemin. Sixty-three patients (average age: 48.2 ± 13.4; range: 18-74 years) suffering from different shoulder complaints were included in the study. The ASES was completed twice at 3- to 7-day intervals for test-retest reliability. The intraclass correlation coefficient was used to calculate the test-retest reliability, and Cronbach's alpha was used for internal consistency. Patients were asked to complete the short form 36 (SF-36) and the Shoulder Pain and Disability Index (SPADI) for correlation. Validity was evaluated by external correlation of the ASES with the SPADI and SF-S6 questionnaire, which may also be defined as 'construct validity'. The results were analysed using Pearson's correlation test.

Results: The test-retest reliability of the ASES pain and function subscales and total ASES score were 0.95, 0.86 and 0.94, respectively. Cronbach's alpha coefficient for the total ASES was 0.88. The correlation between the total ASES and total SPADI score was -0.82; the correlation coefficient between the ASES pain subscale and SPADI pain subscale was -0.79 (p < 0.000); and the correlation between the ASES and SPADI function subscales were -0.53 (p < 0.000). The highest correlation was between ASES and SF-36 bodily pain, as well as ASES and SF-36 mental health (r = 0.64, r = 0.56, p < 0.000), and the lowest correlations were between ASES and the SF-36 physical component score and between ASES and SF-36 social function (r = 0.28, r = 0.33 p < 0.000).

Conclusion: The Turkish version of the ASES is a valid and reliable shoulder assessment form that can be used for numerous shoulder disorders.

Level of evidence: III.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / standards*
  • Reproducibility of Results
  • Shoulder Pain / diagnosis*
  • Surveys and Questionnaires*
  • Translations
  • Turkey
  • Young Adult