Turkish version of the patient-based Constant-Murley Score: Its cross-cultural adaptation, validity, reliability and comparison with the clinician-based version

Turk J Phys Med Rehabil. 2022 Aug 25;68(3):336-347. doi: 10.5606/tftrd.2022.8520. eCollection 2022 Sep.

Abstract

Objectives: The aim of this study was to translate, cross-culturally adapt the patient-based Constant-Murley Score (p-CMS), assess its validity, reliability, and compare it with the clinician-based CMS (c-CMS).

Patients and methods: This cross-sectional study included a total of 51 shoulders of 46 patients (22 males, 24 females; mean age: 49±10 years; range, 29 to 70 years) with shoulder pain between December 2015 and July 2016. After translation of p-CMS, each participant was asked to complete the final Turkish version of the p-CMS. The c-CMS was assessed by a physiatrist who was blinded to the p-CMS. Retest of the p-CMS was performed in patients (n=15) who did not receive any treatment between two visits (Days 3 to 5).

Results: A total of 51 shoulders (n=5 bilateral shoulder pain) were tested. Strength, subjective, objective, and total scores were significantly different between the p-CMS and c-CMS (p<0.001). Pain scores of the c-CMS and p-CMS revealed similar results with 95% limits of agreement of -3.81 and 4.81. Weighted kappa statistics demonstrated that the levels of agreement ranged between 0.343 and 0.698 in subjective and between 0.379 and 0.515 in objective components. For test-retest reliability of the p-CMS, intraclass correlation coefficient values ranged between 0.838 and 0.995.

Conclusion: The Turkish version of the p-CMS has internal consistency and test-retest reliability to evaluate shoulder function in Turkish patients with shoulder pathologies. Considering the differences in test protocols and scoring methods of c-CMS and p-CMS, their interchangeable use is not supported.

Keywords: Constant-Murley Score; patient-reported outcome measures; reliability; shoulder pain; validity..