The Shoulder Activity Level: an Italian Translation, Cross-Cultural Adaptation and Validation

Introduction. In this study we aimed to cross-culturally translate the Shoulder Activity Level (SAL) into Italian language and assess its clinimetric properties including reliability, validity, and responsiveness. The objective was to evaluate activity level in patients with shoulder disorders. Methods. Italian version of the SAL was obtained after forward-backward translation. Three questionnaires were completed by the participants: SAL, SST and SPADI. Fifty patients completed the SAL again, 1 week after the first administration to evaluate the test-retest reliability. Then was evaluated construct validity using Spearman's rank correlation, test-retest reliability and internal consistency were assessed using Intraclass Correlation Coefficient (ICC) and Cronbach's alpha, respectively. Results. No language difficulties were reported during translation process. Test-retest reliability of the SAL was good with an ICC of 0.896 and a Cronbach's alpha level of 0.739 was also obtained. The correlation between the SAL and the SPADI was moderate, proving divergent validity (rs = - 0.235), even the correlations between the SAL and the SST were moderate proving convergent validity (rs = 0.247). Conclusions. The study provides statistically significant results of test-retest reliability, internal consistency, construct validity, and responsiveness of the Italian version of the SAL in patients with shoulder disorders. Therefore, it seems that this instrument is a useful measure of shoulder activity level in research setting and clinical practice.