The Oxford Shoulder Score: Cross-cultural adaptation and translational validation into Afrikaans


  • Editorial Office
  • N Kruger University of Cape Town
  • L Stander Stellenbosch University
  • S Maqungo University of Cape Town
  • S Roche University of Cape Town
  • M Held University of Cape Town


Patient Reported Outcome Measure (PROM), Oxford Shoulder Score (OSS), shoulder pain, Afrikaans, questionnaire, cross-cultural, quality of life, psychometrics, rotator cuff disease


Purpose: The Oxford Shoulder Score (OSS) is a robust and universally utilised shoulder score that has been translated for use in Western and Asian countries. This study aimed to translate, cross-culturally adapt and psychometrically validate the Afrikaans version of the OSS for use in Africa.
Methods: Translation and cross-cultural adaptation was performed in accordance with guidelines in the literature. Onehundred-and-eight consecutive patients with either degenerative or inflammatory pain of the shoulder were prospectively enrolled. Patients were evaluated by completing the Afrikaans OSS, Constant-Murley, quickDASH, and the Subjective Shoulder Value (SSV) scores. Comprehensibility and acceptance, as well as any floor or ceiling effects, were calculated. Reliability was assessed through reproducibility. Internal consistency was assessed using Cronbach’s alpha. Validity was determined using a Pearson correlation coefficient between the Afrikaans OSS and the other validated shoulder scores.
Results: Comprehensibility and acceptance were excellent, and no floor or ceiling effects were observed. Reproducibility (r=0.99) and internal consistency (Cronbach’s alpha = 0.93) were both excellent. Correlation of the Afrikaans OSS with the Constant-Murley and quickDASH was excellent (r=0.84; r=0.81 respectively), and very good with the SSV and Visual Analogue Scale (VAS) pain score (r=0.73; r=0.66). 
Conclusion: The Afrikaans OSS proved understandable, acceptable, reliable and valid. It is an appropriate instrument for use in Afrikaans-speaking patients with shoulder pain from degenerative or inflammatory origin.
Level of evidence: Level 3

Author Biographies

N Kruger, University of Cape Town

MBChB(UCT), MSc (t) Diag Imaging (OXON), MSc (res) Orth (OXON)

Orthopaedic Research Unit,

Department of Orthopaedics,

University of Cape Town

L Stander, Stellenbosch University

BSc(Hons)(Stel)Anatomy, BSc Anatomy(Stel), BTech(Hons)(CPUT)

Division of Anatomy and Histology

Faculty of Medicine and Health Sciences

Stellenbosch University


Cape Town

S Maqungo, University of Cape Town

MBChB, FC Orth(SA), MMed

Professor and Head: Orthopaedic Trauma Service

Orthopaedic Research Unit

Department of Orthopaedics

University of Cape Town

S Roche, University of Cape Town

MBChB, FC Orth(SA)

Professor and Head: Shoulder and Elbow Unit

Orthopaedic Research Unit

Department of Orthopaedics

University of Cape Town

M Held, University of Cape Town

MD, PhD(UCT), FC Orth(SA)

Orthopaedic Research Unit

Department of Orthopaedics

University of Cape Town







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