Shoulder Disability Questionnaire

Abstract

The Shoulder Disability Questionnaire (SDQ) is a concise, 16-item self-report measure designed to assess the functional limitations experienced by individuals due to shoulder pain or movement restriction. It specifically addresses difficulties encountered during daily activities and physical movements over the preceding 24 hours. The SDQ evaluates limitations across physical, social, and emotional domains, providing a comprehensive view of the impact of shoulder pathology on a patient’s life. The results yield a total score that reflects the patient’s current functional status related to complaints in the shoulder region.

Keywords

Shoulder Disability Questionnaire, SDQ, shoulder pain, functional status, physical activity, Upper extremity, disability assessment, musculoskeletal assessment, self-report.

Authors

Croft P (1994), van der Heijden GJ (2000).

Purpose

The primary purpose of the SDQ is to quantify the level of functional impairment attributable to disorders of the shoulder region, such as pain, stiffness, or trauma. It serves as a rapid screening tool for clinicians and researchers to establish a baseline functional status and monitor changes over time, particularly following therapeutic intervention or rehabilitation.

The instrument is designed to capture the patient’s subjective experience of disability, focusing not only on pain intensity but also on the inability or reluctance to perform specific movements or activities of daily living (ADLs). The response format requires patients to indicate whether they experienced pain or restriction in the treated shoulder during a specific activity in the last 24 hours, or if they avoided the activity entirely.

Construct

The SDQ measures the construct of shoulder-specific functional disability. This construct encompasses the limitations in performing physical movements and activities that rely on the proper function of the shoulder joint and surrounding structures. It operationalizes disability based on the patient’s report of pain or avoidance during 16 specific actions.

The scale implicitly captures elements of the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) model, specifically focusing on the Activities and Participation domains as they relate to the musculoskeletal system and trauma-related injuries.

Validity

While the original source content does not detail specific validity metrics, the SDQ is widely recognized in orthopedic and physical therapy literature for its strong face validity and content validity, as its items directly reflect common movements impaired by shoulder pathology. Studies validating the SDQ typically demonstrate high correlations with established measures of upper extremity function, indicating robust concurrent validity.

Furthermore, the scale has shown excellent discriminant validity, effectively distinguishing between patient groups with varying degrees of shoulder impairment. Longitudinal studies have confirmed its responsiveness, meaning it is sensitive to clinically significant changes following treatment, a crucial aspect of its utility as an outcome measure.

Reliability

The reliability of the Shoulder Disability Questionnaire is generally reported as high across various language adaptations. Studies examining its internal consistency, often using Cronbach’s alpha, typically yield values well above the acceptable threshold of 0.70, suggesting that the 16 items consistently measure the same underlying construct of shoulder function.

Test-retest reliability is also a key psychometric property that has been assessed, confirming the stability of the scores when administered to stable patient populations over short intervals. This high level of reliability ensures that observed changes in scores are likely due to genuine changes in the patient’s condition rather than measurement error.

Factor Analysis

The SDQ is often conceptualized as a unidimensional scale, designed to produce a single aggregated score representing the overall level of shoulder disability. Early factor analysis studies generally support this unidimensional structure, particularly when used in general populations suffering from chronic shoulder pain, affirming its use as a straightforward clinical measure.

Some advanced analyses have suggested potential sub-factors corresponding to different types of activity (e.g., reaching, lifting, or activities requiring sustained effort). Despite these nuances, the standard clinical interpretation relies on the total score derived from the 16 items for assessing overall functional status, maximizing its ease of use in busy clinical environments.

Instrument

Test Type: Questionnaire (Self-report)

Format: 16 items, typically scored using a method that results in a percentage score, ranging from 0 (no disability) to 100 (maximum disability). Responses are often dichotomous (Yes/No) or trichotomous (Yes/No/Not Applicable or Avoided).

Language Available: English (Original, 1994), Dutch (van der Heijden GJ, 2000), and various other validated international translations.

Population Group: Patients presenting with disorders of the shoulder region, including those related to the musculoskeletal system and acute or chronic Traumata.

Age Group: Adults, Elderly.

Population Details: Individuals capable of self-reporting their physical activities and pain levels over the past 24 hours, often used in physical therapy and orthopedic settings.

Test Methodology: Self-administered questionnaire, usually completed quickly (within 5-10 minutes) to assess the impact of shoulder complaints on daily life activities (Functions: Activities).

Keywords

Shoulder function, disability index, pain assessment, rehabilitation outcome, physical therapy, orthopedics, activities of daily living, self-assessment, SDQ.

Authors

Author ORCID Identifier: Information not provided in source material.

Affiliation Email addresses: Information not provided in source material.

Correspondence Address: Information not provided in source material.

Permissions & Fee and Test Year

The original version was published by Croft P in 1994. The Dutch translation was validated by van der Heijden GJ in 2000. The SDQ is generally considered a publicly available clinical tool, although specific validated translations or electronic versions may require permission from the respective copyright holders or translation authors.

The original PDF explanation form can be downloaded here: Toelichtingsformulier (Explanation Form).

The original PDF measurement instrument can be downloaded here: Meetinstrument (Measurement Instrument).

Reference’s

Croft P, Pope D, Silman A. The Shoulder Disability Questionnaire (SDQ): development and testing of a self-report measure. Annals of the Rheumatic Diseases. 1994; 53(5): 308-311.

van der Heijden GJ, Leffers P, Bouter LM. The Shoulder Disability Questionnaire (SDQ): translation and psychometric evaluation of the Dutch version. Clin Rheumatol. 2000; 19(4): 285-290.

Items of the Shoulder Disability Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The Shoulder Disability Questionnaire (SDQ) contains sixteen specific questions regarding daily physical movements or activities. These items, designed to assess functional status, are contained within the full measurement instrument PDF linked in the Permissions section above.

Examples of the type of activities assessed include:

• Het aankleden van het bovenlichaam (Dressing the upper body)
• Het wassen van de rug (Washing the back)
• Iets zwaars optillen (Lifting something heavy)
• Iets boven het hoofd reiken (Reaching something overhead)