Cross-cultural adaptation, reliability and validity of the German Shoulder Pain and Disability Index (SPADI).

OBJECTIVE: To cross-culturally adapt the Shoulder Pain and Disability Index (SPADI) from English into German, and to test the reliability and validity of the German version. METHODS: Cross-cultural adaptation of the SPADI was performed according to international guidelines. One hundred and eighteen patients who had undergone shoulder arthroplasty, on average 4 yr previously, completed a questionnaire booklet containing the German SPADI, the Short Form 36 (SF-36), the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, and the American Shoulder and Elbow Surgeons (ASES) questionnaire for the shoulder to assess SPADI's construct validity. One week later, they completed the SPADI again to assess test-retest reliability. RESULTS: The six-step cross-cultural adaptation procedure revealed no major problems with the content or language. The intraclass correlation coefficients for the individual items of the SPADI were between 0.68 and 0.89, and that for the SPADI total score was 0.94. The SPADI total score showed a correlation of 0.61-0.69 with the SF-36 physical scales, of 0.88 with the DASH and of 0.92 with the ASES. CONCLUSIONS: The German SPADI is a practicable, reliable and valid instrument, and can be recommended for the self-assessment of shoulder pain and function.

[Multi-rotation CT during continuous ventilation: comparison of different density areas in healthy lungs and in the ARDS lavage model]. / Multirotations-CT während kontinuierlicher Beatmung: Vergleich unterschiedlicher Dichtebereiche bei gesunden Lungen und im Lavage-ARDS Modell.

PURPOSE: In this animal study, density ranges for CT-based quantification of ventilated lung area were determined. Healthy lungs and ARDS lungs were compared during artificial respiration. MATERIAL AND METHODS: CT-scans were performed in 5 anesthetized pigs using a dynamic multiscan CT option on a predefined transverse slice (slice thickness 1 mm; effective temporal resolution, 250 ms). During continuous CT acquisition, airway pressure was increased or decreased in a stepwise manner. In all images, areas of defined HU ranges were determined planimetrically. The lower threshold was set to -910 HE in all images. The upper threshold was varied from -800 HE to -200 HE in steps of 100 HE. RESULTS: During inspiration in healthy lungs the HU-range of -910 to -700 HU showed the largest increase in area. During inspiration in ARDS lungs the HU range from -910 to -300 HU allowed the most sensitive assessment of area changes. These findings can be explained by recruitment of atelectases (HU-range > -300 HU) and their transition to a HU range from -700 to -300 HU. CONCLUSION: Dynamic multiscan CT acquisitions are a useful method to determine changes of ventilated lung area during a respiratory cycle. Different HU-ranges are required to access volume changes in healthy lungs and in ARDS lungs.