Shoulder Outcome Measurements: Shoulder Pain and Disability Index (SPADI)

The Shoulder Pain and Disability Index (SPADI) is a self-reported questionnaire designed to assess pain and disability in individuals with shoulder pathology. It was developed in 1991 and has since been widely used in both clinical and research settings.

The SPADI consists of 13 items, which are divided into two subscales: pain (5 items) and disability (8 items). Each item is scored on a visual analog scale (VAS) from 0 to 10, with 0 indicating no pain or disability and 10 indicating the worst pain or disability possible. The total score ranges from 0 to 100, with higher scores indicating more pain and disability.

The SPADI can be used in a variety of populations, including patients with rotator cuff tears, shoulder impingement syndrome, adhesive capsulitis, and shoulder instability.

Interpretation of the SPADI scores depends on the specific study or clinical context. In general, higher scores indicate greater pain and disability, while lower scores indicate less pain and disability. In some studies, a change of 10 points on the SPADI has been considered to be a clinically significant improvement.

The SPADI score ranges from 0 to 100, with higher scores indicating greater shoulder pain and disability. Here are the commonly used categories for interpreting SPADI scores:

• 0-20: mild shoulder pain and disability
• 21-40: moderate shoulder pain and disability
• 41-60: severe shoulder pain and disability
• 61-80: very severe shoulder pain and disability
• 81-100: extremely severe shoulder pain and disability

However, it's important to note that there is no universally accepted cutoff for what constitutes a "normal" SPADI score, as this can vary depending on the individual patient and their specific condition. It's also worth considering that a change of 10-20 points on the SPADI score is generally considered to represent a clinically significant improvement or deterioration in shoulder pain and disability.

References:

1. Roach KE, Budiman-Mak E, Songsiridej N, Lertratanakul Y. Development of a Shoulder Pain and Disability Index. Arthritis Care Res. 1991;4(4):143-149. doi:10.1002/art.1790040403
2. Roy JS, Braen C, Leblond J, Desmeules F, Dionne CE, MacDermid JC. Examining measurement properties of the Shoulder Pain and Disability Index: results of a systematic review. J Rehabil Med. 2017;49(5):421-431. doi:10.2340/16501977-2225.