Shoulder Pain and Disability Index (SPADI)


What is the Shoulder Pain and Disability Index?

The Shoulder Pain and Disability Index (SPADI) is a clinical evaluation instrument used to assess the level of shoulder pain and the level of disability produced by pain in the shoulder area. This instrument is commonly used in clinical research and medical practice as a benchmark to assess the impact of shoulder pain on a patient's quality of life. SPADI is one of several questionnaires generally used to evaluate shoulder conditions, and is specifically designed to provide information regarding the level of inability experienced by patients in carrying out various daily activities involving the shoulder.

SPADI can be used in several conditions on the shoulder, such as:

  • Shoulder pain
  • Rotator cuff disease
  • Osteoarthritis
  • Rheumatoid arthritis
  • Frozen shoulder
  • Shoulder arthroplasty

SPADI components

SPADI consists of two main components, namely:

  1. Pain sub scale
    This subscale contains 5 questions designed to assess the level of pain felt by patients in their shoulders. Patients are asked to rate their pain levels in several situations.
  1. Disability subscale
    This subscale also contains 8 questions intended to assess the level of difficulty patients experience in carrying out daily activities involving their shoulder.

SPADI Assessment Method

The SPADI instrument contains a total of 13 questions that must be answered by the patient. At each question point, patients will be asked to give their rating on each question in the form of a Likert scale, where they will give a value from 0 to 10, with 0 meaning no pain or disability, and 10 meaning very severe pain or disability.

SPADI Scoring System

After answering all the questions, the SPADI score will be calculated by adding up the two total scores from each subscale. The final SPADI score results will range from 0-100 with score interpretation:

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

SPADI Reliability

Joint Pain and FracturesInternal ConsistencyShoulder Arthroplasty Excellent internal consistency (Cronbach alpha= 0.95) Shoulder Disorder Excellent internal consistency (Cronbach alpha= 0.96)
Musculoskeletal ConditionsInternal ConsistencyMusculoskeletal conditions and joint pain Excellent internal consistency (Cronbach alpha= 0.94)
Chronic PainInternal ConsistencyShoulder Pain Excellent internal consistency (Cronbach alpha > 0.95)
Non-Specific Patient PopulationsTest/retest ReliabilityTest/retest Reliability of the total SPADI composite subscale score ranged from 0.64 to 0.66. Pearson product-moment correlation coefficient (r) was 0.75 to 0.92 for the overall score

Validitas SPADI

Joint Pain and FracturesConstruct ValidityAdhesive Capjualis Correlation with Disabilities of Arm Shoulder and Hand (DASH) = 0.55 Correlation with HAQ = 0.55 Correlation with Active ROM = -0.38 Shoulder Arthroplasty Correlation with DASH = 0.88 – 0.93 Correlation with ASES = 0.81 – 0.92 Correlation with SF-36 Physical Component Score (PCS) = 0.63 Correlation with SF-36 Mental Component Score (MCS) = 0.08 Correlation with Constant (Murley) Score = 0.82 Shoulder Disorder Correlation with Sickness Impact Profile = 0.57 Correlation of disability subscale with SST = -0.80 Rottator Cuff Disease Correlation with Oxford Shoulder Score (OSS) = 0.57 Subacromial Impingement Correlation with OSS = 0.85
Musculoskeletal ConditionsConstruct ValidityUpper Extremity Musculoskeletal Problems Correlation with Global Disability Rating = 0.64-0.69 Musculoskeletal Conditions and Joint Pain Correlation with Active ROM = -0.32 to -0.52 Correlation with SF-36 PCS = -0.46 Correlation with SF-36 MCS = -0.24
Chronic PainConstruct ValidityShoulder Pain Correlation with Active ROM = -0.090-0.251 Correlation with Dutch Shoulder Disability Questionnaire (SDQ-NL) = 0.330 Correlation with United Kingdom Shoulder Disability Questionnaire (SDQ-UK) = 0.573 Correlation with Shoulder Rating Questionnaire (SRQ) = 0.829
Non-Specific Patient PopulationsCriterion ValidityNeck pain (with or without radiating to the arm): Reviewed with 10 patients, who commented on the construct, completeness, and relevance of the NDI
 Construct ValidityCorrelation with Active ROM = 0.54-0.80 Correlation with Health Assessment Questionnaire (HAQ) = 0.61

Also read: Barthel Index

Reference :

  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.
  3. Shirley Ryan Ability Lab. Shoulder Pain And Disability Index. diakses melalui https://www.sralab.org/rehabilitation-measures/shoulder-pain-and-disability-index pada 12 Oktober 2023
  4. Physiopedia. Shoulder Pain and Disability Index (SPADI). diakses melalui https://www.physio-pedia.com/Shoulder_Pain_and_Disability_Index_(SPADI) pada 12 Oktober 2023


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