The conceptually equivalent Dutch version of the Western Ontario Rotator Cuff Index (WORC)(c)

Ronald N. Wessel*, Nienke Wolterbeek, Anouk J. M. Fermont, Henk van Mameren, Heleen Sonneveld, Sharon Griffin, Rob A. de Bie

*Corresponding author for this work

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Background: The WORC is a quality of life questionnaire designed for patients with disorders of the rotator cuff, originally developed in English. The purpose of this study was to cross-culturally adapt the WORC for use in the Dutch population and to evaluate reliability, agreement and floor and ceiling effects of this Dutch version in a population of patients with rotator cuff disease. Methods: Reliability was tested by measuring the Cronbach's alpha for internal consistency and intraclass correlation coefficients (ICC) for test-retest reliability. Agreement was measured using the Standard Error of Measurement (SEMagreement); and the smallest detectable change (SDC) was calculated based on the SEM. Pearson Correlations Coefficients were used to comparing the WORC with the RAND-36, the Constant Score and 11-point shoulder hindrance scale. Results: Fifty-seven patients entered into this study of whom 50 were available for test-retest validation. The internal consistency of the Dutch WORC tested by Cronbach's alpha was 0.95 for the total questionnaire. The ICC for the WORC is 0.91 with a 95% confidence interval of 0.85-0.95. Standard Error of Measurement was 6.0 points with a Smallest Detectable Change of 16.7 points on a 0-100 scale. Pearson Correlations Coefficients showed a significant positive correlation between the Dutch WORC and Constant Score (r = 0.60) and a strong reversed correlation with the shoulder hindrance scale (r = -0.75). Conclusion: The Dutch WORC seems to be a reliable health-related quality of life questionnaire for patients with rotator cuff disorders.
Original languageEnglish
Article number362
JournalBMC Musculoskeletal Disorders
Publication statusPublished - 21 Dec 2013


  • WORC
  • Quality of life questionnaires
  • Translation process
  • Validation
  • Rotator cuff repair

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