Psychometric Validation of the Arabic Version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) in Libya

Abstract

Objective: This study aimed to adapt and validate the Arabic version of the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form for assessing shoulder disabilities in the Libyan-Arab population.

Methods: A cross-sectional study design was employed, involving 108 participants with shoulder conditions from rehabilitation centers in Misrata, Libya. The ASES form underwent translation and cultural adaptation following established guidelines, including forward translation, synthesis, back-translation, expert review, and pilot testing. Psychometric validation included assessments of reliability, convergent and discriminant validity, and agreement using Cronbach's α, Intraclass Correlation Coefficient (ICC), and Bland-Altman analysis.

Results: The Arabic ASES form demonstrated excellent internal consistency (Cronbach's α = .90) and high test-retest reliability (ICC = 0.95). Convergent validity was confirmed by significant correlations with the DASH (r = -.867, P < .001), ADL (r = .522, P < .001), VAS (r = -.480, P < .001), and SF-MPQ (r = -.554, P < .001). Discriminant validity was supported by weak, non-significant correlations with unrelated constructs such as self-efficacy, sleep quality, and stress. Bland-Altman analysis indicated minimal systematic bias between repeated measurements.

Conclusion: The Arabic ASES form is a reliable, valid, and culturally appropriate tool for evaluating shoulder disabilities in Arabic-speaking populations, particularly in Libya. Its cross-cultural validation supports broader applicability across diverse Arabic-speaking contexts, enhancing clinical and research utility.

Keywords: ASES form; Arabic validation; Libya; cross-cultural adaptation; psychometric evaluation; shoulder disabilities.

Figure 1.

Difference between Time 1 and Time 2 measurements.