Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 11;13(8):23259671251360415.
doi: 10.1177/23259671251360415. eCollection 2025 Aug.

Cross-Cultural Adaptation, Validity, and Reliability Study of the Indonesian Version of the Constant Score in Patients With Shoulder Pain

Andri Maruli Tua Lubis  1 , Juniarto Pangestu  1 , Erica Kholinne  2 , Iman Widya Aminata  3 , Andre Eltapama Landika  1 , Romy Deviandri  4   5
Affiliations

Cross-Cultural Adaptation, Validity, and Reliability Study of the Indonesian Version of the Constant Score in Patients With Shoulder Pain

Andri Maruli Tua Lubis et al. Orthop J Sports Med. .

Abstract

Background: Shoulder pain is one of the main symptoms of patients treated at orthopaedic clinics. The Constant score (CS) is widely used in the literature to assess shoulder functional outcomes. To the authors' knowledge, no outcome measure has been related to shoulder complaints in Indonesia.

Purpose: To perform a translation and cross-cultural adaptation and assess the validity and reliability of the Indonesian CS (CS-INA) as a shoulder functional assessment instrument in Indonesia.

Study design: Cohort study (Diagnosis); Level of evidence, 2.

Methods: After a translation cross-cultural adaptation of the CS into the Indonesian language was performed, the validity and reliability of the CS-INA were investigated. Data from patients with shoulder pain were collected consecutively in the orthopaedic clinic of 2 tertiary hospitals in Jakarta in 2023. The validity and reliability study of the final version of the CS-INA was conducted by 1 researcher in 2 meetings within 1 week. The Indonesian version of the 36-item Short Form Survey (SF-36) questionnaire was also given to the respondents. The correlation between CS-INA and SF-36 was determined to evaluate construct validity, whereas internal consistency, intraclass correlation, standard error of measurement (SEM), and minimal detectable change (MDC) were calculated to provide data on reliability.

Results: A total of 102 shoulders (101 patients) were included in the study. CS-INA showed excellent construct validity with SF-36 (Pearson correlation 0.90; P < .05). The reliability study showed good internal consistency (Cronbach α = 0.85) and intraclass correlation (ICC = 0.86). The SEM of the test and retest was 7.37, whereas the MDC was 14.3. No floor or ceiling effects were observed in this study.

Conclusion: The Indonesian version of the Constant score showed good validity and reliability for the Indonesian population experiencing shoulder pain.

Keywords: Constant score; cross-cultural adaptation; reliability; validity.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from the University of Indonesia—Cipto Mangunkusumo Hospital (KET-1136/UN2.F1/ETIK/PPM.00.02/2023).

Figures

Sample questionnaire of the adapted version of the Indonesian version of the Constant score, complete with sections for health status and activities.
Figure 1.
Sample questionnaire of the adapted version of the Indonesian version of the Constant score.
See this image and copyright information in PMC

References

    1. Barreto RPG, Barbosa MLL, Balbinotti MAA, Mothes FC, da Rosa LHT, Silva MF. The Brazilian version of the Constant-Murley Score (CMS-BR): convergent and construct validity, internal consistency, and unidimensionality. Rev Bras Ortop. 2016;51(5):515-520. - PMC - PubMed
    1. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-3191. - PubMed
    1. Celik D. Turkish version of the modified Constant-Murley score and standardized test protocol: reliability and validity. Acta Orthop Traumatol Turc. 2016;50:69-75. - PubMed
    1. Çırakoğlu D, Uslu T. Quality of life in patients with shoulder pain and the effect of physical therapy on quality of life. ODU Med J. 2022;9(2):45-55.
    1. Constant CR, Murley AHG. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160-164. - PubMed

LinkOut - more resources