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Norwegian translation, cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaire
  1. Hilde Fredriksen,
  2. Grethe Myklebust
  1. Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
  1. Correspondence to Hilde Fredriksen; Hilde.Fredriksen{at}


The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, with 10 items and a total score ranging from zero to 100, provides more clinically relevant information about overhead athletes than other shoulder or upper limb patient-reported outcomes.

Objectives To translate, cultural adapt and evaluate the measurement properties of the Norwegian version of KJOC shoulder and elbow questionnaire.

Methods 33 overhead athletes (age 18.6±4.2, 10 men/23 women) were included in the analysis of face validity and known-group validity, of whom 15 went through cognitive interviews. An electronic version was developed, and six handball players were interviewed to ensure measurement equivalence between the paper-based and electronic version of the questionnaire. Test–retest reproducibility (1-week interval) and concurrent validity with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was investigated in 36 handball players (age 20.7±3.8, 17 men/19 women).

Results The translation was conducted, and smaller consensus-based adjustments were made. Athletes found the questionnaire easy to understand, with no differences between paper and electronic based version, and preferred the electronic version. The Norwegian electronic version of the KJOC showed excellent internal consistency (Cronbach's α=0.952) and relative test–retest reliability (Intraclass correlation coefficient, ICC=0.967). SEM, minimal detectable change (MDC) and limits of agreement were 3.1, 8.5 and −9.2 to 7.7, respectively. The concurrent validity versus DASH was moderate (Spearman’s rho=−0.642). However, KJOC had a wider range in scores than DASH, distinguished better between players playing with and without pain and was more sensitive to capture players playing with pain.

Conclusion This study suggests that the Norwegian version of the KJOC is a reliable and acceptable tool for evaluating shoulder and elbow-related problems in overhead athletes (handball players).

  • shoulder
  • elbow
  • questionnaire
  • reliability
  • validity

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  • Contributors Both authors conceived and designed the study. HF recruited the study subjects and performed data collection. HF performed the statistical analyses. Both authors have been involved in the data analyses, drafting and revision of the manuscript, and have approved the final manuscript.

  • Funding The Oslo Sports Trauma Research Center has been established at the Norwegian School of Sport Sciences through generous grants from the Royal Norwegian Ministry of Culture, the South-Eastern Norway Regional Health Authority, the International Olympic Committee, the Norwegian Olympic Committee & Confederation of Sport, and Norsk Tipping AS.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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