Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC)

Almeida, Gonçalo; Amaral, Luísa; Vilarinho, Rui; Magalhães, Bárbara; Silva, Fátima; Abreu, Verónica; Magalhães, André; Esteves, Mário; Cervaens, Mariana

doi:10.3390/healthcare13233081

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Open AccessArticle

Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC)

by

Gonçalo Almeida

^1,*,†

,

Luísa Amaral

^1,†

,

Rui Vilarinho

^1,2

,

Bárbara Magalhães

^3,4

,

Fátima Silva

¹

,

Verónica Abreu

⁵

,

André Magalhães

¹,

Mário Esteves

¹

and

Mariana Cervaens

^1,6

¹

FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, 4200-256 Porto, Portugal

²

CIR, E2S, Polytechnic of Porto, 4200-072 Porto, Portugal

³

Health Research Network (RISE-HEALTH), Center for Translational Health and Medical Biotechnology Research (TBIO), E2S, Polytechnic of Porto, 4200-072 Porto, Portugal

⁴

Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto (FADEUP), 4099-002 Porto, Portugal

⁵

INSIGHT Piaget Research Centre for Ecological Human Development, Instituto Piaget, 4405-678 Vila Nova de Gaia, Portugal

⁶

RISE-HEALTH, Fernando Pessoa University, 4249-004 Porto, Portugal

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Healthcare 2025, 13(23), 3081; https://doi.org/10.3390/healthcare13233081 (registering DOI)

Submission received: 15 October 2025 / Revised: 11 November 2025 / Accepted: 22 November 2025 / Published: 26 November 2025

(This article belongs to the Special Issue Psychometric Properties and Broader Implications of Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs))

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Abstract

Background/Objectives: The Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC) is used to identify dysfunctions and estimate injury risk in overhead sports athletes. Although it has been validated in several countries, a European Portuguese version is currently unavailable. This study aimed to translate, culturally adapt and assess psychometric properties (validity and reliability) of the European Portuguese KJOC (KJOC-PT). Methods: The KJOC-PT was translated and culturally adapted according to international guidelines. One hundred athletes were selected (median age 24 [IQR 17] years, 72% male) and divided into two groups: asymptomatic and symptomatic athletes. The convergent validity was assessed by correlating the KJOC-PT with the Disabilities of the Arm, Shoulder and Hand (DASH) and DASH-Sports. 31 athletes from the initial sample were considered to assess between-day reliability and agreement (Bland-Altman analysis). Floor and ceiling effects were also calculated. Sampling adequacy was assessed using the Kaiser Meyer-Olkin (KMO) test. Results: Minor cultural and linguistic changes were made in the KJOC-PT. This version demonstrated excellent internal consistency (Cronbach’s α = 0.91 to 0.97) and moderate negative correlations for validity (KJOC-PT with DASH, rho = −0.595; with DASH-Sports, rho = −0.533, both p < 0.001). Good reliability (ICC_2,1 = 0.77 to 0.89 [95%CI 0.36 to 0.96]), measurement error (SEM = 4.11 to 6.90; MDC = 11.39 to 19.13) and mean difference ranging from −0.08 ± 6.14 to 3 ± 9.17 were found. No floor effect (0%) and ceiling effects of 24.2% for the total sample (50% for asymptomatic and 5.1% for symptomatic athletes) were found. Conclusions: KJOC-PT is now available and is a valid and reliable instrument for use by athletes in overhead sports.

Keywords: overhead athletes; Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score; translation; cross-cultural adaptation; validity; reliability; European Portuguese version

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MDPI and ACS Style

Almeida, G.; Amaral, L.; Vilarinho, R.; Magalhães, B.; Silva, F.; Abreu, V.; Magalhães, A.; Esteves, M.; Cervaens, M. Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC). Healthcare 2025, 13, 3081. https://doi.org/10.3390/healthcare13233081

AMA Style

Almeida G, Amaral L, Vilarinho R, Magalhães B, Silva F, Abreu V, Magalhães A, Esteves M, Cervaens M. Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC). Healthcare. 2025; 13(23):3081. https://doi.org/10.3390/healthcare13233081

Chicago/Turabian Style

Almeida, Gonçalo, Luísa Amaral, Rui Vilarinho, Bárbara Magalhães, Fátima Silva, Verónica Abreu, André Magalhães, Mário Esteves, and Mariana Cervaens. 2025. "Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC)" Healthcare 13, no. 23: 3081. https://doi.org/10.3390/healthcare13233081

APA Style

Almeida, G., Amaral, L., Vilarinho, R., Magalhães, B., Silva, F., Abreu, V., Magalhães, A., Esteves, M., & Cervaens, M. (2025). Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC). Healthcare, 13(23), 3081. https://doi.org/10.3390/healthcare13233081

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Cross-Cultural Adaptation, Validity and Reliability of the European Portuguese Version of the Kerlan-Jobe Orthopaedic Clinic Shoulder & Elbow Score (KJOC)

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