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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Development of an item list to assess the forgotten joint concept in shoulder patients

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Johannes M Giesinger, Nicolas Kesterke, David F Hamilton, Bernhard Holzner, Bernhard Jost, Karlmeinrad Giesinger
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

KG and JMG conceived the study objective and study design. BJ, NK, JMG and KG participated in the item selection procedure. KG and DH coordinated data collection. JMG, BH and KG performed the data analysis and interpreted the results. All authors helped to outline the manuscript. KG and JMG drafted the manuscript. All authors read and approved the final version.



To generate an item list for the assessment of joint awareness in shoulder patients and to collect patient feedback on the comprehensibility of the items and the forgotten joint concept.


Item content was generated on the basis of literature search and expert ratings following a stepwise refinement procedure, including final evaluation by an international expert board (n = 12) including members with various professional backgrounds. Items were translated from English to German and evaluated in 30 German-speaking shoulder patients in Switzerland and 30 shoulder patients in the UK.


Literature search identified 45 questionnaires covering 805 issues potentially relevant for the assessment of joint awareness. Stepwise item selection resulted in 97 items to be evaluated by the international expert board leaving 70 items for collecting patient feedback. The majority of patients indicated that the introductory text explaining the forgotten joint concept was easy or very easy to understand (79.3%) and that the items were clear (91.4%).


We developed a list of 70 questions for the assessment of joint awareness in shoulder patients and obtained positive patient feedback for these. In a next step, we will administer the items to a large international patient sample to obtain data for psychometric analysis and development of a measurement model, which is the basis for creation of computer-adaptive assessments or static short-forms.
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