Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science


Health and Rehabilitation Sciences

Collaborative Specialization

Musculoskeletal Health Research


MacDermid, Joy C.


Rotator cuff disorders (RCDs) are a common musculoskeletal problem with a higher prevalence in women and after the age of 60. Due to the increasing need for patient-centered care, researchers have been directed towards the use of patient reported outcomes (PROs) to evaluate the progress of patient recovery, as the experience varies across individuals.

Recently, the Western Ontario Rotator Cuff Index was reduced in items to create the shortened version of the Western Ontario Rotator Cuff Index (Short-WORC). However, the Short-WORC’s psychometrics have yet to be evaluated. Therefore, this mixed-methods thesis aimed to evaluate the psychometric properties of the Short-WORC in a patient population of RCDs. First, we created the framework of evaluation by synthesizing the literature on the cultural adaptions of the WORC. Then, we quantitatively assessed the reliability and validity, and qualitatively assessed the content validity of the Short-WORC in a prospective rotator cuff population.

Overall, the findings suggestthat the Short-WORC demonstrates evidence of validity, reliability and sensitivity to change when measuring quality of life in rotator cuff pathology. Findings suggest the appropriate recommendations and advancement of clinical research in rotator cuff pathology.

Summary for Lay Audience

Rotator cuff disorders (RCDs) are the most common cause of shoulder pain. The rotator cuff is made up of muscles that surround the shoulder. Injuries can be caused from an accident or a fall, or other times as a result of repetitive overhead motions overtime. One way to evaluate shoulder pain is through a patient reported outcome (PROs).

A PRO is a questionnaire that measures your injury and its recovery from the patient perspective. PROs are an important tool to help make healthcare more patient-focused. This study looked at a PRO called the Shortened Western Ontario Rotator Cuff Index (Short-WORC) which helps clinicians better understand shoulder pain and how it affects a patient’s quality of life. The Short-WORC was tested to see if the scores it produces are consistent over time and if the Short-WORC is able to correctly measure quality of life after a RCD. We first developed a framework to see how the original Western Ontario Rotator Cuff Index (WORC) was used across other cultures. Then, we used different research methods to test the consistently of the scores and if the Short-WORC accurately measures quality of life for a patient. Then we had interviews to gain a better understanding of how patients felt about the Short-WORC and if there were changes that needed to be done. After all these studies, we can conclude the Short-WORC is a good tool for quality of life and understanding RCDs in patients, but there is still some more evaluation needed on it before we can conclude it being the gold standard tool.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.