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- Title
POVEZAVA MED OBSEGOM GIBLJIVOSTI RAMENSKEGA SKLEPA IN DOSEŽKI NA DVEH OCENJEVALNIH LESTVICAH V REHABILITACIJSKI OBRAVNAVI BOLNIKOV Z MEHKOTKIVNIMI OKVARAMI RAMENSKEGA SKLEPA.
- Authors
Đorđević, Dragana Marković; Lonzarić, Dragan; Bojnec, Vida; Papež, Breda Jesenšek
- Abstract
Background: Functional status of the shoulder joint is usually assessed with its range of motion whereas self-assessed outcome measures are used to evaluate patient's functioning. The correlation between shoulder range-of-motion and self-assessed outcome measures in patients with shoulder problems is not sufficiently studied. The aim of the study was to assess the correlations between shoulder range of motion in patients with soft tissue shoulder impairments and scores of two commonly used outcome measures: SPADI (Shoulder Pain and Disability Index), a joint-specific questionnaire, and QuickDASH (Disabilities of the Arm, Shoulder and Hand -- the short version), a region-specific questionnaire. The correlation between the two questionnaires was also assessed in the study. Methods: Fifty patients sent to the Institute of Physical and Rehabilitation Medicine of the University Medical Centre Maribor due to soft tissue shoulder problems were included in the prospective study; 36 of them completed the study (25 men, 11 women). Their average age was 60 years. The first assessment was done at the beginning of the study and the second one after completion of the outpatient physical therapy programme (after 3.8 months on average). The outcome measures studied were passive and active range of motion and two self-assessed questionnaires, SPADI and QuickDASH. Pain was assessed using Visual Analogue Scale (VAS) at the beginning and at the end of the study. In addition, 5-point Likert scale was used to assess the level of improvement. Results: The largest relative gain in shoulder range of motion was achieved with active movement as assessed by the Constant percentage model (from 48.5 to 71.1 points on average, 47 % rise). The mean SPADI total score improved from 68.3 to 49.7, the mean QuickDASH score improved from 56.5 to 41.1 (p < 0.001). The change in SPADI total score statistically significantly correlated only with changes in active range of motion. The change in QuickDASH score did not significantly correlate with change of active anteflexion but it did correlate with changes of passive abduction and passive external rotation of the shoulder. Nearly perfect correlation was observed between SPADI pain score and SPADI total score (r = 0.96, p < 0.001). Correlations between SPADI total score and QuickDASH score were moderate to high (r = 0.64--0.87, p < 0.001), whereas the changes in those scores did not correlate significantly. The mean VAS rating improved from 6.5 to 3.9. Statistically significant difference (p ≤0.022) was found when comparing average scores of the three scales between the „improved“ group (28 patients) and the „not improved“ group (8 patients). Conclusions: The SPADI questionnaire did not prove to be superior over the QuickDASH questionnaire when comparing range of motion of the shoulder with self-assessed outcome measure. Even though moderate to high correlation was found between the scores of the questionnaires at the initial and final assessment, the changes in the scores did not correlate significantly. Nearly perfect correlation of SPADI total score and SPADI pain score speaks in favour of convergent validity of the questionnaire when assessing pain. SPADI and QuickDASH questionnaires differ in their content, hence usage of both questionnaires is recommended in rehabilitation outcome assessment of patients with shoulder problems.
- Subjects
MARIBOR (Slovenia); LONGITUDINAL method; SHOULDER joint; SHOULDER; LIKERT scale
- Publication
Rehabilitation / Rehabilitacija, 2018, Vol 17, Issue 2, p18
- ISSN
1580-9315
- Publication type
Article