Investigating the patient acceptable symptom state cut-offs: longitudinal data from a community cohort using the shoulder pain and disability index

Tran, Gui; Dube, B.; Kingsbury, Sarah R.; Tennant, Alan; Conaghan, Philip G.; Hensor, Elizabeth M A

doi:10.1007/s00296-019-04486-3

Cited by 17 publications

(10 citation statements)

References 21 publications

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“…Moreover, ROC curves with AUC were computed for pain intensity and disability for all patients. To determine if a patient was a 'case' on reference standard instruments, the individual's scores were compared to cut-off values defined in the literature: RMDQ � 4 [47], NDI � 15 [48], WOMAC DIS � 2.1 [49], SPADI-DIS � 4.1 [50].…”

Section: Statistical Analysesmentioning

confidence: 99%

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Validation of the German version of the STarT-MSK-Tool: A cohort study with patients from physiotherapy clinics

Karstens

Zebisch²,

Wey

et al. 2022

PLoS ONE

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Background The STarT-MSK-Tool is an adaptation of the well established STarT-Back-Tool, used to risk-stratify patients with a wider range of musculoskeletal presentations. Objective To formally translate and cross-culturally adapt the Keele STarT-MSK risk stratification tool into German (STarT-MSKG) and to establish its reliability and validity. Methods A formal, multi-step, forward and backward translation approach was used. To assess validity patients aged ≥18 years, with acute, subacute or chronic musculoskeletal presentations in the lumbar spine, hip, knee, shoulder, or neck were included. The prospective cohort was used with initial data collected electronically at the point-of-consultation. Retest and 6-month follow-up questionnaires were sent by email. Test-retest reliability, construct validity, discriminative ability, predictive ability and floor or ceiling effects were analysed using intraclass correlation coefficient, and comparisons with a reference standard (Orebro-Musculoskeletal-Pain-Questionnaire: OMPQ) using correlations, ROC-curves and regression models. Results The participants’ (n = 287) mean age was 47 (SD = 15.8) years, 51% were female, with 48.8% at low, 43.6% at medium, and 7.7% at high risk. With ICC = 0.75 (95% CI 0.69; 0.81) test-retest-reliability was good. Construct validity was good with correlations for the STarT-MSKG-Tool against the OMPQ-Tool of rs = 0.74 (95% CI 0.68, 0.79). The ability of the tool [comparison OMPQ] to predict 6-month pain and disability was acceptable with AUC = 0.77 (95% CI 0.71, 0.83) [OMPQ = 0.74] and 0.76 (95% CI 0.69, 0.82) [OMPQ = 0.72] respectively. However, the explained variance (linear/logistic regression) for predicting 6-month pain (21% [OMPQ = 17%]/logistic = 29%) and disability (linear = 20%:[OMPQ = 19%]/logistic = 26%), whilst being comparable to the existing OMPQ reference standard, fell short of the a priori target of ≥30%. Conclusions The German version of the STarT-MSK-Tool is a valid instrument for use across multiple musculoskeletal conditions and is availabe for use in clinical practice. Comparison with the OMPQ suggests it is a good alternative.

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Section: Statistical Analysesmentioning

confidence: 99%

“…All predictive ROC at least resulted in acceptable AUC. The cut-offs used to differ between cases and non-cases were derived from the literature [47][48][49][50]. Nonetheless, various methods exist to define cut-offs leading to different values [58].…”

Section: Plos Onementioning

confidence: 99%

Validation of the German version of the STarT-MSK-Tool: A cohort study with patients from physiotherapy clinics

Karstens

Zebisch²,

Wey

et al. 2022

PLoS ONE

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“…A reduction of 40% on the ‘total’ SPADI scale was considered sufficient improvement. 24 Full abduction was defined as equal to or greater than 160°, full external rotation was defined as equal to or greater than 45°. 25 Pain was assessed using 100 mm Visual Analogue Scale (VAS) for pain with a 20 mm reduction on the VAS 26 considered adequate improvement.…”

Section: Methodsmentioning

confidence: 99%

Suprascapular nerve block for the treatment of adhesive capsulitis: a randomised double-blind placebo-controlled trial

Shanahan

Gill²,

Briggs³

et al. 2022

RMD Open

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ObjectiveAdhesive capsulitis is a common painful shoulder condition. Treatment for the condition remains unsatisfactory. Suprascapular nerve block (SSNB) shows promise as a treatment option for adhesive capsulitis but there are no randomised controlled trials that examine its effect on pain or duration of the condition. The objective of this study was to examine the efficacy of SSNB for the management of adhesive capsulitis.MethodsA randomised double-blind placebo-controlled trial of SSNB and standard therapy versus placebo and standard therapy was performed. In total, 54 patients were enrolled in the study. 27 patients received a glenohumeral joint (GHJ) injection and physiotherapy plus a 3-month SSNB, and 27 patients received a GHJ injection and physiotherapy plus a 3-month placebo injection. Patients were followed to resolution of their symptoms as measured by a combination of range of movement, pain scores, Shoulder Pain and Disability Index (SPADI) scores and perceived recovery scores. The primary outcome measure was time to resolution of symptoms.ResultsParticipants who received the SSNB reduced the duration of their symptoms of adhesive capsulitis by an average of 6 months (mean time to resolution 5.4 (95% CI 4.4 to 6.3) months vs 11.2 (95% CI 9.3 to 13) months) in the placebo group. They also had reduced pain scores, improved range of movement and lower SPADI scores compared with the placebo group across all time points.ConclusionSSNB reduced the duration of adhesive capsulitis and resulted in improved pain and disability experience for patients.Trial registration numberAustralian New Zealand Clinical Trials Registry (ANCTRN 12615001378516).

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“… 37 The patient acceptable symptom state (PASS) was defined based on the preoperative SPADI values. 39 If the baseline SPADI was >66, the PASS threshold value for SPADI total was 49.2, pain 46.4, and disability 46.8. If the baseline SPADI was <66, the PASS threshold value for SPADI total was 39.4, pain 36.7, and disability 25.1.…”

Section: Methodsmentioning

confidence: 99%

“…If the baseline SPADI was <66, the PASS threshold value for SPADI total was 39.4, pain 36.7, and disability 25.1. 39 Any complications or revision surgeries were also recorded. The patients who were in need of revision surgery were categorized as a failure in the study.…”

Section: Methodsmentioning

confidence: 99%

Superior Capsular Reconstruction Using 3-layered Fascia Lata Autograft Reinforced with a Nonresorbable Suture Mesh

Polacek

Nyegaard

2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose The purpose of this study was to evaluate the short-term clinical outcomes and the complications related to arthroscopic superior capsular reconstruction (SCR) using a 3-layered fascia lata autograft (FLA) reinforced with a nonresorbable suture mesh, in the treatment of irreparable massive rotator cuff tears (MRCTs). Methods Consecutive patients with irreparable MRCTs (Goutallier 4, Hamada grade 1-2, Bateman 3-4) who were treated with arthroscopic SCR using reinforced FLA in 2018 were included. Patients with an irreparable subscapularis/infraspinatus, serious cardiovascular condition, systemic infection, rheumatic disease, and known alcohol/drug abuse were excluded from the study. Range of motion and Shoulder Pain and Disability Index (SPADI) scores were assessed preoperatively, at 6 months, and at 12 months postoperatively. A simple t test was used to compare the outcomes. P values <.05 were considered significant. Complications and revision surgeries were registered. Results A total of 24 consecutive patients (15 males, 9 females) with a mean age of 61 years (range, 41-76) were enrolled. Twenty (83%) patients achieved minimal clinically important difference in the SPADI score (>18) and 14 (58%) experienced substantial clinical benefit in SPADI (>45). The mean SPADI score improved from 59.0 to 9.7 ( P < .0001) at 1-year follow-up. Active abduction improved from 59.5° to 154.3° ( P < .0001) and active forward flexion improved from 67.0° to 160.3° ( P < .0001) at 1-year follow-up. Eighteen (75%) patients achieved substantial clinical benefit in active abduction (>28.5°) and active forward flexion (>35.4°). Complications included progression of osteoarthritis in 2 cases, tear of the graft in 1 case, and pullout of the anchor in another. Two patients experienced donor site morbidity after harvesting the fascia lata autograft. Conclusions Eighty-three percent of the patients achieved minimal clinically important difference and were successfully treated with arthroscopic SCR using a FLA reinforced with a suture mesh. The procedure had a complication rate of 17% and 8.5% of the patients experienced donor site morbidity. All complications occurred in patients who were previously treated with an attempted rotator cuff repair. Level of Evidence Level IV, therapeutic case series.

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Investigating the patient acceptable symptom state cut-offs: longitudinal data from a community cohort using the shoulder pain and disability index

Cited by 17 publications

References 21 publications

Validation of the German version of the STarT-MSK-Tool: A cohort study with patients from physiotherapy clinics

Validation of the German version of the STarT-MSK-Tool: A cohort study with patients from physiotherapy clinics

Suprascapular nerve block for the treatment of adhesive capsulitis: a randomised double-blind placebo-controlled trial

Superior Capsular Reconstruction Using 3-layered Fascia Lata Autograft Reinforced with a Nonresorbable Suture Mesh

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