Responsiveness of six outcome assessment instruments in total shoulder arthroplasty

Abstract

Objective. To assess the responsiveness (sensitivity to change) of 6 shoulder outcome instruments. Methods. In a prospective cohort study of 153 total shoulder arthroplasties, outcome was measured by the Short Form 36 (SF-36); Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH); Shoulder Pain and Disability Index (SPADI); American Shoulder and Elbow Surgeons questionnaire for the shoulder (ASES); and the Constant (Murley) Score (CS). Responsiveness was mainly quantified by effect sizes before and 6 months after operation. Sensitivity analysis of the effects by receiver operating characteristic (ROC) curves was performed to determine the instruments' ability to classify effects into global health change assessment categories. Results. Effect sizes of the self-assessment total scores were 0.71, 1.19, 2.10, and 2.13 for the SF-36, DASH, SPADI, and ASES, respectively. The clinical ASES and the CS had effect sizes of 1.87 and 2.23, respectively. The SPADI (effect size 2.12) and the CS (effect size 2.72) were most responsive for pain. For functioning, the patient ASES (effect size 2.10), the CS (effect size 1.82), and the clinical ASES (effect size 1.85) were almost equal. The SF-36 bodily pain scale and most scores of the condition-specific instruments showed a significant area under the ROC of up to 0.77. Conclusion. The SPADI and/or the CS are the most suitable for short, responsive, shoulder-specific assessment. The more expensive patient ASES can be used for most responsive shoulder-function assessment. For a comprehensive measurement of health and quality of life, the DASH and/or the SF-36 should be added to the set.

Shoulder Pain and Mobility Deficits: Adhesive Capsulitis

“…The measurement properties of the DASH have been extensively investigated. 2,8,15,43,47,53,72,118 The MDC has been reported to be between 6.6 and 12.2 points (weighted average, 10.5 points), 8,43,118 and the minimal clinically important difference has been reported to be 10.2 points. 115,118 The SPADI 112 is a 13-item patient self-report tool with 2 domains, 5 pain items, and 8 items of disability.…”

Tradução e adaptação cultural à língua portuguesa do American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) para avaliação da função do ombro

“…This last section is composed by one item related to pain and ten items related to function, and the validity, reliability, and responsivity of this section have been demonstrated. 27,28 The item related to pain is evaluated by a VAS (10 cm) that ranges from "no pain at all" to "pain as bad as it can be". The items related to function are evaluated by a four-point Likert scale.…”

“…Besides, studies have demonstrated that the ASES has better responsiveness than similar tools. 28 Besides providing a new tool for Brazilian rehabilitation professionals for clinical-and research-oriented uses, the Portuguese translation and cultural adaptation of the ASES will help standardize functional evaluation methods of the shoulder, similar to that of the methods used in other countries, allowing comparison of studies undertaken in different populations. Thus, the objective of the present study was to establish the Portuguese translation and cultural adaptation of the ASES to be used in patients with different shoulder disorders.…”

“…Although the psychometric properties of the original ASES have been investigated, 27,28 determination of the validity, reliability, and responsivity of the Portuguese version is ongoing, since this information is fundamental to support its use.…”

Efficacy of Hand Behind Back Mobilization With Movement for Acute Shoulder Pain and Movement Impairment: A Randomized Controlled Trial

“…32 The SPADI questionnaire is a shoulder specific, responsive and valid measure of shoulder pain and disability. 33,34,35 When the SPADI questionnaire is used prior to treatment and then at discharge, the MDC is 18 points.…”