Validity, responsiveness and minimal important change of the EQ-5D-5L in patients after rotator cuff repair, shoulder arthroplasty or thumb carpometacarpal arthroplasty

Marks, Miriam; Grobet, Cécile; Audigé, Laurent

doi:10.1007/s11136-021-02849-7

Cited by 15 publications

(13 citation statements)

References 43 publications

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“…It was able to detect large improvements at 6 months postsurgery, consistent with the very large effect sizes reported in different populations and at various time points postsurgery. 4,10,11,37,38 We also found that, in this population, the OSS was considerably more responsive than the EQ-5D-5L and EQ-VAS. Given that the EQ-5D-5L and EQ-VAS are non-disease-specific measures, it is not unexpected that both instruments were less efficient at detecting changes in joint-specific outcomes.…”

Section: Discussionsupporting

confidence: 60%

Measurement Properties of the Oxford Shoulder Score and Minimal Clinically Important Changes After Primary Total Shoulder Replacement Surgery

Fang,

Ackerman,

Page

et al. 2024

Arthritis Care & Research

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ObjectiveTo evaluate the measurement properties of the Oxford Shoulder Score (OSS) and estimate the minimal clinically important change (MCIC) in patients undergoing primary total shoulder replacement in Australia.MethodsDe‐identified data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were used for this analysis. Pre‐ and 6‐month post‐operative OSS scores were used, with EQ‐5D‐5L and shoulder pain scores used as comparators. Floor and ceiling effects, internal consistency reliability, construct validity and responsiveness to change were evaluated using standard psychometric methods. Mean change and predictive modelling approaches (with and without adjustment for the proportion of improved patients) were used to calculate MCIC thresholds, with patient‐perceived improvement after surgery as the anchor.ResultsPre‐operative OSS data were available for 1,117 patients (59% female; 90% aged ≥ 60 years) undergoing primary total shoulder replacement. No floor or ceiling effects were observed pre‐ or post‐operatively. The OSS showed high internal consistency reliability (Cronbach alpha >0.89), good construct validity and high responsiveness to change (effect size 1.88). The MCIC derived from the mean change method was 6.50 points (95% confidence interval [CI] 4.41, 8.61). The predictive modelling approach produced an MCIC estimate of 8.42 points (95% CI 5.68, 12.23) after adjustment.ConclusionThe OSS has good measurement properties to capture pain and function outcomes following shoulder replacement procedures, and is highly responsive to change. Based on robust methods, an increase in OSS scores of at least 8 points can be considered as meaningful improvement after surgery from the patient's perspective.

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Section: Discussionsupporting

confidence: 60%

Measurement Properties of the Oxford Shoulder Score and Minimal Clinically Important Changes After Primary Total Shoulder Replacement Surgery

Fang,

Ackerman,

Page

et al. 2024

Arthritis Care & Research

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“…30 However, this clinically relevant improvement persisted only in the thermal capacitive-resistive radiofrequency group at 1 month post-intervention and was almost reached at 3 months post-intervention. Similarly, all groups obtained a significant improvement in the EQ-5D score at post-intervention (minimum clinically important difference = 0.05 points), 31 but only the thermal group improved the EQ-5D outcome at 1 month post-intervention. The pressure pain threshold only improved in the thermal capacitive-resistive radiofrequency group at post-intervention.…”

Section: Discussionmentioning

confidence: 82%

Capacitive resistive monopolar radiofrequency at 448 kHz plus exercising versus exercising alone for subacromial pain: A sham-controlled randomized clinical trial

et al. 2022

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Objective To investigate the effectiveness of thermal and sub-thermal capacitive-resistive monopolar radiofrequency at 448 kHz plus exercising compared to sham radiofrequency plus exercising on pain, functionality, and quality of life in patients with subacromial pain. Design Randomized, controlled, parallel, double-blind, three-arm clinical trial. Setting Hospital and Primary Care. Subjects Eighty-one participants with subacromial pain in three intervention groups. Interventions Three interventions with capacitive-resistive radiofrequency (thermal, sub-thermal, and sham) over 9 sessions (3 per week) plus an exercising protocol identical for all groups over 15 sessions (5 per week). Outcome measures Visual analogue scale and pressure pain threshold for pain, Shoulder Pain and Disability Index and Quick-Disabilities of the Arm, Shoulder and Hand for functionality, and quality of life via the European Quality of Life-Five Dimensions were assessed at baseline, immediately posttreatment, and 1 month and 3 months post-intervention. Results No between-group differences were found in the pain visual analogue scale (F = 1.0; P = 0.37), Shoulder Pain and Disability Index (F = 1.0; P = 0.36), European Quality of Life-Five Dimensions (F = 0.76; P = 0.47), and pressure pain (F = 0.14; P = 0.86) outcomes, with a statistical power < 0.30 for all comparisons. Between-group differences were found in the Quick-Disabilities of the Arm, Shoulder and Hand (F = 3.4; P < 0.038), with an improvement of −14.1 points (confidence interval at 95% (95% CI) −28.1 to −0.1) in the thermal versus the sham group at 1 month follow-up. The mobility dimension of European Quality of Life-Five Dimensions improved in a greater proportion of participants in the thermal group (22.2% thermal, 7.4% sub-thermal, and 0.0% sham; P = 0.02) Conclusion Adding thermal radiofrequency to exercising can further improve slightly functionality and mobility in people with subacromial pain in the short term, but not pain perception. Future studies with larger sample sizes are warranted to increase statistical power.

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“…the EuroQuol-5D (EQ-5D) [ 51 ] instrument is an established measure of quality of life, which is recommended in cost economics and heath technology assessment studies, including interventions at the shoulder such as rotator cuff repair [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Shoulder Rehabilitation Exercises With Kinematic Biofeedback After Arthroscopic Rotator Cuff Repair: Protocol for a New Integrated Rehabilitation Program

Parel¹,

Candoli²,

Filippi³

et al. 2023

JMIR Res Protoc

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Background The recovery of scapular and humeral physiological kinematic parameters, as well as the sensorimotor control of movement, plays a primary role in the rehabilitation process after arthroscopic rotator cuff repair. A highly customized rehabilitation approach is required to achieve this aim. Biofeedback can be a useful tool, but there is poor evidence of its application in the rehabilitation after arthroscopic rotator cuff tear repair. Objective The aim of this paper is to outline an innovative exercise-based rehabilitation program exploiting visual biofeedback for the recovery of patients arthroscopically treated for rotator cuff repair. Methods For establishment of the innovative program, a multidisciplinary team involving experts in shoulder surgery, rehabilitation medicine, physical therapy, and biomedical and clinical engineering was formed. Starting from a conventional rehabilitation program, the team selected a set of exercises to be integrated with a biofeedback tool, named the INAIL (National Institute for Insurance against Accidents at Work) Shoulder and Elbow Outpatient program (ISEO program). ISEO is a motion analysis system based on inertial wearable sensors positioned over the thorax, scapula, humerus, and forearm. ISEO can return a visual biofeedback of humerus and scapula angles over time or of the scapula-humeral coordination, with possible overlap of patient-specific or asymptomatic reference values. A set of 12 progressive exercises was defined, divided into four groups based on humerus and scapula movements. Each group comprises 2-4 of the 12 exercises with an increasing level of complexity. Exercises can require the use of a ball, stick, rubber band, and/or towel. For each exercise, we present the starting position of the patient, the modality of execution, and the target position, together with notes about the critical factors to observe. The type of visual biofeedback to adopt is specified, such as the coordination between angles or the variation of a single angle over time. To guide the therapist in customizing the patient’s rehabilitation program, a list of operative guidelines is provided. Results We describe various applications of the ISEO exercise program in terms of frequency and intensity. Conclusions An innovative rehabilitation program to restore scapular and humeral kinematics after rotator cuff repair based on kinematic biofeedback is presented. Biofeedback is expected to increase patient awareness and self-correction under therapist supervision. Randomized controlled trials are needed to investigate the potential effect of the exercise-based biofeedback in comparison with conventional rehabilitation programs. International Registered Report Identifier (IRRID) DERR1-10.2196/35757

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Validity, responsiveness and minimal important change of the EQ-5D-5L in patients after rotator cuff repair, shoulder arthroplasty or thumb carpometacarpal arthroplasty

Cited by 15 publications

References 43 publications

Measurement Properties of the Oxford Shoulder Score and Minimal Clinically Important Changes After Primary Total Shoulder Replacement Surgery

Measurement Properties of the Oxford Shoulder Score and Minimal Clinically Important Changes After Primary Total Shoulder Replacement Surgery

Capacitive resistive monopolar radiofrequency at 448 kHz plus exercising versus exercising alone for subacromial pain: A sham-controlled randomized clinical trial

Shoulder Rehabilitation Exercises With Kinematic Biofeedback After Arthroscopic Rotator Cuff Repair: Protocol for a New Integrated Rehabilitation Program

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