Comparison of clinical and patient-based measures to assess medium-term outcomes following shoulder surgery for disorders of the rotator cuff. Comparative Evaluation of the Measurement Properties of Various Shoulder Outcome Instruments Objective evaluation of shoulder function using body-fixed sensors: a new way to detect early treatment failures? The CSAW Study (Can Shoulder Arthroscopy Work?) – a placebo-controlled surgical intervention trial assessing the clinical and cost effectiveness of arthroscopic subacromial decompression for shoulder pain: study protocol for a randomised controlled trial American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness. Comparison of customized versus standard exercises in rehabilitation of shoulder disorders The Southampton examination schedule for the diagnosis of musculoskeletal disorders of the upper limb Comparison of the University of California-Los Angeles Shoulder Scale and the Simple Shoulder Test with the shoulder pain and disability index: single-administration reliability and validity. Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review The responsiveness of the Shoulder Disability Questionnaire Prospective Longitudinal Analysis of Postoperative Shoulder Function: A Ten-Year Follow-up Study of Full-Thickness Rotator Cuff Tears Functional activity characteristics of individuals with shoulder dysfunctions. Synthesising ‘best evidence’ in systematic reviews when randomised controlled trials are absent: three tips for authors to add value for clinician readers A randomized, controlled clinical trial of a treatment for shoulder pain. Interrater reproducibility of clinical tests for rotator cuff lesions. Shoulder disorders in general practice: prognostic indicators of outcome. Reliability and validity of shoulder function outcome measures in people with a proximal humeral fracture
OBJECTIVE To compare different assessment s following  shoulder surgery for impingement syndrome with or without rotator cuff tear or repair . METHODS A prospect i ve study of 93 patients was conducted . St and ard assessment s were performed before , at 6 months , and at 4 years following shoulder surgery using the patient-based Oxford Shoulder Score ( OSS ) , the Medical Outcomes Study Short Form-36 ( SF-36 ) question naire , and a surgeon-assessed Constant Shoulder Score . Patients were categorized according to the surgery received in relation to the presence of cuff tears : full repair , partial repair , cuff tear/no repair , no tear/no repair . RESULTS Most patients ( 57 % ) received subacromial decompression for impingement with no cuff tear . This group had the fewest pre- and postoperative symptoms . The category of patients who received only partial repair of a cuff tear had worse scores on all outcome assessment s compared with other groups . Patient-based measures were more stable over time than the Constant . CONCLUSION The shoulder-specific measures had greater sensitivity than the SF-36 in registering significant differences in outcomes between comparison groups at 6 months and 4 years Background Various shoulder outcome instruments have been used despite lack of information on their measurement properties ; reliability , responsiveness , and validity ; and correlation with health-related quality of life . Hypothesis Most shoulder outcome instruments have poor correlation with Short Form−36 , a general measure of health-related quality of life , and with each other . Study Design Cohort study ( diagnosis ) ; Level of evidence , 2 . Methods A consecutive group of 285 patients who had undergone shoulder surgery completed several shoulder outcome instruments — Short Form−36 ; University of California , Los Angeles shoulder score ; American Shoulder and Elbow Surgeons shoulder evaluation form ; Constant score ; Simple Shoulder Test ; Western Ontario Shoulder Instability Index ; and the rating sheet for Bankart repair ( Rowe score)—preoperatively and at 3 , 6 , 9 , and 12 months postoperatively . Internal consistency , st and ardized response mean , effect size , and Pearson correlation were used to evaluate reliability , responsiveness , and validity . Results The American Shoulder and Elbow Surgeons form , Simple Shoulder Test , and Western Ontario Shoulder Instability Index displayed good internal consistency . The University of California , Los Angeles shoulder score and American Shoulder and Elbow Surgeons form exhibited good responsiveness , whereas Short Form−36 showed the least responsiveness . Pearson correlation coefficients between the shoulder outcome instruments and Short Form−36 were less than excellent ( r < .60 ) . Pearson correlation coefficients between the outcome instruments were generally low except for the Constant score and University of California , Los Angeles shoulder score ( r = .673 , P < .01 ) . Conclusion There was no single shoulder outcome instrument that was superior to the others in terms of the measurement properties . Most of the tested shoulder outcome instruments did not reflect health-related quality of life well and poorly correlated with each other . This meant that the comparison of a given surgical result with different outcome instruments might be of little practical utility . Further prospect i ve and serial studies should be conducted to develop better shoulder outcome instruments that have significant reliability , responsiveness , validity , and correlation with health-related quality of life . A careful combination of outcome instruments might be necessary to compensate the current evaluation systems BACKGROUND Variable definitions of outcome ( Constant score , Simple Shoulder Test [ SST ] ) have been used to assess outcome after shoulder treatment , although none has been accepted as the universal st and ard . Physicians lack an objective method to reliably assess the activity of their patients in dynamic conditions . Our purpose was to clinical ly vali date the shoulder kinematic scores given by a portable movement analysis device , using the activities of daily living described in the SST as a reference . The secondary objective was to determine whether this device could be used to document the effectiveness of shoulder treatments ( for glenohumeral osteoarthritis and rotator cuff disease ) and detect early failures . METHODS A clinical trial including 34 patients and a control group of 31 subjects over an observation period of 1 year was set up . Evaluations were made at baseline and 3 , 6 , and 12 months after surgery by 2 independent observers . Miniature sensors ( 3-dimensional gyroscopes and accelerometers ) allowed kinematic scores to be computed . They were compared with the regular outcome scores : SST ; Disabilities of the Arm , Shoulder and H and ; American Shoulder and Elbow Surgeons ; and Constant . RESULTS Good to excellent correlations ( 0.61 - 0.80 ) were found between kinematics and clinical scores . Significant differences were found at each follow-up in comparison with the baseline status for all the kinematic scores ( P < .015 ) . The kinematic scores were able to point out abnormal patient outcomes at the first postoperative follow-up . CONCLUSION Kinematic scores add information to the regular outcome tools . They offer an effective way to measure the functional performance of patients with shoulder pathology and have the potential to detect early treatment failures Background Arthroscopic subacromial decompression ( ASAD ) is a commonly performed surgical intervention for shoulder pain . The rationale is that removal of a bony acromial spur relieves symptoms by decompressing rotator cuff tendons passing through the subacromial space . However , the efficacy of this procedure is uncertain . The objective of this trial was to compare the efficacy and cost-effectiveness of ASAD in patients with subacromial pain using appropriate control groups , including placebo intervention . Methods / Design The trial is a three-group , parallel design , pragmatic , r and omised controlled study . The intervention content for each group ( ASAD , active monitoring with specialist re assessment ( AMSR ) and investigational shoulder arthroscopy only ( AO ) ) enables assessment of ( 1 ) the efficacy of the surgery against no surgery ; ( 2 ) the need for a specific component of the surgery — namely , removal of the bony spur ; and ( 3 ) quantification of the placebo effect . Concealed allocation was performed using a 1:1:1 r and omisation ratio and using age , sex , baseline Oxford Shoulder Score ( OSS ) and centre as minimisation criteria . The primary outcome measure is the OSS at 6 months post r and omisation .  A total of 300 patients recruited over 24 months from a minimum of 14 UK shoulder units over 24 months were required to detect a difference of 4.5 points on the OSS ( st and ard deviation , 9 ) with 90 % power and to allow for 15 % loss to follow-up . Secondary outcomes include cost-effectiveness , pain , complications and patient satisfaction . A substantial qualitative research component is included . The primary analysis will be conducted on the modified intention-to-treat analysis . Sensitivity analysis will be used to assess the robustness of the results with regard to the underlying assumptions about missing data using multiple imputation . Discussion This trial uses an innovative design to account for the known placebo effects of surgery , but it also will delineate the mechanism for any benefit from surgery . The investigational AO group is considered a placebo intervention ( not sham surgery ) , as it includes all components of subacromial decompression except the critical surgical element . Some discussion is also dedicated to the challenges of conducting placebo surgery trials . Trial registration sUK Clinical Research Network UKCRN12104 . Registered 22 May 2012.International St and ard R and omised Controlled Trial IS RCT N33864128 . Registered 22 June 2012 . Clinical Trials.gov NCT01623011 . Registered 15 June 2012 The purpose of this study was to examine the psychometric properties of the American Shoulder and Elbow Surgeons St and ardized Shoulder Assessment Form ( ASES ) , patient self-report section . Patients with shoulder dysfunction ( n = 63 ) completed the ASES , The University of Pennsylvania Shoulder Score , and the  Short Form-36  during the initial evaluation , 24 to 72 hours after the initial visit , and after 3 to 4 weeks of physical therapy . The test-retest reliability ( intraclass correlation coefficient[1-way r and om-effects ] , 0.84 ; 95 % CI lower limit , 0.75 ) and internal consistency ( Cronbach alpha , 0.86 ) values were acceptable . The st and ard error of the measure was 6.7 ASES points ( 90 % CI , 11.0 ) . Construct and discriminant validity was demonstrated . Responsiveness was demonstrated with a st and ardized response mean of 1.5 and an effect size of 1.4 . The minimal detectable change was 9.7 ASES points ( 90 % CI , 16 ) , and the minimal clinical ly important difference was 6.4 ASES points . The results indicate that the ASES is a reliable , valid , and responsive outcome tool Objective ( s ) : ( 1 ) To compare the effectiveness of customized exercises with that of st and ard exercises for the treatment of patients with shoulder disorders . ( 2 ) To determine whether four weeks or eight weeks would be needed to see improvement in outcome measures . Design : A single-blinded r and omized clinical trial . Setting : An outpatient physical therapy clinic affiliated with an academic institution . Subjects : Thirty patients with shoulder disorders were tested and treated between February 2003 and December 2004 . Interventions : Patients were r and omized to a customized or st and ard exercise group . Each patient first underwent a st and ardized physical therapy assessment . Based on the results of the assessment , a classification was determined and a classification-specific exercise programme was instructed to the patients in the customized exercise group . The st and ard exercise group , regardless of classification , received preselected st and ard exercises . Both groups were followed for eight weeks . Main measures : Shoulder range of motion , strength , pain intensity and function were assessed three times ( weeks 0 , 4 and 8) . Results : There were no significant differences between the customized and st and ard exercise groups in measures of shoulder range of motion , strength , pain intensity and function after four or eight weeks of exercise . Patients in both groups had significant improvements in shoulder strength , pain intensity and function . Significant improvements occurred at week 8 , but not at week 4 . Conclusion : The customized shoulder exercises did not provide additional benefit to our shoulder patients than the st and ard exercises OBJECTIVES Following a consensus statement from a multidisciplinary UK workshop , a structured examination schedule was developed for the diagnosis and classification of musculoskeletal disorders of the upper limb . The aim of this study was to test the repeatability and the validity of the newly developed schedule in a hospital setting . METHOD 43 consecutive referrals to a soft tissue rheumatism clinic ( group 1 ) and 45 subjects with one of a list of specific upper limb disorders ( including shoulder capsulitis , rotator cuff tendinitis , lateral epicondylitis and tenosynovitis ) ( group 2 ) , were recruited from hospital rheumatology and orthopaedic outpatient clinics . All 88 subjects were examined by a research nurse ( blinded to diagnosis ) , and everyone from group 1 was independently examined by a rheumatologist . Between observer agreement was assessed among subjects from group 1 by calculating Cohen 's κ for dichotomous physical signs , and mean differences with limits of agreement for measured ranges of joint movement . To assess the validity of the examination , a pre-defined algorithm was applied to the nurse 's examination findings in patients from both groups , and the sensitivity and specificity of the derived diagnoses were determined in comparison with the clinic 's independent diagnosis as the reference st and ard . RESULTS The between observer repeatability of physical signs varied from good to excellent , with κ coefficients of 0.66 to 1.00 for most categorical observations , and mean absolute differences of 1.4 ° –11.9 ° for measurements of shoulder movement . The sensitivity of the schedule in comparison with the reference st and ard varied between diagnoses from 58%–100 % , while the specificities ranged from 84%–100 % . The nurse and the clinic physician generally agreed in their diagnoses , but in the presence of shoulder capsulitis the nurse usually also diagnosed shoulder tendinitis , whereas the clinic physician did not . CONCLUSION The new examination protocol is repeatable and gives acceptable diagnostic accuracy in a hospital setting . Examination can feasibly be delegated to a trained nurse , and the protocol has the benefit of face and construct validity as well as consensus backing . Its performance in the community , where disease is less clear cut , merits separate evaluation , and further refinement is needed to discriminate between discrete pathologies at the shoulder BACKGROUND AND PURPOSE Shoulder scales are often used to evaluate treatment efficacy , yet little is known about the psychometric properties of these scales . Only one scale has undergone psychometric scrutiny : the Shoulder Pain and Disability Index ( SPADI ) . This study compared 2 shoulder measures -the University of California-Los Angeles ( UCLA ) Shoulder Scale and the Simple Shoulder Test (SST)-with the SPADI . SUBJECTS One hundred ninety-two patients with shoulder disorders were recruited from one physician 's office to complete the self-report sections of the 3 scales . METHODS Cronbach alpha values and st and ard errors of measurement ( SEM ) were calculated for each of the multi-item subscales . Validity was examined through calculation of correlation coefficients among the 3 scales . Factor analysis was completed to assess the underlying constructs of the SPADI and the SST . RESULTS Cronbach alpha values ranged from.85 to.95 . The SEM values for the multi-item scales ranged from 4.75 to 11.65 . Evidence for validity to reflect function was indicated by the correlation between the SST and the SPADI disability subscale . The factor analysis of the SPADI revealed loading on 1 factor , whereas the SST loaded on 2 factors . CONCLUSION AND DISCUSSION All scales demonstrated good internal consistency , suggesting that all items for each scale measure the same construct . However , the SEMs for all scales were high . Factor loading was inconsistent , suggesting that patients may not distinguish between pain and function Background . This paper aim ed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer- review ed evidence supporting their reliability , validity , and responsiveness to change . Methods . A systematic review of r and omised controlled trials among people with wrist osteoarthritis was undertaken . Studies reporting reliability , validity , or responsiveness were identified using a systematic reverse citation trail audit procedure . Psychometric properties of the instruments were examined against predefined criteria and summarised . Results . Thirteen clinical trials met inclusion criteria . The most common patient-reported outcome was the disabilities of the arm , shoulder , and h and question naire ( DASH ) . The DASH , the  Michigan H and Outcomes Question naire ( MHQ ) , the  Patient Evaluation Measure ( PEM ) , and the  Patient-Reported Wrist Evaluation ( PRWE ) had evidence supporting their reliability , validity , and responsiveness . A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis H and Index as another suitable instrument that had favourable reliability , validity , and responsiveness . Conclusions . The DASH , MHQ , and AUSCAN Osteoarthritis H and Index instruments were supported by the most favourable empirical evidence for validity , reliability , and responsiveness . The PEM and PRWE also had favourable empirical evidence reported for these elements . Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted Objective —To evaluate the responsiveness of the Shoulder Disability Question naire ( SDQ ) . Methods —The study was conducted within the framework of an observational study on shoulder disorders in primary care . After first presentation of their complaints to the general practitioner and after one and six months , participants completed the SDQ , a single question on functional status ( FSQ ) , and an ordinal 11 point scale for the severity of pain ( PSS ) . Responsiveness of the SDQ was evaluated compared with that of the FSQ and PSS , by calculating responsiveness ratios and by plotting receiver operating characteristic ( ROC ) curves . Recovery according to the patient was used as an external criterion for clinical ly relevant improvement ( complete recovery or much improved on a six point Likert scale was denoted as clinical ly relevant improvement ) . Results —A total of 349 consecutive patients with shoulder disorders were enrolled in the observational study . Response rates ranged between 96 % and 89 % . Responsiveness ratios were slightly higher for the PSS compared with the SDQ ( 2.53 versus 2.22 at one month , 2.24 versus 1.89 at six months ) . The area under the ROC curve was 0.84 for both the SDQ and the PSS , and 0.72 for the FSQ . Conclusion —The results of this study confirm the responsiveness of the SDQ , making it a useful instrument to assess functional disability in longitudinal studies Background : Rotator cuff repair  is associated with good short or mid-term results , but to date there have been no long-term functional outcome studies demonstrating durability of results over time . In most long-term studies , the results have been compared with those of historical controls or with those of other , short-term follow-up studies . The purpose of the present prospect i ve study was to evaluate short and long-term shoulder function after surgical repair in a single population of patients in order to follow changes over time . Methods : Thirty-three patients underwent surgery , performed by one surgeon , for the treatment of a chronic , symptomatic , full-thickness rotator cuff defect . Data were obtained from question naires and physical examinations preoperatively , at two years , and at ten years . Identical st and ardized pain and function question naires were used and clinical evaluation was performed in a consistent fashion at all time-periods . The activity level , Constant score , level of disability , shoulder function score , and patient ’s subjective rating of the outcome were determined at the time of the final follow-up and compared with the same parameters at the two-year follow-up examination in order to determine if early results change with time . Results : At the ten-year follow-up examination , there was no change in the raw Constant score determined at the two-year examination . When the Constant score was normalized for expected age-related changes , the percentage of patients who had a satisfactory result at ten years was even greater than the percentage at two years . Activity level decreased significantly over the time-period ( p = 0.005 ) . At the final follow-up examination , twelve patients worked at the same occupation as they had when the two-year examination was performed , two worked at a less strenuous occupation , and the remaining patients were retired . Only two patients retired because of problems related to the shoulder . The level of disability decreased over the study period , and there was a small improvement in the patients ’ self- assessment shoulder function score . The patients ’ subjective assessment of the outcome remained unchanged . Conclusions : The results of open rotator cuff repair for chronic tears do not deteriorate with time ( ten years ) . The level of disability decreases , presumably because of a concurrent decrease in the activity level and in the dem and on the shoulder as the patient ages . It is important to consider age-related changes when assessing the final outcome Shoulder-related dysfunction affects individuals ' ability to function independently and thus decreases quality of life . Functional task assessment is a key concern for a clinician in diagnostic assessment , outcome measurement , and planning of treatment programs . The purpose of this study was to test the reliability of the FASTRAK 3-dimensional ( 3-D ) motion analysis and surface electromyography ( sEMG ) systems to analyze 3-D shoulder complex movements during functional tasks and compare motion patterns between subjects with and without shoulder dysfunctions (SDs).For the test , sEMG and 3-D motion analysis systems were used to characterize the functional tasks . Twenty-five asymptomatic male subjects and 21 male subjects with right shoulder disorders performed four functional tasks which involved arm reaching and raising activities with their dominant arms . Reliability was estimated by the intraclass correlation coefficient ( ICC ) . Motion pattern was compared between two groups using mixed analysis of variances ( ANOVAs ) . Shoulder complex kinematics and associated muscular activities during functional tasks were reliably quantified ( ICC=0.83 - 0.99 ) from the means of three trials . Relative to the group without SDs , the group with SDs showed significant alteration in shoulder complex kinematics ( 3 degrees -40 degrees ) and associated muscular activities ( 3 - 10 % maximum ) . Scapular tipping , scapular elevation , upper trapezius muscle function , and serratus anterior muscle function may have implication s in the rehabilitation of patients with SDs ‘ More research is needed ’ is a most unhelpful conclusion for the clinician reader of a systematic review . Clinicians look to research ers for the ‘ research evidence ’ part of Professor Sackett ’s ‘ three circles ’ of evidence -based practice .1 The clinician can not ignore the patient in front of him or her just because there is no evidence from systematic review s or r and omised controlled trials ( RCTs ): ‘ Kindly forget about your shoulder problem , until we have better research to tell me what to do ’ ? This will not do ! In this editorial , we share three practical tips for authors synthesis ing lower level evidence in systematic review s , when high- quality RCTs are absent . Our goal is to help authors help clinicians help patients . Consider the patient who plays tennis and presents with shoulder pain . Right now , the clinician who is seeking RCT evidence on how to progress from impairment-focused tasks in neutral shoulder positions to high-level , sport-specific tasks will be disappointed . Being able to function in shoulder elevation positions above BACKGROUND AND PURPOSE The aim of this study was to evaluate the efficacy of a physical therapy approach to the treatment of  shoulder pain .  Subjects . Sixty-six volunteers with shoulder pain believed to be of local mechanical origin were r and omly allocated to either a treatment group or a control group . METHODS Subjects in the treatment group received 1 month of physical therapy aim ed at restoring function of their shoulder muscles . Subjects in the control group received no treatment . Outcome measurements of pain intensity , range of motion ( ROM ) , isometric muscle force , functional impairment , and self-perception of improvement were obtained by blinded assessment . RESULTS Subjects in the treatment group showed improvement in pain-free abduction and flexion ROM , functional impairment , and self-perception of improvement . The control group deteriorated slightly over the experimental period in ROM and functional impairment measures . CONCLUSION AND DISCUSSION These results suggest that the physical therapy approach used in this study is effective in improving shoulder function in subjects experiencing pain of mechanical origin . The results also provide little evidence of spontaneous recovery over a 1-month period BACKGROUND Rotator cuff lesions are common in the community but reproducibility of tests for shoulder assessment has not been adequately appraised and there is no uniform approach to their use . OBJECTIVE To study interrater reproducibility of st and ard tests for shoulder evaluation among a rheumatology specialist , rheumatology trainee , and research nurse . METHODS 136 patients were review ed over 12 months at a major teaching hospital . The three assessors examined each patient in r and om order and were unaware of each other 's evaluation . Each shoulder was examined in a st and ard manner by recognised tests for specific lesions and a diagnostic algorithm was used . Between-observer agreement was determined by calculating Cohen 's kappa coefficients ( measuring agreement beyond that expected by chance ) . RESULTS Fair to substantial agreement was obtained for the observations of tenderness , painful arc , and external rotation . Tests for supraspinatus and subscapularis also showed at least fair agreement between observers . 40/55 ( 73 % ) kappa coefficient assessment s were rated at > 0.2 , indicating at least fair concordance between observers ; 21/55 ( 38 % ) were rated at > 0.4 , indicating at least moderate concordance between observers . CONCLUSION The reproducibility of certain tests , employed by observers of varying experience , in the assessment of the rotator cuff and general shoulder disease was determined . This has implication s for delegation of shoulder assessment to nurse specialists , the development of a simplified evaluation schedule for general practitioners , and uniformity in epidemiological research studies BACKGROUND Shoulder pain is common in primary health care . Nevertheless , information on the outcome of shoulder disorders is scarce , especially for patients encountered in general practice . AIM To study the course of shoulder disorders in general practice and to determine prognostic indicators of outcome . METHOD For this prospect i ve follow-up study , 11 Dutch general practitioners recruited 349 patients with new episodes of shoulder pain . The participants filled out a question naire at presentation and further ones after 1 , 3 , 6 and 12 months ; these contained questions on the nature , severity and course of the shoulder complaints . The association between potential prognostic indicators and the status of shoulder complaints ( absence or presence of symptoms ) was evaluated after one and 12 months of follow-up . RESULTS After one month , 23 % of all patients showed complete recovery ; this figure increased to 59 % after one year . A speedy recovery seemed to be related to preceding overuse or slight trauma and early presentation . A high risk of persistent or recurrent complaints was found for patients with concomitant neck pain and severe pain during the day at presentation . CONCLUSION A considerable number of patients ( 41 % ) showed persistent symptoms after 12 months . It may be possible to distinguish patients who will show a speedy recovery from those with a high risk of long-st and ing complaints by determining whether there is a history of slight trauma or overuse , an early presentation or an absence of concomitant neck pain Abstract Purpose : Investigate test -- retest reliability and validity of five shoulder outcome measures in people during their active rehabilitation after a shoulder fracture . Method : This prospect i ve longitudinal study assessed shoulder function in 20 people ( 16 women , mean age 68.1 years ) with surgical or conservative management at 6 , 12 and 13 weeks post proximal humeral fracture using three patient-reported ( Disabilities of Arm , Shoulder and H and ; Oxford Shoulder Score ; Subjective Shoulder Value ) and two clinician-administered ( Constant Score ; UCLA Shoulder score ) outcome measures . Results : Content analysis categorised items into multiple domains of functioning for each outcome measure . Construct validity testing between measures found moderate to strong correlations ( r = 0.43–0.92 ) . Longitudinal validity ( responsiveness ) , represented by correlations between change scores , was moderate to strong ( r = 0.44–0.83 ) . Although ICCs2,1 for test – retest reliability ranged from 0.75 to 0.93 , Limits of Agreement between measurements were relatively wide ( 10–23 % of available range of scores ) . Minimal clinical ly important difference estimates varied between anchor- and distribution-based methods . Conclusions : The five outcome measures assessing shoulder function provided values for reliability and validity that meet measurement requirements for use in groups of people after a proximal humeral fracture . However , the use of these outcome measures might be limited by low absolute agreement between measurements and their content covering multiple domains of functioning . Implication s for Rehabilitation Linking the International Classification of Functioning , Disability and Health ( ICF ) to the content of common shoulder function outcome measures showed that multiple domains of functioning are combined into a single score . This might not be preferred for measurement of the single construct of “ shoulder function ” . Currently available shoulder function outcome measures may not be sufficiently reliable to monitor change in an individual after a proximal humeral fracture during the rehabilitation phase
They have been shown to be valid , reliable , and responsive , with a low administration burden .
BACKGROUND The aim of this study was to perform a st and ardized and systematic evaluation of the available evidence on multi-item shoulder-specific patient-reported outcome measures that are applicable to a wide spectrum of disorders .