The Responsiveness of Patient- Reported Outcome Tools in Shoulder Surgery Is Dependent on the Underlying Pathological Condition
| Autor: | Cale A. Jacobs, Chaitu S. Malempati, Jeremy M. Burnham, Eric C. Makhni, Lee Gammon, R Zackary Unger |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Shoulder surgery medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Outcome (game theory) Rotator Cuff Injuries Arthroscopy 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Muscle Strength Patient Reported Outcome Measures Range of Motion Articular Pathological Aged 030222 orthopedics business.industry Middle Aged Treatment Outcome Physical therapy Female Patient-reported outcome business |
| Zdroj: | The American Journal of Sports Medicine. 47:241-247 |
| ISSN: | 1552-3365 0363-5465 |
| Popis: | Background:Given the high number of available patient-reported outcome (PRO) tools for patients undergoing shoulder surgery, comparative information is necessary to determine the most relevant forms to incorporate into clinical practice.Purpose:To determine the utilization and responsiveness of common PRO tools in studies involving patients undergoing arthroscopic rotator cuff repair or operative management of glenohumeral instability.Study Design:Systematic review.Methods:A systematic review of rotator cuff and instability studies from multiple databases was performed according to PRISMA guidelines. Means and SDs of each PRO tool utilized, study sample sizes, and follow-up durations were collected. The responsiveness of each PRO tool compared with other PRO tools was determined by calculating the effect size and relative efficiency (RE).Results:After a full-text review of 238 rotator cuff articles and 110 instability articles, 81 studies and 29 studies met the criteria for final inclusion, respectively. In the rotator cuff studies, 25 different PRO tools were utilized. The most commonly utilized PRO tools were the Constant (50 studies), visual analog scale (VAS) for pain (44 studies), American Shoulder and Elbow Surgeons (ASES; 39 studies), University of California, Los Angeles (UCLA; 20 studies), and Disabilities of the Arm, Shoulder and Hand (DASH; 13 studies) scores. The ASES score was found to be more responsive than all scores including the Constant (RE, 1.94), VAS for pain (RE, 1.54), UCLA (RE, 1.46), and DASH (RE, 1.35) scores. In the instability studies, 16 different PRO tools were utilized. The most commonly used PRO tools were the ASES (13 studies), Rowe (10 studies), Western Ontario Shoulder Instability Index (WOSI; 8 studies), VAS for pain (7 studies), UCLA (7 studies), and Constant (6 studies) scores. The Rowe score was much more responsive than both the ASES (RE, 22.84) and the Constant (RE, 33.17) scores; however, the ASES score remained more responsive than the Constant (RE, 1.93), VAS for pain (RE, 1.75), and WOSI (RE, 0.97) scores.Conclusion:Despite being frequently used in the research community, the Constant score may be less clinically useful as it was less responsive. Additionally, it is a greater burden on the provider because it requires objective strength and range of motion data to be gathered by the clinician. In contrast, the ASES score was highly responsive after rotator cuff repair and requires only subjective patient input. Furthermore, separate PRO scoring methods appear to be necessary for patients undergoing rotator cuff repair and surgery for instability as the instability-specific Rowe score was much more responsive than the ASES score. |
| Databáze: | OpenAIRE |
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