Assessing shoulder disability in orthopaedic specialist care: Introducing the Copenhagen Shoulder Abduction Rating (C-SAR)

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Background: Differences in shoulder-disability among common shoulder-disorders in orthopaedic specialist care is unknown. Furthermore, rating of shoulder disability using patient-reported outcomes is time-consuming, and a faster approach is needed. Objectives: First, compare shoulder-disability among common shoulder-disorders. Secondly, rate shoulder-disability according to the new and quick Copenhagen Shoulder Abduction Rating (C-SAR) and investigate criterion validity of C-SAR. Methods: Cross-sectional study including 325 consecutive patients with shoulder-disorders in orthopaedic specialist care. We assessed shoulder abduction range-of motion and pain during testing (NRS:0-10), and shoulder-disability using Shoulder Pain and Disability Index (SPADI) subscales. Patients were sub-grouped using CSAR, which is based on shoulder abduction range-of-motion and pain during testing: Severe (range-of-motion < 90), Medium (range-of-motion > 90, NRS:> 5), Mild (range-of-motion > 90, NRS:< 5). Shoulder-disability was compared among diagnostic categories and C-SAR subgroups using ANCOVA-models. Results: Most patients were diagnosed with either subacromial impingement (n = 211) or full-thickness/complete rotator-cuff tear (n = 18), but adhesive capsulitis (n = 22) was the diagnostic category related to worst SPADI scores. Data for C-SAR subgrouping were available from 187/229 (82%) patients with rotator-cuff related disorders (subacromial impingement or rotator-cuff tears). C-SAR subgrouping was not feasible for patient with adhesive capsulitis or glenohumeral injury. Differences in shoulder-disability between Mild (n = 67) and Medium (n = 56) C-SAR subgroups were large for both SPADI-subscales (ES: 1.0, p < .0001). Only SPADIfunction differed significantly between Severe (n = 64) and Medium C-SAR subgroups (ES: 0.4, p = .017). Conclusion: In orthopaedic specialist care, adhesive capsulitis relates to highest level of shoulder-disability, while C-SAR is a promising test to rate shoulder-disability for most patients, namely those with rotator-cuff related disorders.

OriginalsprogEngelsk
Artikelnummer102593
TidsskriftMusculoskeletal Science and Practice
Vol/bind61
Antal sider7
ISSN2468-7812
DOI
StatusUdgivet - 2022

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