Article

PURPOSE: Investigate test--retest reliability and validity of five shoulder
outcome measures in people during their active rehabilitation after a shoulder
fracture. This prospective 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 Hand; 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
clinically 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. Implications 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.

Langue : ANGLAIS