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Comparative Study
. 2016 Aug:29:90-9.
doi: 10.1016/j.jelekin.2015.06.009. Epub 2015 Jul 9.

Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear?

Meghan E Vidt  1 , Anthony C Santago 2nd  2 , Eric J Hegedus  3 , Anthony P Marsh  4 , Christopher J Tuohy  5 , Gary G Poehling  5 , Michael T Freehill  5 , Michael E Miller  6 , Katherine R Saul  7
Affiliations
Comparative Study

Can self-report instruments of shoulder function capture functional differences in older adults with and without a rotator cuff tear?

Meghan E Vidt et al. J Electromyogr Kinesiol. 2016 Aug.

Abstract

Rotator cuff tears (RCT) are prevalent in older individuals and may compound age-associated functional declines. Our purpose was to determine whether self-report measures of perceived functional ability are valid for older patients with RCT. Twenty five subjects participated (12M/13F; age=63.9±3.0years); 13 with RCT and 12 controls (CON). Participants completed self-report measures of shoulder function (SST, ASES, WORC) and health-related quality of life (SF-36). Isometric joint moment and range of motion (ROM) were measured at the shoulder. Relationships among functional self-reports, and between these measures and joint moment and ROM were assessed; group differences for total and subcategory scores were evaluated. There were significant correlations among self-reports (rs=0.62-0.71, p⩽0.02). For RCT subjects, ASES was associated with all joint moments except adduction (p⩽0.02); SST, ASES, and WORC were associated with abduction and external rotation ROM (p⩽0.04). For RCT subjects, SST and WORC were associated with SF-36 physical function subcategory scores (p⩽0.05). The RCT group scored worse than CON on all functional self-reports (p<0.01) and WORC and ASES subcategories (p<0.01). In conclusion, SST, ASES, and WORC demonstrate utility and discriminant validity for older individuals by distinguishing those with RCT, but this work suggests prioritizing ASES given its stronger association with functional group strength.

Keywords: Activities of daily living; Aged; Range of motion; Rotator cuff; Self report; Strength; Upper extremity.

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Conflict of interest statement

Conflict of Interest

MTF serves as a consultant for Smith and Nephew, although no financial remuneration was received related to the information from this study. CJT has an ownership interest in a medical device used for measuring tension in rotator cuff tendon repairs with research applications, however, development and testing of this device is outside the scope of the work presented in this manuscript. None of the other authors have any conflicts of interest to disclose related to the content of this article.

Figures

Figure 1
Figure 1
Mean±SD self-report measures of shoulder function for rotator cuff tear (white) and control (gray) groups. Maximum scores indicating best (SST, ASES) or worst (WORC) outcome are indicated by gray bars in the background. Rotator cuff tear group had worse scores than controls for (A) SST (p<0.01); (B) ASES (p<0.01); and (C) WORC (p<0.01). * indicates statistical significance. Note: standard deviations from this cohort are reported; it is not possible to obtain a score larger than what is indicated by the shaded gray bars in the background.
Figure 2
Figure 2
Mean±SD for ASES and WORC subcategories for rotator cuff tear (white) and control (gray) groups. Shaded bars in background indicate the best (ASES: ADL) or worst (ASES: pain, instability; WORC: all categories) score. (A) Rotator cuff tear group had significantly worse ASES category scores for pain (p<0.01), instability (p<0.01), and ADL (p<0.01); (B) Rotator cuff tear group had significantly worse scores on all WORC categories (all p<0.01); * indicates statistical significance. Note: standard deviations from this cohort are reported; it is not possible to obtain a score larger than what is indicated by the shaded gray bars in the background.
Figure 3
Figure 3
Mean±SD for each subcategory score for the SF-36 for rotator cuff tear (white) and control (gray) groups. Shaded bars in background indicate the best score. The rotator cuff tear group had worse scores on all categories than controls, with significantly worse scores on the physical function (p=0.02), limitations due to physical health (p=0.01), limitations due to emotional problems (p=0.03), and pain categories (p<0.01). Note: standard deviations from this cohort are reported; it is not possible to obtain a score larger than what is indicated by the shaded gray bars in the background.
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