The relationship of range of motion and muscle strength to patients' perspectives in pain, disability, and health-related quality of life in patients with rotator cuff disease.

Abstract

The literature emphasizes that a consideration of patients' perspectives is an important part of the assessment process; however, it is ignored by many clinicians because they believe physical impairment measures can reflect patients' perspectives about their symptoms. But the relevance of changes in physical impairments to changes in patient-reported outcome scores in rotator cuff disease is ambiguous. The purpose of this study is to determine the relationship between changes in glenohumeral range of motion (ROM) and shoulder muscle strength and changes in pain, disability, and health-related quality of life scores before and after physical therapy in patients with rotator cuff disease. This was a retrospective study of thirty-nine patients with unilateral rotator cuff disease. All patients received a 6-week physical therapy program. The outcome measures were glenohumeral ROM, shoulder muscle strength, pain and disability using the Shoulder Pain and Disability Index (SPADI), and health-related quality of life as measured by the Western Ontario Rotator Cuff Index. All outcomes were measured before and after the treatment period. There were weak correlations between the changes in abduction ROM and the SPADI-total score (r = - 0.32, p < 0.05), and the changes in external rotation strength and the SPADI-disability score (r = - 0.32, p < 0.05). There was no correlation between the changes in the other parameters. This study implies that the changes in glenohumeral ROM and shoulder muscle strength do not represent the changes in patients' perspectives in pain, disability, and health-related quality of life after the physical therapy program in patients with rotator cuff disease.