Total Shoulder Pain And Disability Index Score Research Articles

Is the correlation of the core muscle performance with shoulder pain and function altered by scapular dyskinesis in subjects with shoulder pain?

BACKGROUND: Daily activities that involve upper limb movements require muscle activation from different body parts by transferring forces and energy along the functional kinetic chain. The scapulae connect and transfer forces between the trunk and the upper limbs, so scapular dyskinesis may compromise the performance of the kinetic chain. OBJECTIVE: To assess the relationship between core muscle performance and shoulder pain and function in individuals with shoulder pain, with and without scapular dyskinesis. METHODS: Data was collected from 77 non-athlete adults aged between 18 and 50 years with shoulder pain, 45 had scapular dyskinesis. Core muscle performance was measured using the prone bridging test (PBT). Shoulder pain and disability were measured by the Shoulder Pain and Disability Index (SPADI), and the upper limbs’ stability was assessed by the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). The peak torque of shoulder external and internal rotators was measured using an isokinetic dynamometer. Multiple linear regression models evaluated the relationship between the PBT and CKCUEST, SPADI, and shoulder rotator strength. RESULTS: Significant correlations were found between the PBT and the SPADI total score (r = – 0.522), pain domain (r = – 0.513), and disability domain (r = – 0.501); normalized score (r = 0.593), and the power (r = 0.624) of the CKCUEST; and peak torque for external (r = 0.256) and internal (r = 0.292) rotations. Scapular dyskinesis did not influence the magnitude of the correlations and predictive values. CONCLUSION: The PBT was correlated with shoulder pain and function, but scapular dyskinesis did not affect the magnitude of these relationships.

Shoulder Pain and Disability Scores and the Factors Influencing Them among Orthopedic Surgeons Working in the Kingdom of Saudi Arabia: A Cross-Sectional Study.

(1) Background: Musculoskeletal pain is common among orthopedic surgeons. Their common musculoskeletal issues include shoulder pain and disability. Many associated factors could lead to this pain and disability; by identifying these, we can prevent orthopedic surgeons' pain and improve their functional capacity. (2) Methods: This study aimed to gather quantitative data regarding the shoulder pain and disability experienced by orthopedic surgeons. It also aimed to explore the potential correlations between demographic characteristics and work-related factors and their pain and disability. This study interviewed 150 orthopedic surgeons working in the Kingdom of Saudi Arabia, asking questions on the Shoulder Pain and Disability Index (SPADI) scale and about their demographic characteristics. (3) Results: All interviewed orthopedic surgeons were male, married, and nonsmokers. Their SPADI pain subsection score was 25.24%, their SPADI disability subsection score was 21.25%, and their total SPADI score was 22.79%. Among the examined demographic characteristics, total SPADI scores have a significant positive correlation with body weight (Spearman's ρ = 0.432; p < 0.05) and body mass index (BMI; ρ = 0.349; p < 0.05). (4) Conclusions: Our findings indicate that all orthopedic surgeons generally suffer from moderate shoulder pain and disability. Body weight and body mass index are important factors that may influence shoulder pain and disability among orthopedic surgeons.

Low-level laser therapy versus ultrasound therapy combined with home-based exercise in patients with subacromial impingement syndrome: A randomized-controlled trial.

The aim of this study was to evaluate the effects of low-level laser therapy (LLLT) and therapeutic ultrasound (US) combined with home-based exercise (HBE) versus HBE alone in patients with subacromial impingement syndrome (SAIS). Between March 2021 and July 2021, a total of 60 patients with SAIS (19 males, 41 females; mean age: 51.3±10.4 years; range, 30 to 70 years) were included. The patients were randomly allocated to an LLLT group (LG), an US therapy group (UG), and a control group (CG). The LLLT and US therapy programs were applied five times a week, for a total of 15 sessions. Home-based exercise programs and cold-pack therapy were administered to patients in each group. The patients were evaluated at baseline and one and three months of follow-up using the Visual Analog Scale (VAS) for pain during activity, at rest, and at night, and the Shoulder Pain and Disability Index (SPADI). All groups showed a significant improvement in the VAS and SPADI scores after the first month (p<0.05). The VAS activity pain score (p=0.008), SPADI pain score (p=0.003), SPADI disability score (p=0.012), and SPADI total score (p=0.003) significantly decreased in the LG compared to the CG at one month of follow-up. However, there were no significant differences in the outcome measures among the three groups at three months (p>0.05). The LLLT combined with HBE is more effective than HBE program alone for relieving activity pain and improving shoulder functions in the short term. However, LLLT and US therapy do not provide additional effects in terms of pain and disability at three months.

Cross-Cultural Adaptation, Reliability, and Validity of the Greek Version of the Fremantle Shoulder Awareness Questionnaire (FreSHAQ-GR) in Patients with Chronic Shoulder Pain.

Shoulder pain is one of the most common musculoskeletal pathologies. The association of shoulder pain with impaired proprioception and bodily self-awareness called for the cross-cultural adaptation of the Fremantle Shoulder Awareness Questionnaire (FreSHAQ) in Greek. The FreSHAQ is a relatively new self-assessment 9-item scale for impaired somatic awareness in patients with shoulder pain. The study included 100 participants (54 women) between 20 and 80 years old, with chronic shoulder pain (>3 months duration), able to comprehend and speak Greek, and recruited from three private physical therapy practices. The cross-cultural adaptation process was followed to develop the Greek version of the questionnaire (FreSHAQ-GR). Further testing for construct validity via exploratory factor analysis and correlational analysis with the Shoulder Pain and Disability Index (SPADI), the Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH), the pain catastrophizing scale (PCS), a pain intensity visual analog scale (PI-VAS) in the last week, and the demographic characteristics followed. Test-retest reliability of the FreSHAQ-GR in a sub-sample of patients (n = 25) was tested upon repeated completion of the scale after a week and examined with the intraclass correlation coefficient (ICC2,1), the standard error of the measurement (SEM), and the minimum detectable change (MDC) indices. The internal consistency of the scale was also assessed. The factor analysis revealed that the scale comprised one factor relevant to shoulder awareness but with fewer items (first 6 items) than the original FreSHAQ. Additionally, the FreSHAQ-GR (both versions) demonstrated statistically significant correlations (Spearman's r) with participants' age (r = -0.31/-0.29, p < 0.002), the PI-VAS (r = 0.54/0.52, p < 0.001), the SPADI total score and both of its subscales (r = 0.39-0.45/0.34-0.39, p < 0.001), the QuickDASH (r = 0.37/0.34, p < 0.001), and the PCS (r = 0.50/0.40, p < 0.001). The questionnaire's internal consistency (Cronbach's α/McDonald's ω) was 0.833/0.827 for the 9-item and 0.871/0.867 for the 6-item FreSHAQ-GR. Test-retest reliability was excellent for both versions of the FreSHAQ-GR (ICC2,1(95% CI) = 0.97/0.98 (0.91-0.99/0.94-0.99), and with a low error margin (SEM = 1.31/0.94 and MDC95% = 3.63/2.61). Therefore, the FreSHAQ-GR (6-item version) possesses very good measurement properties and can be administered to Greek-speaking patients with chronic shoulder pain.

Bangla Version of the Shoulder Pain and Disability Index (SPADI): Translation, Cross-Cultural Adaptation, Validation and Reliability Assessment

Introduction: Shoulder pain comes next to back and knee pain, considering the frequency of musculoskeletal ailments. The Shoulder Pain and Disability Index (SPADI) is considered a highly specific questionnaire for assessing shoulder pain and functions. The objective of the study was to assess the validity and reliability of the Bangla version of SPADI (B-SPADI) among the Bangla-speaking patients. Materials and methods: The B-SPADI was developed using a designed process that included forward translation and backward translation, authentication, response, and final rectification. Validity and reliability were conducted in 48 patients with shoulder pain. The reliability was appraised by executing internal consistency and test-retest analyses. Its validity was assessed by comparing the SPADI with the SF- 36, Disabilities of the Arm, Shoulder, and Hand (DASH), and American Shoulder and Elbow Surgeons (ASES) questionnaire. Results: The cross-cultural adaptation method was flawlessly aligned with the content or language. Internal consistency (Cronbach’s alpha) was 0.97 for the total SPADI score. Intraclass Correlation Coefficient (ICC) was 0.95 for the total SPADI with 0.92 for pain subtotal and 0.96 for disability subtotal. The SPADI total score showed a correlation of 0.63–0.71 with the SF-36 physical scales, of 0.89 with the DASH and of 0.94 with the ASES. All of the items were statistically significant (P&lt;0.001). Conclusion: The B-SPADI came out as an appropriate valid, and reliable instrument for measuring pain and disability in patients with shoulder afflictions. J Bangladesh Coll Phys Surg 2022; 40: 159-165

PSYCHOMETRIC ANALYSIS OF URDU VERSION OF SHOULDER PAIN AND DISABILITY INDEX: A RELIABILITY AND VALIDITY STUDY

Background: Shoulder-related pain leads to disability due to the impairment of functional movements of the shoulder and affects the quality of life. Realizing the importance of cultural adaptation and validation, Shoulder Pain and Disability Index (SPADI) is need to be translated and validated in the Urdu language. Objective: to determine the validity and evaluate the reliability of the Urdu version of the Shoulder pain and disability index (SPADI-U) in the Urdu-speaking population with shoulder pathologies in Pakistan. Methodology: The SPADI-U was administered to 135 respondents; of which 105 were subjects with shoulder pathology and the remaining 30 were healthy individuals for determination of its discriminant (Construct) validity. Visual analogue scale (VAS) and active range of motion were used to evaluate its convergent (construct) and criterion validity, respectively. It’s internal and intra-rater reliability was also evaluated and a retest was conducted after 2-3 days of first administration and was completed by 50 patients. The data were analysed in SPSS version 21. Results: Cronbach’s alpha value for SPADI-U was 0.920, and intraclass coefficient (ICC, 95% CI)) value ranged between 0.700 and 0.938 for individual items. High values of 0.935 (0.887-0.963) for a total SPADI score were observed. The Pearson’s correlation coefficient showed moderately negative correlation (range r= -0.457 to -0.683) with SPADI-U indicating its acceptable criterion validity. Whereas, the high positive correlation of VAS with SPADI; for pain (r=0.871, 0.910, 0.891) and disability (r= 0.877, 0.915 and 0.813), showing good convergent validity. Mann-Whitney U-test was used for discriminant validity with significant difference (p&lt;0.05) between the groups. No floor and ceiling effect was found. Conclusion: SPADI-U is valid and reliable tool for use in Urdu speaking individuals. Key words: Psychometrics, reliability and validity, shoulder, SPADI-U, Urdu version

Is Shoulder Pain and Disability Index a Prognostic Factor for Neuropathic Shoulder Pain?

IntroductionSo far, investigations in patients with rotator cuff diseases have used pain measurement tools such as visual analog scale (VAS) for nociceptive pain as well as neuropathic pain (NeuP) specialized ones like Douleur Neuropathique 4 Question (DN4) and Pain Detect. The study’s goal was to look at the existence of NeuP in patients with chronic shoulder pain, as well as variables that may be predictive of its progression.MethodsThere were 112 outpatients in all. Current and previous pain intensity levels were documented with the numerical rating scale (NRS), the Shoulder Pain and Disability Index (SPADI) was used to assess pain and disability levels, and the S-LANSS (self-completed Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale) was used to diagnose NeuP. The Pearson Chi-Square test was employed to check for any relationships between variables. The Mann-Whitney U test was also employed to check for between-group differences (with or without NeuP). To investigate factors that may be utilized as a prognostic for NeuP, logistic regression was performed, with those components (from the univariate analysis) that were statistically significant being included.ResultsAccording to the S-LANSS questionnaire for NeuP diagnosis, 21 patients had NeuP. According to S-LANSS, chi-square test findings revealed that NeuP is independent of sex, smoking, size, and location or rotator cuff tear. Univariate analysis with Mann-Whitney U test revealed statistically significant differences in SPADI and NRS scores between the two patient groups (p < 0.001). Α multivariate analysis using S-LANSS as the binary dependent variable and NRS currently, NRS average last month and SPADI total score as independent variables (with statistical significance) revealed that total SPADI score may be considered as an independent prognostic factor for NeuP (odds ratio = 1.189, p < 0.001).LimitationsDue to the limited number of patients who participated in the study, the findings were deemed insufficient in terms of statistical power. In particular, the power analysis of the study (type I error probability being [a] = .05) was less than 80% (for the total SPADI score), hence relatively small. As a result, there is a limited probability of a type I error.ConclusionsUsing S-LANSS, we discovered that 18.8% of patients with rotator cuff tears had NeuP. The SPADI scores (pain and disability) in the NeuP group were substantially greater than in the nociceptive pain group. As previous studies have suggested utilizing certain levels of the VAS for pain assessment and specialized questionnaires for NeuP evaluation, we recommend that SPADI be included as a tool for emphasizing the neuropathic features of shoulder pain.

Relationship Between Intensity of Neck Pain and Disability and Shoulder Pain and Disability in Individuals With Subacromial Impingement Symptoms: A Cross-Sectional Study

ObjectiveThis study aimed to verify a possible relationship between shoulder disability and shoulder pain intensity and the variables related to cervical-spine dysfunction, and determine which of these can differentiate moderate to severe shoulder pain (>4 on a numerical rating scale [NRS]) from mild shoulder pain (≤4 on the NRS) in individuals with subacromial impingement symptoms. MethodsOne hundred and forty volunteers with shoulder pain were evaluated. Demographic information and variables related to the shoulder and neck were collected. Self-reported pain and disability of the shoulder and cervical spine were measured using the Shoulder Pain and Disability Index (SPADI) and Neck Disability Index (NDI) questionnaires, respectively. An NRS was used to measure pain in the shoulder and cervical spine. A purposeful modeling strategy was used to determine the best model to predict shoulder disability and shoulder pain (dependent variables). Multiple logistic regression analysis followed by receiver operating curve analysis was used to determine which variables better differentiated moderate to severe shoulder pain from mild shoulder pain. ResultsVariables such as Neck Disability Index (NDI) score (β = 1.09, P = .00) and age (β = −0.19, P = .03) were associated with the total SPADI score. Neck pain was significantly associated with shoulder pain (β = 0.40, P = .00). The combination of variables predicting moderate to severe shoulder pain was total SPADI score (odds ratio [OR] = 1.15, P = .003), neck pain (OR = 3.20, P = .04), and age (OR = 1.01, P = .05). ConclusionOur results demonstrate the important connection between shoulder- and neck-related symptoms in individuals with subacromial impingement symptoms.

Optimising outcomes of exercise and corticosteroid injection in patients with subacromial pain (impingement) syndrome: a factorial randomised trial

ObjectivesTo compare the clinical effectiveness of (1) physiotherapist-led exercise versus an exercise leaflet, and (2) ultrasound-guided subacromial corticosteroid injection versus unguided injection for pain and function in subacromial pain (formerly...

Evaluating Correlations of Coracohumeral Ligament Thickness with Restricted Shoulder Range of Motion and Clinical Duration of Adhesive Capsulitis with Ultrasound Measurements

The primary objective of this study is to evaluate, using ultrasound measurements, the correlation between coracohumeral ligament (CHL) thickness and restricted shoulder range of motion (ROM) in patients with adhesive capsulitis (AC). The secondary objective is to investigate the correlation between CHL thickness and disease duration. Prospective cross-sectional survey. Clinical research of a tertiary care hospital. Overall, 65 patients with clinically diagnosed AC were enrolled. Ultrasound measurements of CHL thickness in the axial oblique plane were obtained under maximal external rotation of the glenohumeral joint. Both Shoulder Pain and Disability Index (SPADI) and shoulder ROM were prospectively evaluated by an experienced investigator. CHL thickness was compared with shoulder ROM and SPADI. The association between CHL thickness and disease duration was also investigated. Simple linear regression analysis showed significant inverse correlation between CHL thickness and shoulder ROM including external rotation (ER) (r = -0.335, P = .006) and internal rotation (IR) (r = -0.409, P = .001). CHL thickness also correlated with disease duration (r = -0.352, P = .004). Multiple linear regression analysis demonstrated that CHL thickness was significantly associated with restricted ER (r = -0.293, P = .02) and IR (r = -0.363, P = .003) after adjusting for age and disease duration. On the other hand, CHL thickness showed no significant correlation with abduction (r = -0.210, P = .09), flexion (r = -0.170, P = .176), or total SPADI score (r = 0.176, P = .16). Moreover, CHL was significantly thicker in patients with disease duration >6 months (P = .004, difference in means: 0.55 mm, 95% confidence interval: -0.922, -0.183). CHL was significantly thicker in later-stage AC. CHL thickness correlated negatively with ER and IR of the shoulder. Furthermore, CHL thickening could be observed in the early stage of the disease course. These imaging findings may assist in confirming the diagnosis of AC, leading to early intervention and treatment options.

Effectiveness of therapeutic inflatable ball self-exercises for improving shoulder function and quality of life in breast cancer survivors after sentinel lymph node dissection.

The survival rate of breast cancer survivors (BCSs) is > 90%. Particular issues are upper arm dysfunction caused by surgery and treatments. Physical activity has been recommended to improve shoulder function and quality of life (QoL) in BCSs. However, rehabilitation programs tend not to be continuous. To explore the effectiveness of therapeutic inflatable ball self-exercise for improving shoulder function and QoL in breast cancer survivors (BCSs) following breast cancer surgery. Seventy-two BCSs were allocated to two groups, conventional self-exercise (CSE; n = 34; age, 48.9 ± 7.2years) and therapeutic inflatable ball self-exercise (IBE; n = 38; age, 47.7 ± 8.9years); 22 in the CSE and 23 in the IBE group completed the interventions. Both groups performed intervention for 12weeks, three times per week and 15min a day at least. Measurement was performed three times for shoulder range of motion (ROM), handgrip strength, Shoulder Pain and Disability Index (SPADI), and Functional Assessment of Cancer Therapy-Breast (FACT-B). Flexion and extension ofshoulder ROM showed significant differences between the two groups at 12weeks. Flexion and extension of shoulder ROM showed significant differences for t1-t2 (p = 0.02) and t0-t1 (p = 0.04). Abduction showed a significant difference for t0-t1 (p = 0.03), t1-t2 (p = 0.02), and t0-t2 (p = 0.01). CSE (7 points) and IBE (20 points) satisfied the MDC in FACT-B total score. The MDC of the SPADI total score was 13 points in the CSE group and 9 points in the IBE group. IBE would be more appropriate to start the rehabilitation for BCSs and CSE would be effective after the pain has improved.

Validacija srpske verzije upitnika o bolu i ograničenoj pokretljivosti ramena (SPADI)

Introduction/Aim: The Shoulder Pain and Disability Index (SPADI) is recommended and frequently used instrument for measuring current shoulder pain and disability in an outpatient setting. However, the validity and reliability of the Serbian SPADI are unknown. Aim of this study was to evaluate the reliability and validity of the Serbian version of SPADI. Methods: The research was conducted as a panel study at the Institute for Orthopedic Surgery Banjica (IOSB) on 33 patients with shoulder pain syndrome who were referred to a physician at IOSB during 2016 and 2017. Cross-cultural adaptation was performed according to the international guidelines. Internal validity was assessed by determining the Cronbach's alpha coefficient. Intraclass correlation coefficient (ICC) was used for testretest reliability. Factor analysis was used to examine the structure of the questionnaire. Results: The SPADI questionnaire in our sample had an adequate level of internal consistency (Cronbach alpha = 0.946). The test-retest reliability of the SPADI questionnaire was very high (ICC = 0.997). Using exploratory factor analysis, one factor solution explained 50,1% of the variance. Conclusion: The Serbian version of SPADI questionnaire has a high level of internal consistency and the test-retest reliability but our results suggest that pain and disability, although distinguishable conceptually, may not be distinguished by patients. Since there was no support for separation into two dimensions we recommend the use of total SPADI score only as a measure of the impact impaired shoulder.

The relationships between shoulder pain, range of motion, and disability in patients with shoulder dysfunction.

Shoulder dysfunction is a major cause of musculoskeletal pain in general population. A variety of shoulder disorders can cause a reduction in shoulder range of motion and subsequent disability. To investigate the relationship between the shoulder pain, range of motion, and disability in patients with shoulder dysfunction. Sixty-four patients (49 men and 15 women) with shoulder disorders with a varying diagnosis including, adhesive capsulitis, rotator cuff injury, impingement syndrome, acromio-clavicular pain, and instability, participated in this cross-sectional study. Participants were asked to report the shoulder pain intensity and level of disability on a numerical rating scale (NRS) and the shoulder pain and disability index (SPADI), respectively. In addition, the active shoulder range of motion was evaluated. The Spearman rank correlation coefficient was used to investigate the association between the shoulder pain, range of motion, and disability. A good negative correlation found between the shoulder abduction, flexion, and rotation range of motion with the NRS score (rho =-0.710 to -0.747). A moderate negative correlation found between the extension and the NRS score (rho =-0.643). A good negative correlation found between abduction and the SPADI total score (rho =-0.714). A moderate negative correlation found between the shoulder flexion and rotation range of motion with the SPADI total score (rho =-0.547 to -0.694). A fair negative correlation found between the extension and the SPADI total score (rho =-0.495). A moderated positive correlation found between the NRS and the SPADI total score (rho = 0.667). The flexion, abduction, and rotation ROMs were most significantly associated with severity of pain and the physical disability in patients with shoulder dysfunction. Further, longitudinal studies are required to confirm these results.

The effectiveness of extracorporeal shockwave treatment in subacromial impingement syndrome and its relation with acromion morphology

ObjectiveThe aim of this study was to evaluate the effectiveness of the extracorporeal shock wave therapy in the subacromial impingement syndrome and its relationship with the acromion morphology. MethodsThirty patients (24 women, 6 men) with subacromial impingement were evaluated. The average age of patients was 53.6 ± 9.8 years (range 39–80). Patients were divided into 3 groups according to the acromion morphology. ESWT 1500 at 0.12 am mL/mm2 violence was applied once a week for 3 weeks. Shoulder pain and disability index (SPADI) was used to assess function and pain scores of the patients. The evaluations were made prior to and 12 weeks after the ESWT. ResultsThirteen shoulders had type 1 acromion, 11 shoulders type 2 acromion and 6 shoulders type 3 acromion. After ESWT, the SPADI pain score decreased from 16.1 ± 5.1 (7–25) to 10.4 ± 4.9 (1–20); SPADI functional score decreased from 37.3 ± 19.8 (5–70) to 26.7 ± 17.5 (1–60); SPADI total score decreased from 53.4 ± 24.5 (14–95) to 37.1 ± 21.6 (2–74) (p < 0.05; paired t test). In each group better functional outcomes were achieved after ESWT (p < 0.05; paired t test). There were no differences between the groups according to functional outcome both before and after the ESWT treatment (p > 0.05, one way ANOVA test). ConclusionESWT was found to be effective in the treatment of impingement syndrome both for pain and functional outcome in the early period regardless of acromion morphology. Level of evidenceLevel IV, Therapeutic study.

One question might be capable of replacing the Shoulder Pain and Disability Index (SPADI) when measuring disability: a prospective cohort study

QuestionsIs it possible to replace the Shoulder Pain and Disability Index (SPADI) with a single substitute question for people with shoulder pain, when measuring disability and how well does this substitute question perform as a predictor for recovery.DesignA prospective cohort study.ParticipantsA total of 356 patients with shoulder pain in primary care.AnalysesConvergent, divergent, and “known” groups validity were assessed by using hypotheses testing. Responsiveness was assessed using the Receiver Operating Curve and hypothesis testing. In addition, we performed multivariate regression to assess if the substitute question showed similar properties as the SPADI and if it affected the model itself, using recovery as an outcome.ResultsThe Spearman correlation coefficient between the total SPADI score and the substitute question was high, and moderate with the Shoulder Disability Questionnaire. The correlation between the substitute question and the EQ-5D-3L was low and the responsiveness was acceptable. The substitute question did not significantly contribute to both prognostic prediction models as opposed to the SPADI. Regardless all models showed poor to fair discrimination.ConclusionThe single question is a reasonable substitute for the SPADI and can be used as a screening instrument for shoulder disability in primary clinical practice. It has slightly poorer predictive power and should therefore not be used for prognosis.

The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial

AimThe purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. Material and methodsThirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). ResultsThe clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). ConclusionIt was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them.

The Greek version of Shoulder Pain and Disability Index (SPADI): translation, cultural adaptation, and validation in patients with rotator cuff tear.

BackgroundThis study aimed to translate and culturally adapt a Greek version of the Shoulder Pain and Disability Index (SPADI) questionnaire and to validate its usage in Greek patients.Materials and methodsA forward and backward translation was performed, and the final version of the Greek questionnaire was administered to 134 outpatients (mean age 47.4 ± 14.5) with rotator cuff tear under conservative treatment. The questionnaire was re-administered 2–5 days later to assess test–retest reliability. Patients completed the Greek SPADI, the Greek version of the Quick DASH (Disability of the Arm, Shoulder and Hand Questionnaire) and the EuroQoL EQ-5D. 102 of the 134 questionnaires were considered valid.ResultsThe internal consistencies of the SPADI total and its subscales measured with Cronbach’s alpha coefficient were high (0.932 for SPADI-Total, 0.899 for SPADI-Disability, 0.905 for SPADI-Pain). Intraclass correlation coefficients showed excellent test–retest reliability (0.899 for Disability, 0.902 for Pain, and 0.929 for total SPADI). A significantly high positive correlation was found between the SPADI total score and its subscales, and Quick DASH for Pain and Disability. Significant correlations were also found between SPADI scales and EQ-5D variables. There was a moderate positive correlation with the variables “self-reliance” (r = 0.66), “common activities” (r = 0.58), and “pain/discomfort” (r = 0.49), and a weaker correlation with the “mobility” variable (r = 0.20). Factor analysis (PAF method) revealed a bidimensional formation of the SPADI. Eight items (five pain/three disability) weighted the first factor by >0.5, and five disability items weighted the second factor.ConclusionsThe Greek SPADI represents a valid and reliable tool for measuring pain and disability in patients with painful shoulder disorders.Level of evidenceLevel 3.

Usefulness of a Hanging Position With Internal Rotation of Shoulder in Ultrasonography-Guided Intra-articular Steroid Injection for Adhesive Capsulitis.

ObjectiveTo evaluate the feasibility of a new position (internal rotation in hanging) in ultrasonography, we compared the length of the glenohumeral joint space and the effectiveness of steroid injection with the hanging position and with the commonly used abdomen or cross position.MethodsA prospective, randomized controlled trial was performed in 42 patients with adhesive capsulitis of shoulder. We used three arm positions for the posterior approach as follows: the patient's palm on thigh, other hand on abdomen (abdomen position); hand on patient's opposite shoulder (cross position); arm in hanging position with internal rotation of shoulder (hanging position). The order of shoulder position was randomized and blinded. Real-time ultrasonography-guided intra-articular steroid injection was performed by posterior approach at the first position in each patient. The Brief Pain Inventory (BPI), the Shoulder Pain and Disability Index (SPADI), and range of motion (ROM) were measured before steroid injection and 2 weeks after injection.ResultsThe lengths of the joint space were 2.88±0.75, 2.93±0.89, and 2.82±0.79 mm in abdomen, cross, and hanging position respectively, with no significant difference among the three positions (p=0.429). Treatment efficacy was significantly improved in ROM, total BPI, and SPADI in all three positions (p<0.001). The changes in ROM for shoulder abduction were 23.6°±19.7°, 22.2°±20.9°, and 10.0°±7.8° in abdomen, cross, and hanging position, respectively. Changes in total BPI scores were 25.1±15.7, 23.6.±18.0, 11.6±6.1, and changes in total SPADI score were 35.0±14.2, 30.9±28.9, and 16.5±10.3 in abdomen, cross, and hanging position, respectively. There were no significant difference among the three positions for all parameters (p=0.194, p=0.121, and p=0.108, respectively.ConclusionFor patients with adhesive capsulitis who cannot achieve or maintain abdomen or cross position, scanning and injection with the shoulder in internal rotation with hanging position may be a useful alternative.

Upper extremity impairments, pain and disability in patients with diabetes mellitus

ObjectivesTo determine the severity of, and relationships between, upper extremity impairments, pain and disability in patients with diabetes mellitus, and to compare upper extremity impairments in patients with diabetes with non-diabetic controls. DesignCase–control, cross-sectional design. SettingUniversity-based, outpatient diabetes centre and physical therapy research clinic. ParticipantsTwo hundred and thirty-six patients with diabetes attending an outpatient diabetes clinic completed the Shoulder Pain and Disability Index (SPADI) questionnaire. A detailed shoulder and hand examination was conducted on a subgroup of 29 volunteers with type 2 diabetes, and 27 controls matched for age, sex and body mass index. InterventionsNone. Main outcome measuresSPADI score, passive shoulder range of motion (ROM) and strength, grip strength, hand sensation, dexterity and limited joint mobility of the hand. ResultsSixty-three percent (149/236) of patients with diabetes reported shoulder pain and/or disability [median SPADI score 10.0 (interquartile range 0.0 to 39.6)]. Compared with the control group, the subgroup of patients with diabetes had substantial reductions in shoulder ROM, shoulder muscle strength, grip and key pinch strength (P<0.05). Patients with diabetes had a greater prevalence of decreased sensation (26/27 vs 14/27) and limited joint mobility of the hand (17/27 vs 4/27) compared with the control group. Total SPADI score was negatively correlated (P<0.05) with shoulder ROM (r=−0.42 to −0.74) and strength measures (r=−0.44 to −0.63) in patients with diabetes. ConclusionsUpper extremity impairments in this sample of patients with diabetes were common, severe and related to complaints of pain and disability. Additional research is needed to understand the unique reasons for upper extremity problems in patients with diabetes, and to identify preventative treatments.

AB0838-HPR Cervical pain and disability in patients with shoulder disorders: pilot study

BackgroundDisorders that affect shoulder complex have been associated with increased upper trapezius muscular activity [1]could have result in mechanical restrains in cervical spine where muscles origin. It would be possible...