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.

Background Pain induction is the primary characteristic of a rotator cuff tear while muscle weakness appears as a secondary feature, leading to further disability. Objectives The study aimed to determine the effectiveness of physiotherapeutic interventions through transcutaneous electrical nerve stimulation (TENS) or microcurrent electrical nerve stimulation (MENS) in conjunction with kinesiotherapy in patients with partial thickness rotator cuff tear. Methods This was a blinded randomized prospective study. The study recruited 42 outpatients with partial rotator cuff tear under conservative treatment selected from the 401 General Military Hospital of Athens and the University General Hospital ‘Attikon’ during 2015 - 2017. Patients were assessed for pain and disability using the SPADI (shoulder pain and disability index), a numerical rating scale (NRS) for pain, and the EuroQoL-5 questionnaire for the evaluation of the quality of life. The first group received TENS and kinesiotherapy while the second group received MENS and kinesiotherapy. Three measurements were recorded. The first assessment was performed during the initial patient visit; the second after completion of the physiotherapeutic sessions, and the third one three months after the initial assessment. A follow-up ultrasound scan was performed three months after the completion of the therapeutic sessions to assess the anatomical healing of the rotator cuff tear. Results Repeated measurements analysis indicated a significant improvement in pain scores, functionality, and patients’ quality of life (P value < 0.001). Comparison of the two treatment methods did not reveal any significant differences (P value > 0.05) despite the fact that the MENS was associated with a greater improvement in pain intensity and TENS with a greater improvement in functionality and quality of life. Conclusions Using MENS and TENS appears to be equally effective in terms of pain relief, functional improvement, and quality of life enhancement in patients.

Exercise is often recommended for fibromyalgia. The aim of this study was to investigate the possible influence and change in the pain characteristics of fibromyalgia patients when breathing exercises were added to their exercise program. A total of 106 patients were included and randomly divided into two groups. Τhe first group of patients followed a program of active exercises up to the limits of pain, lasting 30 min with a repetition of two times a week. Patients of the second group followed the same program with the addition of diaphragmatic breaths when they reached the pain limit. The patients completed three questionnaires: the Fibromyalgia Rapid Screening Tool (FiRST), the Brief Pain Inventory (BPI), and the Pain Quality Assessment Scale (PQAS)—once at the beginning, once again after three weeks of exercise, and again 3 months since the beginning of the program. Independent t-tests for the mean total change scores in pain scales demonstrated that for the second group there was a greater improvement in all pain scales, except for the PQAS Deep Pain subscale (p = 0.38). In conclusion, both groups showed significant improvement in all characteristics of the pain scales; however, the improvement of the second group was significantly higher.