Intraobserver and interobserver reliability for the strength test in the Constant-Murley shoulder assessment

Purpose: The objective of this study was to develop and examine the measurement properties of a shortened version of the Western Ontario Rotator Cuff Index (WORC), the SHORTWORC, in individuals with rotator-cuff pathology. Methods: The study occurred in two stages, both using secondary analysis of existing data sets. The first stage used cross-sectional data from candidates for rotator-cuff surgery to develop the SHORTWORC. The second stage examined various measurement properties of the SHORTWORC by analyzing scores from the WORC, the American Shoulder and Elbow Surgeons questionnaire, and the Constant-Murley score obtained from patients before and after rotator-cuff surgery. Approaches to validating the SHORTWORC included calculating the standard error of measurement (SEM) at an instant in time, performing a confirmatory factor analysis, correlating findings among the questionnaires, and examining differences between men and women. Sensitivity to change was investigated using standardized response mean and relative efficiency. Results: Data for 712 patients were used to develop the SHORTWORC, the final version of which consisted of 7 questions. Data for 166 patients (86 men, 80 women; mean age 57 e 11 years) were used for validation. The SEM based on internal consistency (SEM IC ) was calculated as 7.43 SHORTWORC points. The SHORTWORC had similar convergent validity (r ¼ 0.72 À 0.82) and sensitivity to change (SRM ¼ 1.20 vs. 1.25, p > 0.05) to the longer version. The relative efficiency of the SHORTWORC was 3.19 times that of the WORC (95% CI, 1.50-71.51) in discriminating men's from women's level of disability. Conclusions: The SHORTWORC has indicators of validity, relative efficiency, and sensitivity to change comparable to those of the original version but has a smaller response burden.Key Words: outcome measures; reliability of results; shortened version; validity of results; WORC. RÉ SUMÉObjectif : L'objectif de cette é tude é tait de cré er et d'analyser les proprié té s de mesure d'une version abré gé e du Western Ontario Rotator Cuff Index (WORC), le SHORTWORC, chez les personnes aux prises avec une pathologie de la coiffe des rotateurs. Mé thode : Ce projet s'est dé roulé en deux é tapes. Une analyse secondaire des ensembles de donné es existants a é té ré alisé e à chacune d'elles. La premiè re a fait appel à des donné es transversales de candidats à une intervention chirurgicale pour la coiffe des rotateurs pour l'é laboration de l'indice abré gé SHORTWORC. La deuxiè me é tape s'est penché e sur les diverses proprié té s de mesure de l'indice SHORTWORC en analysant les pointages obtenus dans le cadre du WORC, les ré sultats au questionnaire de l'American Shoulder and Elbow Surgeons et les indices de l'é chelle Constant-Murley; tous ont é té obtenus auprè s des patients avant intervention chirurgicale pour la coiffe des rotateurs. Les outils de validation du SHORTWORC comprenaient notamment l'erreur type de mesure (ETM) à un point pré cis dans le temps, l'analyse du facteur de confirmation, la...

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“…The CMS is reported to be reliable and valid in patients with shoulderor rotator-cuff-related pathologies. 21,32,33 …”

Section: American Shoulder and Elbow Surgeons Questionnaire (Ases) 11mentioning

confidence: 99%

A Shortened Version of the Western Ontario Rotator Cuff Disability Index: Development and Measurement Properties

Razmjou

Stratford

Holtby

2012

Physiotherapy Canada

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“…The limit of the manual resistance was reported to be from 220 to 294.2 N (30 kg) in previous studies [1][2][3][4][5][6] . Methods previously reported for fixing a HHD to overcome this problem and prevent the angle of the joint from changing include using a stick 7) , a steel support 8) , and a belt [9][10][11][12][13][14][15] . Among these studies, Katoh et al 12,13) used a belt to help steady the HDD and investigated the reliability of isometric muscle strength measurements of the lower limbs (flexion, extension, abduction, adduction, internal rotation and external rotation of the hip, flexion and extension of the knee, and dorsiflexion and plantar flexion of the ankle), in healthy men and women with a mean age of 20 years.…”

Section: Introductionmentioning

confidence: 99%

Validity of Isometric Muscle Strength Measurements of the Lower Limbs Using a Hand-held Dynamometer and Belt: a Comparison with an Isokinetic Dynamometer

Katoh

Hiiragi

Uchida³

2011

J Phys Ther Sci

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Abstract.[Purpose] The aim of this study was to evaluate the validity of isometric muscle strength measurements of the lower limbs and hips made with a hand-held dynamometer and belt by comparing them with measurements obtained by an isokinetic dynamometer.[Subjects] The subjects were 24 healthy adults (12 men, 12 women) with a mean age of 20.4 years.[Method] Measurements were made with both instruments on the flexors, extensors, abductors, adductors, external rotators and internal rotators of the hip and flexors and extensors of the knee.[Results] Measurements obtained with the hand-held dynamometer and belt were significantly lower than those obtained with the isokinetic dynamometer. Pearson's correlation coefficients for the measurements made with the two instruments ranged from 0.52 to 0.88 for all muscle groups except the hip abductors which was 0.34. In the hip abductors, the coefficient was 0.65 when forces of 450 N and higher were excluded.[Conclusion] Isometric muscle strength measurements of the lower limbs and hips obtained with a hand-held dynamometer and belt are considered to be valid except for measurement of hip abduction of subjects with high muscle strength.

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“…The scoring system has been demonstrated to have high rates of intraobserver and interobserver correlation and to correlate strongly with patient satisfaction. (10) In our study which evaluated 50 patients undergoing double-row repair of rotator cuff tear (>3 cm), we found that there was an improvement in the constant score from 43.68 to 76.52 and from 44.36 to 77 in both the groups respectively (Refer chart 1 under 'Results and observations' ) after a mean followup of 24 months. But, between the two groups, our study didn't find any significant difference in the final clinical outcome.…”

Section: Discussionmentioning

confidence: 72%

Radiological and Clinical Assessment of Two Groups of Anchors in Double-Row Rotator Cuff Repair

Saini¹,

Saini²,

Meena³

et al. 2016

jemds

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OBJECTIVERotator cuff tears are a common shoulder problem and recently double-row repair techniques have shown superior biomechanical advantages when compared to single-row constructs in a properly selected patient. This study compared 2.8 mm and 4.5 mm anchors with respect to clinical and radiological outcome in two groups of patients. Of course, for the same number of 4.5 anchors used. Volume of Bone Replaced (VBR) will be far less if 2.8 anchors are used in equal number. But, in such surgeries, the ultimate objective was to restore the anatomic footprint and the number of anchors used varied accordingly. MATERIAL AND METHODS50 patients of rotator cuff tear (Size >3 cm) were treated with double-row method of repair arthroscopically. In 25 patients, 2.8 mm anchors were used and in rest 25 patients 4.5 mm anchors were used. Operated patients underwent CT scan of the shoulder during followup period. Using computer software (OsiriX), the cylindrical bone defects made for the anchors were measured by using the formula for volume of the cylinder. For every case, total Volume of Bone Replaced (VBR) was calculated. Since the plane of the anchor cannot always be sagittal or coronal, hence using MPR (Multiplanar reconstruction) tool in OsiriX, a plane was selected in which length of the anchor is the largest meaning that it is the plane parallel to true long axis of the anchor. Radius of the cylinder was calculated in a plane 90 degree to the previously defined plane. RESULTSComparing the two groups, we didn't find any significant difference in the clinical outcome. However, there was a significant difference in one radiological parameter-Volume of Bone Replaced (VBR). CONCLUSIONThere was no difference in clinical recovery in the two groups. However, Volume of Bone Replaced (VBR) was more in 4.5 mm anchor group when compared to 2.8 mm anchor group. This finding can be important to a surgeon when he is operating a re-tear in an already operated double-row patient since there will be a relatively more bone stock available for the surgeon to place additional anchors.

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Intraobserver and interobserver reliability for the strength test in the Constant-Murley shoulder assessment

Cited by 68 publications

References 22 publications

A Shortened Version of the Western Ontario Rotator Cuff Disability Index: Development and Measurement Properties

A Shortened Version of the Western Ontario Rotator Cuff Disability Index: Development and Measurement Properties

Validity of Isometric Muscle Strength Measurements of the Lower Limbs Using a Hand-held Dynamometer and Belt: a Comparison with an Isokinetic Dynamometer

Radiological and Clinical Assessment of Two Groups of Anchors in Double-Row Rotator Cuff Repair

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