Shoulder activity level in the preoperative assessment of patients with rotator cuff tears

Ryliškis, Sigitas; Brophy, Robert H.; Kocius, Manvilius; Marx, Robert G.

doi:10.1007/s00167-009-0904-z

Cited by 15 publications

(12 citation statements)

References 29 publications

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“…In addition, the Shoulder Activity Level was the primary activity level score outcome examined in this study since it is a validated, patient-determined outcome score that can be used to measure a patient’s activity level. 19 , 20 , 21 …”

Section: Methodsmentioning

confidence: 99%

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Baumgarten

2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To determine whether patients who require margin convergence would have equivalent postsurgical patient-determined scores compared with patients with standard rotator cuff repair. The secondary purpose of this study was to determine whether the short-term results found for patients with margin convergence repairs would be durable through medium-term follow-up. Methods A retrospective analysis of patients undergoing arthroscopic rotator cuff repair was performed to examine the effects of marginal convergence on patient-determined outcomes (Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, Single Assessment Numeric Evaluation, and Shoulder Activity Level). Patient-determined outcomes in patients who had margin convergence repairs were compared with patients who had standard rotator cuff repair. Prospective follow-up of patients that had margin convergence repairs was performed to determine whether patient-determined outcomes deteriorated over time. Results Two-hundred-seventy-two patients had standard rotator cuff repairs and 9 patients had margin convergence rotator cuff repair (3.2%). All patients had significant improvements in their Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and Single Assessment Numeric Evaluation. Patients requiring margin convergence rotator cuff repair had similar preoperative and postoperative scores compared with patients with a standard rotator cuff repair. At a mean follow-up of 7.5 years, there was no change in outcome scores compared with the early follow-up time point (mean 3.3 years) for patients undergoing margin convergence. Conclusions Arthroscopic margin convergence repair techniques along with the treatment of concomitant pathologies result in similar patient-determined outcomes compared with standard rotator cuff repair techniques. These results appear to be durable and do not deteriorate from short-term to medium-term follow-up. Level of evidence III: Retrospective comparative study

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Section: Methodsmentioning

confidence: 99%

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Baumgarten

2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Patient-reported outcomes measures have become an important component of determining patient outcomes after sports-related injuries treated both surgically and nonsurgically. 2 , 4 , 5 , 8 , 9 , 13 , 15 , 16 , 18 , 20 - 22 , 24 , 25 , 28 An important component of patient-reported outcomes measures is the baseline activity level of a patient, which is in effect a functional measure of musculoskeletal health. It is important to be able to quantify a patient’s activity level so it can be evaluated within a context of other patients for both research needs and for comparison with population normative data when treating injuries.…”

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confidence: 99%

Is the Marx Activity Scale Reliable in Patients Younger Than 18 Years?

2015

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Background:There is no baseline activity scale yet validated in pediatric patients. The Marx and Tegner scales have been validated in adult patients only. The Tegner scale involves questions not pertinent to children, such as their work activity. The Marx scale is simple, and all its questions can be related to athletic activities.Hypothesis:The Marx scale is reliable for use in a pediatric population.Study Design:Cohort study.Level of Evidence:Level 2.Methods:Patients younger than 18 years were given the Marx activity scale in clinic and again 3 weeks later. The patients were divided into 3 groups, of at least 50 patients each, based on presenting diagnosis: knee injury, lower extremity (non-knee) injury, and upper extremity injury. Test-retest reliability was determined for the overall scores and the individual questions. Differences in scores were also compared based on age (<14 vs ≥14 years).Results:A total of 162 patients (mean age, 14.4 years; range, 8-17 years) were included. The Marx scale had a high intraclass correlation coefficient (ICC) overall as well as for each of its 4 questions. Both older and younger patients had ICCs >0.80, though the older group generally had higher scores. The mean score was 13.55 (out of 16), and 50.6% scored the maximum; only 1.9% scored the minimum. Mean scores for the knee, lower extremity, and upper extremity groups were 13.71 (SD, 3.70), 13.22 (SD, 4.18), and 13.68 (SD, 3.33), respectively (P > 0.05). There also was no difference in total score based on age (P = 0.88).Conclusion:The Marx activity scale is reliable in patients younger than 18 years with injuries to the knee and lower extremities, though the scale was less reliable in patients younger than 14 years. There is a significant ceiling effect present, which limits its overall usefulness.Clinical Relevance:Although there is no other current substitute, the Marx activity scale is not an ideal measurement of younger patients’ baseline activity levels.

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“…Because the activity scale is designed to measure patients' overall level of activity, patients are asked to indicate how often they performed each activity during their healthiest and most active state in the previous year. Previous studies using the SAS have shown its reliability, validity, and responsiveness [4,5,19]. Among subjects with no history of shoulder symptoms or treatment for a shoulder condition, the shoulder activity score decreases with age and is lower in women than men [13].…”

Section: Methodsmentioning

confidence: 97%

“…Among subjects with no history of shoulder symptoms or treatment for a shoulder condition, the shoulder activity score decreases with age and is lower in women than men [13]. In patients with shoulder disorders, the shoulder activity score is highest in patients with shoulder instability, intermediate in patients with rotator cuff disease, and lowest in patients with shoulder osteoarthritis [19]. In addition, patients are asked two multiple-choice questions regarding level of sports participation (without organized officiating, with organized officiating, or at a professional level) in contact and overhead-throwing sports.…”

Section: Methodsmentioning

confidence: 99%

Shoulder Activity Level is Associated With Type of Employment and Income in the Normative Population Without Shoulder Disorders

Brophy¹,

Lin²,

Skillington³

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Socioeconomic variables influence various healthcare issues in different ways. The effect of socioeconomic variables on the shoulder has not been well studied. Because activity level, defined by how much a patient actually does, is an important patient outcome measure and prognostic factor for the shoulder, studying its association with occupation and income will advance our understanding of how these variables relate to shoulder disorders, treatments, and outcomes. Questions/purpose We asked: (1) Does shoulder activity score correlate with income level, stratified by gender? (2) Do different employment groups-heavy, moderate, light, student, retired-have different shoulder activity scores, as stratified by gender? (3) Is type of sports participation (contact or overhead) associated with income level, employment type, race, or household size? Methods A survey collected the Brophy and Marx shoulder activity score and demographic information, such as age, gender, race, income, type of employment, and household size from 1625 individuals 18 years and older with no current or previous shoulder pain or injury who are members of a research panel matched to the United States population by age, gender, household income and size, race/ethnicity, and geography. Men and women were analyzed separately. Activity level was controlled for age. Results Shoulder activity correlated with income level among men (R = 0.03; p \ 0.001) and women (R = 0.06; p = 0.0002). For men, heavy employment had the highest Shoulder Activity Scale (SAS) level (12.1 ± 4.9), which was more than SAS levels in sedentary (9.1 ± 4.5; mean difference, 3.0; 95% CI, 2.5-3.6; p = 0.001), student (8.8 ± 5.1; mean difference, 3.3; 95% CI, 3.0-3.7; p = 0.007), retired (8.0 ± 4.6; mean difference, 4.1; 95% CI, 3.6-4.7; p = 0.0001), and not working (7.5 ± 5.3; mean difference, 4.6; 95% CI, 4.6-4.6; p \ 0.001) categories; similarly, for women, heavy employment had the highest SAS level (12.0 ± 5.8). However, as there were few women working in heavy labor, the only significant difference in women was between moderate employment (8.8 ± 4.2) and sedentary employment (7.0 ± 4.1; mean difference, 1.8; 95% CI, 1.6-1.9; p = 0.0015). Participation in contact (19.9% vs 12.0%; p = 0.006) and overhead sports (25.2% vs 14.

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Shoulder activity level in the preoperative assessment of patients with rotator cuff tears

Cited by 15 publications

References 29 publications

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Patient-Determined Outcomes After Arthroscopic Margin Convergence Rotator Cuff Repair

Is the Marx Activity Scale Reliable in Patients Younger Than 18 Years?

Shoulder Activity Level is Associated With Type of Employment and Income in the Normative Population Without Shoulder Disorders

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