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A COMPARISON OF FUNCTIONAL ASSESSMENT SCORES IN SUBACROMIAL IMPINGEMENT



Abstract

The aim of the present study is to compare the Oxford Shoulder Score (OSS), the Shoulder Pain and Disability Index (SPADI) and the SF36 in terms of their correlation and sensitivity to change in a group of patients with subacromial impingement.

Patients attending a specialist shoulder clinic over a six-month period with a diagnosis of subacromial impingement completed the OSS, SPADI and SF36 on each of up to four attendances at six-week intervals, regardless of treatment. The data were analysed by creating scatter plots for each scoring system compared with each other, calculation of correlation coefficients, and calculating the effect size for each scale between subsequent visits (the difference in mean score divided by the standard deviation of the change in score for all individuals). This is a measure of sensitivity to change.

Three-hundred and twenty-three sets of scores were obtained in 110 patients. Scores were recorded across the whole range of the OSS and SPADI in our population. Similarly, the physical functioning component of the SF 36 ranged from 0 to 100. However, total SF 36 scores ranged only from 478 to 831.

There was good correlation between the OSS and SPADI scores (correlation coefficient = 0.86), although in 71% of observations the SPADI score was greater than the OSS when expressed as a percentage. The correlation between the OSS and SPADI was less good with the physical functioning component of the SF 36 (0.57 and 0.51 respectively), and worse with the total SF 36 (0.37 and 0.27 respectively) The OSS and SPADI showed good effect sizes (0.211 and 0.212) compared to the physical functioning and total SF 36 scores (0.104 and 0.063).

The OSS and SPADI show close correlation between each other, and were similarly sensitive to change in a group of patients with impingement. However, the SF 36 shows a poor spread of scores and less sensitivity to change in this group. These data support the use of the OSS or SPADI in these patients.

These abstracts were prepared by Mr Cormac Kelly. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.