Abstract
Introduction
The Stanmore Percentage of Normal Shoulder Assessment (SPONSA) is a simple, fast and reproducible measure of the subjective state of a shoulder. It has been invaluable in our busy clinical practice. This study validates the SPONSA score against the Oxford Shoulder and Constant score and demonstrates a greater sensitivity to change.
Methods
The SPONSA involves defining the concept of ‘normality’ in a shoulder and then asking patients to express the current state of their shoulder as a percentage of normal. The score uses a specific script which is read exactly as typed.
The SPONSA, Oxford Shoulder and Constant scores were measured by an independent observer in 61 consecutive patients undergoing treatment for shoulder conditions in our unit. Scores were recorded at 2-6 weeks before admission, immediately before intervention, and between 3-6 months post-intervention. The time taken to measure each score was recorded.
Results
The SPONSA was tested for inter- and intra-observer reproducibility according to the method described by Bland and Altman (1986), and was validated against the Oxford and Constant scores using the Pearson correlation coefficient. The Inter-observer and intra-observer reproducibility was excellent. The overall correlation between the SPONSA and the Constant score was 0.79. The correlation for the Oxford score was -0.79.
Results for the SPONSA's sensitivity to change pre- and post-treatment show that effect size is larger than the Constant and comparable to the Oxford score. The SPONSA had an effect size of 0.72 as compared to -0.65 for the Oxford score and 0.38 for the Constant score. The mean times to complete the SPONSA, Oxford and Constant scores were 31.9 seconds, 129.5 seconds and 163.3 seconds respectively.
Conclusion
These results validate the SPONSA against the Oxford Shoulder and Constant score and show a very high correlation. However the SPONSA score takes significantly less time.
