Agreement between patient self-assessment and physician assessment of shoulder range of motion

Bastian Uribe; Youssef El Bitar; Brian R Wolf; Matthew Bollier; John E Kuhn; Carolyn M Hettrich

doi:10.1016/j.jse.2016.02.010

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Agreement between patient self-assessment and physician assessment of shoulder range of motion

Journal article

Peer reviewed

Agreement between patient self-assessment and physician assessment of shoulder range of motion

Bastian Uribe, Youssef El Bitar, Brian R Wolf, Matthew Bollier, John E Kuhn and Carolyn M Hettrich

Journal of shoulder and elbow surgery, Vol.25(10), pp.1649-1654

10/2016

DOI: 10.1016/j.jse.2016.02.010

PMID: 27066961

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Abstract

Shoulder outcome scores that include range of motion (ROM) and apprehension signs are limited by the need for direct involvement of the physician. Patient-reported outcome measures are patient centered and self-administered, and they can help physicians track the patient's progress between office visits and for long-term follow-up once the patient has been discharged. Thirty consecutive patients completed a form before their 6-month follow-up after surgery on the labrum or capsule as a result of instability or pain related to instability. The form included bilateral ROM, apprehension, and instability episodes. The same parameters were measured by the physician during the visit. The patient's and physician's responses were compared. The primary outcome was the percentage agreement with exact and approximate agreement. Exact agreement was moderate for forward elevation at 56.6%; fair for abduction and external rotation at 90° at 24.5% and 34%, respectively; and poor for internal rotation at 90° and external rotation with the arm at the side at 2.6% and 12%, respectively. Approximate agreement within a range of positive or negative 20° range was very good for forward elevation (94%), abduction (92%), and external rotation at 90° (87%); moderate for external rotation with the arm at the side; and fair for internal rotation at 90°. There was 70% agreement regarding apprehension, 93% regarding subluxation events, and 100% regarding redislocation events. Some measures of shoulder ROM showed a moderate to high level of agreement between patient-reported measurements and the physician's measurements. This method for short- and long-term follow-up could potentially replace routine clinic visits.

patient-reported outcome

apprehension sign

agreement study

self-assessment

Shoulder physical examination

range of motion

Details

Title: Subtitle: Agreement between patient self-assessment and physician assessment of shoulder range of motion
Creators: Bastian Uribe - Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
Youssef El Bitar - Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
Brian R Wolf - Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
Matthew Bollier - Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
John E Kuhn - Vanderbilt Sports Medicine, Vanderbilt University, Nashville, TN, USA
Carolyn M Hettrich - Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Journal of shoulder and elbow surgery, Vol.25(10), pp.1649-1654
Publisher: Elsevier Inc
DOI: 10.1016/j.jse.2016.02.010
PMID: 27066961
ISSN: 1058-2746
eISSN: 1532-6500
Language: English
Date published: 10/2016
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984040201502771

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8 Times Cited - Web of Science