| Does objective shoulder impairment explain patient-reported functional outcome? A study of proximal humerus fractures. | |
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MedLine Citation:
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PMID: 20951061 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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HYPOTHESIS: Following a healed proximal humerus fracture, patient-reported outcome is predicted by objective physical examination findings. Range of motion and strength thresholds can correctly identify subjects with normal functioning shoulders. METHODS: Subjects were age ≥55 years with a healed proximal humerus fracture. Impairment was measured with a focused physical examination of the shoulder; patient-reported outcome was assessed using 4 outcome questionnaires. Linear regression was used to determine how well variations in shoulder impairment explain differences in patient-reported outcomes. ROC curves were constructed to determine the physical examination thresholds that would correctly identify normally functioning shoulders. RESULTS: Thirty-one subjects with a mean age of 70 ± 8 years participated. The mean patient-reported outcome scores were: DASH 21 ± 19, ASES 82 ± 17, SST 8 ± 3, and Oxford 20 ± 8. The linear regression analysis suggests that shoulder impairment explains 38% of the Oxford, 50% of the DASH, 58% of the SST, and 70% of the ASES variance. Abduction strength was a significant predictor for all functional outcomes. Based on ROC analysis, forward flexion had the best discriminatory ability for identifying normally functioning shoulders (area under curve, 0.93). A threshold of 120° forward flexion correctly classified 90% of the shoulders. CONCLUSION: Range of motion and strength thresholds can identify subjects with normal shoulder function. A discordance between shoulder impairment and patient-reported outcome has been demonstrated and further work to identify patient, injury, or treatment factors to minimize this discrepancy is still needed. |
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Authors:
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Gerard P Slobogean; Vanessa K Noonan; Akin Famuyide; Peter J O'Brien |
Publication Detail:
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Type: Journal Article Date: 2010-10-15 |
Journal Detail:
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Title: Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] Volume: 20 ISSN: 1532-6500 ISO Abbreviation: J Shoulder Elbow Surg Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-01-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9206499 Medline TA: J Shoulder Elbow Surg Country: United States |
Other Details:
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Languages: eng Pagination: 267-72 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Orthopaedics, University of British Columbia, Vancouver, BC Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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