The Relationship between Kinesiophobia and Return to Sport after Shoulder Surgery for Recurrent Anterior Instability.

Purpose To evaluate the relationship between kinesiophobia and patient's return to sport after shoulder stabilization surgery. The hypothesis was that kinesiophobia represents an independent factor correlated to the difference between preinjury and postoperative level of sport. Methods This study retrospectively evaluated 66 patients (mean age: 35.5, standard deviation [SD] = 9.9 years) and at a mean follow-up of 61.1 (SD = 37.5) months after arthroscopic Bankart's repair or open Bristow-Latarjet procedure. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK); return to the preinjury sport was assessed by the difference between baseline and postoperative degree of shoulder involvement in sport (D-DOSIS) scale. The Western Ontario Shoulder Instability index (WOSI) was used to evaluate participants' perceptions of shoulder function. Results TSK showed correlation with D-DOSIS ( ρ = 0.505, p < 0.001) and the WOSI score ( ρ = 0.589, p < 0.001). There was significant difference in TSK and WOSI scores between participants who had and had not returned to their previous level of sport participation ( p = 0.006, and 0.0001, respectively). Conclusion This study demonstrated that kinesiophobia is correlated to the return to sport after shoulder stabilization surgery. Level of Evidence Level IV, retrospective case series.

Psychometric properties of three different scales for subjective evaluation of shoulder pain and dysfunction in Italian patients after shoulder surgery for anterior instability.

BACKGROUND: The Italian versions of Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST), and University of California-Los Angeles (UCLA) Shoulder Rating Scale have been validated to assess shoulder dysfunction in patients treated for neck cancer. The present study investigated the psychometric properties of the Italian versions of the SPADI, SST, and UCLA in patients after shoulder surgery for anterior instability. MATERIALS AND METHODS: The study population included 98 patients. Patients completed the Italian SPADI, SST, and UCLA, and Western Ontario Shoulder Instability Index (WOSI), American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form, Oxford Shoulder Score (OSS), and 36-Item Short Form Health Survey (SF-36). Reproducibility was assessed by asking patients to complete another UCLA, SPADI, and SST 48 hours after the first. Validity was assessed by calculating the correlation between the SPADI, SST, and UCLA and the WOSI, ASES, OSS, and the SF-36 Physical Health subscales. RESULTS: The internal consistencies of the SPADI (α = 0.97) and the SST (α = 0.87) were very high. The test-retest reliability was excellent with intraclass correlation coefficient of 0.97 for the SPADI, 0.93 for UCLA pain, 0.95 for UCLA function, and 0.97 for the SST. A significant correlation was found between the Italian SPADI, SST, and UCLA and the WOSI, the ASES and the OSS. DISCUSSION: Psychometric properties of the Italian SPADI, SST, and UCLA compared well with those reported for the original versions, supporting their use as reliable clinimetric instruments in the setting of shoulder disorders after surgery for recurrent anterior instability.

The Degree of Shoulder Involvement in Sports (DOSIS) scale is a valid and responsive instrumentation for shoulder assessment in patients after surgery for anterior instability.

PURPOSE: The purpose of this study was to evaluate validity and responsiveness of the Degree of Shoulder Involvement in Sport (DOSIS) scale. METHODS: A web-based survey was developed to test the construct validity of the DOSIS scale. Fifty-three patients with a median age of 33 years (range 17-59) were included in the study. Convergent validity was evaluated by external correlation (Spearman's rank correlation coefficient, r) of the DOSIS with the Brophy-Marx and Tegner activity scales, the Western Ontario shoulder instability index (WOSI), the Simple Shoulder Test (SST), and the Short-Form 36 (SF-36). Responsiveness was analysed by relative efficiency calculation of the DOSIS versus the Brophy-Marx and Tegner activity scales. RESULTS: The DOSIS showed strong correlation with the Brophy-Marx and Tegner activity scales, a moderate correlation with the WOSI and SST scores, and a moderate correlation with the physical functioning, role physical and role emotional subscores of the SF-36. The distribution of the DOSIS scores had no serious ceiling or floor effects. The DOSIS demonstrated lesser responsiveness when compared to the Brophy-Marx and Tegner activity scales. CONCLUSION: The DOSIS showed an adequate validity and responsiveness. The clinical relevance of this study is that the DOSIS scale can be used for sport-specific shoulder assessment in patients after surgery for anterior instability. LEVEL OF EVIDENCE: III.