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Simplified assessment of elbow dysfunction and stiffness

Description

Background - The objective of this study was to determine if an Assessment through a Single Subjective Evaluation of Stiffness (ASSES) is correlated to an objective measurement of elbow stiffness and dysfunction (the Shanghai Elbow Dysfunction Score, SHEDS), as well as to other clinical and functional elbow scores. This could potentially streamline and decrease the number of questionnaires needed for follow-up. Moreover, such a score could function as a straightforward, standardized question for elbow studies, which currently lack simple and reliable stiffness outcome measures.

 

Methods - Between July 2021 and March 2023, ASSES was gathered from patients dealing affected by different types of elbow traumatic and degenerative conditions, along with SHEDS and other elbow scores (single Assessment Numeric Evaluation, SANE; Mayo Elbow Performance Index, MEPI; Oxford Elbow Scale, OES; quick-DASH; EuroQoL-5D, EQ5D). Correlations were computed using Pearson’s r-coefficient between the individual questionnaires.

 

Results - A total of 83 patients completed the questionnaires. ASSES demonstrated a moderate correlation with SHEDS, SANE, OES, and DASH (r = 0.518; r = 0.536; r = -0.501; p < 0.001). Notably, SANE exhibited a stronger correlation with these scales than ASSES (r = 0.761; r = 0.622; r = -0.6236; p < 0.001). The combined use of ASSES and SANE maintained a similar coefficient for SHEDS and slightly increased the strength of correlation with OES and DASH (r = 0.740; r = 0.658; r = -0.644; p < 0.001). SHEDS displayed a strong correlation with MEPI and DASH (r = 0.7132; r = -0.7734; p < 0.001) and a moderate correlation with EQ5D and OES (r = 0.543. r = 0.675; p < 0.001).

 

Conclusions - In summary, ASSES demonstrated a solid correlation with SHEDS, though a more robust correlation was observed between the latter and SANE. SHEDS continued to prove its worth as a valuable clinical score, correlating well with both functional assessments and quality-of-life evaluations. While the information gathered with SHEDS couldn't be significantly condensed into a shorter outcome assessment tool, utilizing both ASSES and SANE appeared to lighten the patients' questionnaire burden during follow-up, enabling a comprehensive assessment without requiring a physical consultation.

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Davide Cucchi

Davide Cucchi

M C

Max Christian Bönsch

A Z

Alberto Zellner

S V

Suncana Van Hattem

J B

Jessica Bojko

A M

Alessandra Menon

P R

Pietro Randelli

P A

Paolo Arrigoni

ESSKA Continuous Professional Education Partners