title: The simple shoulder test is responsive in assessing change following shoulder arthroplasty.
abstract: METHODS
  Prospective cohort study with repeated measures.
  
  
  OBJECTIVE
  To establish the responsiveness of the Simple Shoulder Test (SST) in comparison to other commonly used clinical outcomes in patients undergoing shoulder arthroplasty.
  
  
  BACKGROUND
  Responsiveness statistics are a useful means to compare different outcomes in terms of their ability to detect clinical change. While the responsiveness of the SST has been established for rotator cuff repair, it has not been determined for patients undergoing arthroplasty.
  
  
  METHODS
  Patients undergoing shoulder arthroplasty (n=120) were evaluated prior to surgery and 6 months after. The evaluation included the SST, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and isometric strength. Responsiveness to change was assessed using standardized response mean (SRM), while longitudinal construct validity was evaluated using Pearson correlation. Receiver operating characteristics curves were plotted to determine clinically important difference of SST.
  
  
  RESULTS
  The SST and Disabilities of the Arm, Shoulder and Hand questionnaire were highly responsive (SRM, >1.70) for this population. For the assessment of impairment, range of motion (SRM, 0.64-1.03) was moderately to highly responsive, while isometric strength was minimally to moderately responsive (SRM, 0.32-0.69). The clinically important difference of the SST was established at 3.0 SST points. Pearson correlations indicated moderate associations between the change scores of the SST and the Disabilities of the Arm, Shoulder and Hand questionnaire (r=0.49).
  
  
  CONCLUSIONS
  The SST has been previously shown to be valid and highly reliable. The present results show that the SST is also responsive following shoulder arthroplasty and that it has a clinically important difference of 3.0 SST points. This should provide confidence to clinicians who wish to use a brief shoulder-specific measure in their practice.
authors.affiliation: School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. jean-sebastien.roy.1@ulaval.ca
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Roy
authors.forename: Joy C
authors.initials: JC
authors.lastname: Macdermid
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Faber
authors.forename: Darren S
authors.initials: DS
authors.lastname: Drosdowech
authors.forename: George S
authors.initials: GS
authors.lastname: Athwal
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000601:surgery*