title: A new instrument to measure the activity profile of elderly shoulder pathology patients: the Senior Shoulder Activity score (SSA score).
abstract: BACKGROUND
  Whether rotator cuff repair is indicated in an elderly subject depends on the patient's activity profile and functional demand. A Senior Shoulder Activity (SSA) score is described, as a support for indications and analysis of clinical results according to activity level.
  
  
  METHODS
  The SSA score, comprising 4 levels from "sedentary" to "very active", was validated by comparison against a control group of 113 asymptomatic patients. It was included in the protocol of the French Arthroscopy Society's comparative study of repair versus simple decompression in 143 rotator cuff tears. Recovery of activity was assessed according to procedure.
  
  
  RESULTS
  At 1-year follow-up, suturing was associated with recovery of previous activity level in 87% of the cases and in 80% for decompression, a non-significant difference. When, however, less active patients (SSA 1 and 2) were contrasted with the more active (SSA 3 and 4), clinical results with suture versus decompression on Constant score showed a greater difference in the SSA 3-4 group.
  
  
  CONCLUSIONS
  The SSA score is not the same as the activity item of the Constant score, as it assesses the patient's usual activity level, before symptom onset, whereas the Constant item assesses activity at a given moment, independently of the patient's normal activity profile.
  
  
  CONCLUSIONS
  The Senior Shoulder Activity score is a simple, reproducible complement to the Constant score, revealing differences in clinical results on the latter, according to activity profile. Rotator cuff repair or simple decompression provided recovery of previous SSA activity level in more than 80% of the cases. The difference in clinical results between the two was significantly greater in more active patients. It would seem to follow that suture is more beneficial for more active subjects while simple decompression may be suitable for those with lower functional demand.
authors.affiliation: CHU Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France. Electronic address: julien.deranlot@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Deranlot
authors.forename: P-H
authors.initials: PH
authors.lastname: Flurin
authors.forename: P
authors.initials: P
authors.lastname: Hardy
authors.forename: S
authors.initials: S
authors.lastname: Klouche
mesh_terms: D000367:Age Factors; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D016022:Case-Control Studies; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009043:Motor Activity; D010147:Pain Measurement; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Quality of life; Senior activity level; Shoulder assessment