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Long-term status following arthroscopic scapulothoracic debridement surgery : reliability of measures and a comprehensive assessment profile applied to operated and healthy subjects Plotnikoff, Nadine Annalisa

Abstract

Long-term status following unilateral scapulothoracic arthroscopic debridement is not clear from the literature as no follow-up profiling specific to this intervention which includes the use of both subjective and objective outcome measures is available. A prospective study was first done with a group of healthy subjects to confirm test-retest reliability of two tests of static scapular position (n=30) and five positions for isometric strength testing of the scapular retractor and protractor muscle groups (n=20). High within-session reliability was calculated for both scapular position tests and four of the five scapular strength test positions. Between-session reliability data, however, was more varied. Subsequently, the Modified DeVita's static scapular position test, one scapular retraction and two scapular protraction strength test positions were chosen for the comparative study. A comprehensive assessment profile was then performed on 6 operated.subjects and 6 healthy subjects matched to them, comparing differences between arms in the operated group and between the surgical arms of the operated subjects and the dominant arms of the healthy subjects. The outcome measures utilized were the VAS and DDS pain scales, the DASH questionnaire, isometric scapular retraction and protraction strength testing, the Modified DeVita's Test and isokinetic strength testing of glenohumeral internal and external rotation. At a time frame of at least one year postoperatively, the operated subjects reported significantly higher levels of pain and dysfunction than the healthy subjects did. Scapular retraction and protraction strength was significantly less in the affected arms of the operated group compared to their unaffected arms and to the dominant arms of the healthy group. Glenohumeral internal rotation strength was significantly less in the affected arms of the operated group, compared to their affected arms. Reliability data collected with the operated group confirmed high within-session reliability for the DASH questionnaire. It is hoped that the results of this study will lead to an enhanced understanding of the long-term status of individuals following arthroscopic scapulothoracic procedures and will initiate further development of scapular-based outcome measures, such that their use in clinical assessment and research expands.

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