Patient-reported measures of quality of life and functional capacity in adhesive capsulitis

Fernandes, Marcos Rassi

doi:10.1590/1806-9282.63.04.347

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ORIGINAL ARTICLES • Rev. Assoc. Med. Bras. 63 (4) • Apr 2017 • https://doi.org/10.1590/1806-9282.63.04.347 copy

Patient-reported measures of quality of life and functional capacity in adhesive capsulitis

Medidas relatadas pelos pacientes sobre qualidade de vida e capacidade funcional em capsulite adesiva

Authorship SCIMAGO INSTITUTIONS RANKINGS

Summary

Objective:

To evaluate patient-reported measures of quality of life and functional capacity in adhesive capsulitis before and after suprascapular nerve block treatment; to analyze the influence of clinical and sociodemographic variables on both the outcome and correlation between the respective instruments.

Method:

A prospective clinical study was performed with adhesive capsulitis patients. Inclusion criteria were clinical diagnosis of adhesive capsulitis and a shoulder imaging test. The WHOQOL-BREF and DASH instruments were administered before and after treatment. A Constant test score of 55 points was used as a cutoff point for discontinuation of treatment. Mean values were compared using paired t-test and Wilcoxon. The Pearson or Spearman coefficients were used for correlation analysis. Multiple linear regression analysis was carried out using variables with p<0.20 as predictors in univariate analysis and WHOQOL domains and DASH as outcomes. The significance level was 5%.

Results:

Forty-three patients were evaluated. The comparison between WHOQOL-BREF and DASH mean values before and after the blocks, p<0.05. DASH correlated negatively with the physical, psychological and environmental WHOQOL-BREF domains. Older patients and those with higher levels of education influenced the improvement in patients' quality of life and functional capacity.

Conclusion:

The improvement of adhesive capsulitis with treatment involves an improvement in quality of life and functional capacity. The greater functional capacity of the shoulder matches a better quality of life for patients. Age and education level are the variables that most influence improvement in quality of life and functional capacity.

Keywords:
quality of life; adhesive capsulitis; shoulder pain; sickness impact profile; nerve block

Variables		n	%	p^* * Chi-square test.
Age group	40 \|---- 50 50 \|---- 60 60 +	14 15 14	32.6 34.9 32.6	0.977
Gender	Female Male	23 20	53.5 46.5	0.647
Ethnic group	White Non-white	34 09	79.1 20.9	0.000
Employment	Yes No	20 23	46.5 53.5	0.647
Educational status	Illiterate Until 4 years of formal education 5 to 8 years of formal education More than 8 years of formal education	01 08 08 26	2.3 18.6 18.6 60.5	0.000
Monthly income	1 to 5 minimum salaries More than 5 minimum salaries No salary	27 12 04	62.8 27.9 9.3	0.000
Marital status	Single Married Divorced Widower	01 32 07 03	2.3 74.4 16.3 7.0	0.000
Side	RightLeft	18 25	41.9 58.1	0.286
Dominance	Right-handed Left-handed	41 02	95.3 4.7	0.000
Classification	Primary Secondary	15 28	34.9 65.1	0.047
Pain	Mild Moderate Severe	02 20 21	4.7 46.5 48.8	0.000
Sleep	Affected Unaffected	39 04	90.7 9.3	0.000
Severity	Mild Moderate Severe	10 27 06	23.3 62.8 14	0.000

Domains	Mean	Median	SD	CI	p
Physical 1	45.34	46.42	19.75	39.27-51.43	0.000^ t-paired test; 1=before; 2=after.
Physical 2	67.85	67.85	12.87	63.89-71.82	0.000^ t-paired test; 1=before; 2=after.
Psychological 1	63.95	66.66	16.33	58.93-68.92	0.000^* * Wilcoxon test;
Psychological 2	73.54	79.16	15.77	68.69-78.40	0.000^* * Wilcoxon test;
Social 1	68.21	66.66	19.26	62.29-74.15	0.049^* * Wilcoxon test;
Social 2	73.83	75	19.29	67.90-79.77	0.049^* * Wilcoxon test;
Environment 1	60.24	62.50	15.62	55.44-65.06	0.001^ t-paired test; 1=before; 2=after.
Environment 2	66.42	68.75	15.44	61.67-71.18	0.001^ t-paired test; 1=before; 2=after.
DASH 1	61.68	64.16	18.71	55.92-67.44	0.000^ t-paired test; 1=before; 2=after.
DASH 2	42.11	38.33	18.30	36.48-47.74	0.000^ t-paired test; 1=before; 2=after.

Explanatory variables	PDβ-Standardized	Ps Dβ-Standardized	SDβ-Standardized	EDβ-Standardized	DASHβ-Standardized
Constant	43.10	33.85	10.69	24.09	108.01
Pain	0.16	-------------	-------------	-------------	-------------
Ethnic group	-------------	-------------	0.43^ p<0.01.	-------------	-------------
Age group	0.41^* * p<0.05;	0.38^* * p<0.05;	0.31	0.33^* * p<0.05;	-0.32^* * p<0.05;
Educational status	0.31^* * p<0.05;	0.47^ p<0.01.	0.55^ p<0.01.	0.48^ p<0.01.	-0.34^ p<0.01.
Gender	0.25	-------------	-------------	-------------	-------------
Marital status	-------------	-------------	-------------	-------------	-------------
Monthly income	-0.15	-0.12	-------------	0.00	-0.01
Employment	-------------	-------------	-0.28	-------------	-0.25
Side	-------------	-------------	-------------	-------------	-------------
Dominance	-------------	-------------	-------------	-------------	-------------
Classification	-------------	-------------	-------------	-------------	-------------
Sleep	-------------	0.10	-0.02	0.16	-0.11
Severity	-0.16	-------------	-------------	-------------	-------------
R2	0.40	0.29	0.51	0.31	0.42
Adjusted R2	0.25	0.21	0.41	0.23	0.33
F	2.83	3.89	5.32	4.29	4.47
Significance F	0.01	0.01	0.00	0.00	0.00

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