The Shoulder Pain and Disability Index: Is it sensitive and responsive to immediate change?

BACKGROUND

The Shoulder Pain and Disability Index (SPADI) is designed to detect changes in shoulder pain and disability after a one-week interval. With the new Medicare guideline, the SPADI may have to be employed for time frames of less than one week.

PURPOSE

To determine if the SPADI or its subscales could detect immediate changes in pain and function after a thoracic manipulative intervention known to produce short-term improvement and by comparing it to changes on the numeric pain rating scale (NPRS).

METHODS

Subjects with primary complaints of non-post-surgical shoulder pain completed the NPRS and the SPADI prior to and immediately following interventions.

FINDINGS

The SPADI pain subscale detected statistically significant differences that were also detected using the NPRS. In addition, the SPADI pain score and the NPRS scores were moderately correlated between the pre-intervention SPADI and NPRS scores (r = 0.49-0.61, p < 0.001) and post-intervention SPADI and NPRS scores (r = 0.49-0.67, p < 0.001). These differences did not appear to be sensitive or responsive to immediate change.

CLINICAL RELEVANCE

Since the SPADI may have to be employed in durations of less than one week secondary to third party payer requirements, it is valuable to validate the SPADI for this particular use.

CONCLUSION

Although SPADI scores demonstrated low sensitivity and responsiveness to immediate changes, the SPADI pain scale was able to detect changes in durations of less than one week. This finding should be confirmed through further prospective experimentation.