Negahban Hossein, Behtash Zeinab, Sohani Soheil Mansour, Salehi Reza
a Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran and.
b Department of Physical Therapy , School of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran , Iran.
Disabil Rehabil. 2015;37(24):2300-4. doi: 10.3109/09638288.2015.1005760. Epub 2015 Feb 2.
To identify the ability of the Persian-version of the Shoulder Pain and Disability Index (SPADI) and the Disabilities of the Arm, Shoulder, and Hand (DASH) to detect changes in shoulder function following physiotherapy intervention (i.e. responsiveness) and to determine the change score that indicates a meaningful change in functional ability of the patient (i.e. Minimally Clinically Important Difference (MCID)).
A convenient sample of 200 Persian-speaking patients with shoulder disorders completed the SPADI and the DASH at baseline and then again 4 weeks after physiotherapy intervention. Furthermore, patients were asked to rate their global rating of shoulder function at follow-up. The responsiveness was evaluated using two methods: the receiver operating characteristics (ROC) method and the correlation analysis. Two useful statistics extracted from the ROC method are the area under curve (AUC) and the optimal cutoff point called as MCID.
Both the SPADI and the DASH showed the AUC of greater than 0.70 (AUC ranges = 0.77-0.82). The best cutoff points (or change scores) for the SPADI-total, SPADI-pain, SPADI-disability and the DASH were 14.88, 26.36, 23.86, and 25.41, respectively. Additionally, moderate to good correlations (Gamma = -0.51 to -0.58) were found between the changes in SPADI/DASH and changes in global rating scale.
The Persian SPADI and DASH have adequate responsiveness to clinical changes in patients with shoulder disorders. Moreover, the MCIDs obtained in this study will help the clinicians and researchers to determine if a Persian-speaking patient with shoulder disorder has experienced a true change following a physiotherapy intervention. Implications for Rehabilitation Responsiveness was evaluated using two methods; the receiver operating characteristics (ROC) method and the correlation analysis. The Persian SPADI and DASH can be used as two responsive instruments in both clinical practice and research settings. The MCIDs of 14.88 and 25.41 points obtained for the SPADI-total and DASH indicated that the change scores of at least 14.88 points on the SPADI-total and 25.41 points on the DASH is necessary to certain that a true change has occurred following a physiotherapy intervention.
确定波斯语版的肩痛与功能障碍指数（SPADI）和上肢、肩部和手部功能障碍量表（DASH）检测物理治疗干预后肩部功能变化的能力（即反应性），并确定表明患者功能能力有意义变化的变化分数（即最小临床重要差异（MCID））。
选取200名讲波斯语的肩部疾病患者作为便利样本，在基线时完成SPADI和DASH量表评估，然后在物理治疗干预4周后再次进行评估。此外，要求患者对随访时肩部功能的整体评分进行评级。使用两种方法评估反应性：受试者工作特征（ROC）法和相关性分析。从ROC法中提取的两个有用统计量是曲线下面积（AUC）和称为MCID的最佳截断点。
SPADI和DASH的AUC均大于0.70（AUC范围=0.77 - 0.82）。SPADI总分、SPADI疼痛、SPADI功能障碍以及DASH的最佳截断点（或变化分数）分别为14.88、26.36、23.86和25.41。此外，在SPADI/DASH变化与整体评级量表变化之间发现了中度至良好的相关性（Gamma=-0.51至-0.58）。
波斯语版的SPADI和DASH对肩部疾病患者的临床变化具有足够的反应性。此外，本研究中获得的MCID将有助于临床医生和研究人员确定讲波斯语的肩部疾病患者在物理治疗干预后是否经历了真正的变化。康复意义 使用两种方法评估反应性；受试者工作特征（ROC）法和相关性分析。波斯语版的SPADI和DASH可在临床实践和研究环境中用作两种反应性工具。SPADI总分和DASH获得的14.88分和25.41分的MCID表明，SPADI总分至少14.88分和DASH至少25.41分的变化分数对于确定物理治疗干预后是否发生了真正的变化是必要的。
