Search Filters

  • Presentation Format
  • Media Type
  • Diagnosis / Condition
  • Diagnosis Method
  • Patient Populations
  • Treatment / Technique

Establishing Minimal Clinically Important Difference In The Shoulder Activity Level Rating Scale After Shoulder Surgery

Establishing Minimal Clinically Important Difference In The Shoulder Activity Level Rating Scale After Shoulder Surgery

Darby Adele Houck, BA, UNITED STATES Ian L Verbeck, MS, UNITED STATES Eric C. McCarty, MD, UNITED STATES Rachel M. Frank, MD, UNITED STATES Michelle Wolcott, MD, UNITED STATES Adam Seidl, MD, UNITED STATES Jonathan T. Bravman, MD, UNITED STATES

University of Colorado School of Medicine; Department of Orthopaedics; Division of Sports Medicine and Shoulder Surgery, Aurora, CO, UNITED STATES


2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Diagnosis / Condition

Sports Medicine

This media is available to current ISAKOS Members, Global Link All-Access Subscribers and Webinar/Course Registrants only.

Summary: This is the first study to assess the MCID for the Shoulder Activity Level Rating Scale (MARX) in patients following shoulder surgery.


Background

The Shoulder Activity Level Rating Scale (MARX) is commonly used to predict outcomes of shoulder disorders. The purpose of this study was to establish the minimal clinically important difference (MCID) in MARX activity scores in patients who underwent shoulder surgery.

Methods

Utilizing our institutions prospective outcomes registry, we identified patients who underwent shoulder surgery and completed baseline MARX activity scores. A total of 499 patients that underwent shoulder surgery were included, with 355 patients who underwent rotator cuff repair (RCR), and 144 who underwent total shoulder arthroplasty (TSA). Six patient-reported outcome measures (PROMS) were administered pre- and postoperatively at 3, 6, 12, and 24 months. The change in the PROMS from baseline to the 12-month follow-up was calculated. The MCID was determined with use of the anchor-based and distribution-based techniques.

Results

A total of 499 patients (59.2% male) who underwent shoulder surgery (RCR subgroup, n=355 [63.1% male]; TSA subgroup, n=144 [49.31% male]) were included. The mean age of the combined group was 60.80 (SD: 10.56) years. The RCR subgroup had a mean age of 58.70 (SD: 10.35), while the TSA subgroup had a mean age of 65.97 (SD: 9.30) years. Using the distribution-based method, which was found to be the most reliable, the MCID identified for MARX was 2.36 for the combined group, with MCIDs being 2.27 for the RCR subgroup, and 2.41 for the TSA subgroup. This indicates that an 11.8% (RCR, 11.3%; TSA, 12.1%) increase in the MARX score represents the smallest difference which this specific patient cohort perceives as beneficial. At 12 months after shoulder surgery, the sole significant predictor of obtaining the MCID was whether the patient met the MCID for any PROM in their most recently taken survey for 411 patients in the combined group (OR, 9.53; p=0.031) and 262 patients in the RCR group (OR, 8.91; p=0.043).

Conclusions

This is the first study to assess the MCID for the Shoulder Activity Level Rating Scale (MARX) in patients following shoulder surgery. The estimate of the MCID will facilitate the interpretation and application of this measure of activity level in clinical practice and research.


More ISAKOS 2021: Global Content