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P
atient
-
reported
measures
of
quality
of
life
and
functional
capacity
in
adhesive
capsulitis
R
ev
A
ssoc
M
ed
B
ras
2017; 63(4):347-354
347
ORIGINAL ARTICLE
Patient-reported measures of quality of life and functional capacity
in adhesive capsulitis
M
arcos
R
assi
F
ernandes
1
*
1
MD, PhD in Health Science, Department of Orthopedics/Traumatology, Faculty of Medicine, Universidade Federal de Goiás, Goiânia, GO, Brazil
S
ummary
Study conducted by the Health Science
Strictu Sensu Post-Graduated Program,
Faculty of Medicine, Universidade Federal
de Goiás, Goiânia, GO, Brazil
Article received:
7/12/2016
Accepted for publication:
11/7/2016
*Correspondence:
Address: Av. Azaléias, Qd. 10, Lt. 20
Aparecida de Goiânia, GO – Brazil
Postal code: 74935-187
marcosombro@ig.com.br http://dx.doi.org/10.1590/1806-9282.63.04.347Objective:
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 betweenWHOQOL-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.
I
ntroduction
Adopting a quality of life (QoL) assessment in clinical
practice can assist therapy, allowing a more holistic ap-
proach to the individual that goes beyond the treatment
of his disease. The difficulties in including this evaluation
in clinical practice reside mainly in the health profession-
als’ lack of information about its uses and applicability.
1-3
Since this assessment reflects the perspective of the
patient, and not that of scientists and health profession-
als, it is widely accepted as an indicator of health in med-
ical interventions.
3
Several tools may be used for this
purpose, depending on the situation.
1-4
The World Health
Organization Quality of Life (WHOQOL) questionnaire
was initially developed as an expanded questionnaire, the
WHOQOL-100,
2
and later as the WHOQOL-BREF.
5
The
WHOQOL-BREF is an abbreviated version consisting of
the 26 questions on the WHOQOL-100 with the best
psychometric performance.
5
The Disabilities of the Arm, Shoulder, and Hand
Questionnaire (DASH) is a self-administered regional
questionnaire which assesses symptoms and the func-
tional capacity (FC) of the affected upper limb. It was
developed by the American Academy of Orthopedic Sur-
geons in collaboration with several other organizations.
6