Abril - 2017

ernandes

352

ssoc

ras

2017; 63(4):347-354

major impact on personal relationships with friends and

relatives. On the other hand, the mean DASH score fell,

indicating a decline in shoulder disability and consequent

increase in the functioning of the affected shoulder.

A moderate correlation between DASH and the phys-

ical domain of the WHOQOL-BREF before therapy indi-

cates that functional disability of the shoulder in adhesive

capsulitis has similar effects on the physical aspect of QoL.

However, an analysis of the correlation between the instru-

ments after the blocks revealed a moderate negative cor-

relation between the DASH and the physical and psycho-

logical domains, and a weak negative correlation between

DASH and the environmental domain. This shows that

the less severe the shoulder disability, the better the QoL.

The purpose of DASH is to assess the function of the

affected region and the incapacity component of this

function. The emphasis is on the physical aspect, with a

particular focus on musculoskeletal disorders. Thus, the

most expected correlation of DASH was with the physical

domain of WHOQOL-BREF, which was in fact the high-

est (r=-0.580). It may be that the small number of questions

assessing patients’ social function was insufficient to

generate a correlation between DASH and the WHOQOL-

-BREF social domain.

Pain when adhesive capsulitis patients completed the

initial questionnaire was the only independent variable

that significantly influenced the physical domain of the

WHOQOL-BREF. As 95.3% of cases had moderate to severe

pain, this symptom could explain the low score in this

domain before treatment (45.34). Our study also revealed

that shoulder pain affected the patients’ sleep, daily ac-

tivities and ability to work. These items were part of the

list of questions in this domain and the responses given

suggested low QoL.

Multiple linear regression analysis after SSNB revealed

that better educated patients positively influenced QoL

in all domains of the WHOQOL-BREF. They also posi-

tively affected functional capacity as indicated by lower

DASH scores. Except in the social domain, older patients

positively influenced QoL on the WHOQOL-BREF and

also influenced better functioning of the affected shoul-

der as measured by DASH.

The absence in the literature of studies comparing do-

main means before and after treatment and of analyses of

TABLE 3

Results of multiple linear regression analysis of the WHOQOL-BREF domains and DASH after treatment among

adhesive capsulitis patients.

Explanatory variables

-Standardized

Ps D

-Standardized

DASH

-Standardized

Constant

43.10

33.85

10.69

24.09

108.01

Pain

0.16

-------------

Ethnic group

-------------

0.43**

-------------

Age group

0.41*

0.38*

0.31

0.33*

-0.32*

Educational status

0.31*

0.47**

0.55**

0.48**

-0.34**

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

-------------

0.40

0.29

0.51

0.31

0.42

Adjusted R2

0.25

0.21

0.41

0.23

0.33

2.83

3.89

5.32

4.29

4.47

Significance F

0.01

0.00

PD: physical domain; Ps D: psychological domain; SD: social domain; ED environment domain. *p<0.05; **p<0.01.

Variable coding: pain (severe=0, moderate=5, gentle=10); gender (female=0, male=1); ethnic group (white=1, non-white=2); educational status (illiterate=1, up to four years=2, five to eight ye-

ars=3, more than eight years of formal school=4); marital status (single=1, married=2, divorced=3, widowed=4); monthly income (1 to 5 minimum salaries=1, more than 5 minimum salaries=2,

without salary=3); employment (yes=1, no=2); side (right=1, left=2); dominance (right-handed=1, left-handed=2); classification (primary=1, secondary=2); sleep (affected=0, unaffected=2); seve-

rity (mild=1, moderate=2, severe=3); age group (40 |-- 50 =1, 50 |---60 = 2, 60 + = 3).

-------------: variable was not included in the model of that respective domain.