Responsiveness and minimal important change of the Oxford Shoulder Score, EQ-5D, and the Fear-Avoidance Belief Questionnaire Physical Activity subscale in patients undergoing arthroscopic subacromial decompression

INTRODUCTION: Adequate responsiveness and knowledge of the minimal important change (MIC) is essential when using patient-reported outcome measures to assess treatment efficacy. OBJECTIVE: The objective of this study was to evaluate the responsiveness and MIC of common outcomes in patients with subacromial impingement syndrome undergoing arthroscopic subacromial decompression. METHODS: At baseline and 6 months after surgery, patients completed the Oxford Shoulder Score (OSS), EQ-5D 5-level utility index, EQ visual analogue scale, Fear-Avoidance Belief Questionnaire Physical Activity subscale (FABQ-PA), assessed pain (pain visual analogue scale), and Subjective Shoulder Value. Furthermore, at the 6-month follow-up, patients assessed the overall change with a Global Rating of Change Scale. Responsiveness was examined by analyzing the area under the receiver operating characteristics curve and correlations between the change scores. MIC was assessed using the optimal cutoff point at the receiver operating characteristics curve. RESULTS: Area under the receiver operating characteristics curve estimates were 0.96 (95% confidence interval [CI] 0.91,1.00) for OSS, 0.82 (95% CI 0.66,0.99) for EQ-5D 5-level utility index, 0.73 (95% CI 0.58,0.87) for EQ visual analogue scale, and 0.74 (95% CI 0.58,0.90) for FABQ-PA. MIC were 6.0 points for OSS, 0.024 points for EQ-5D 5-level utility index, 10.0 points for EQ visual analogue scale, and -5.0 points for FABQ-PA. CONCLUSION: Responsiveness of the OSS, EQ-5D, and FABQ-PA was sufficient to measure improvement after arthroscopic decompression surgery

Telemonitored exercise-based cardiac rehabilitation improves physical capacity and health-related quality of life

Introduction Cardiac rehabilitation improves physical capacity, health-related quality of life, and reduces morbidity and mortality among cardiac patients. Telemonitored exercise-based cardiac rehabilitation may innovate existing programmes and increase participation rates. Objective The purpose of this study was to investigate if telemonitored exercise-based cardiac rehabilitation improves physical capacity, muscle endurance, muscle power, muscle strength and health-related quality of life in cardiac patients. Methods A follow-up study on moderate risk patients with ischaemic heart and heart valve disease referred to a 12-week telemonitored exercise-based cardiac rehabilitation intervention at Aarhus University Hospital (Denmark). Participants were encouraged to exercise 60 min three times weekly with moderate/high intensity for 20 min per session. Intensity and duration of training sessions were visualised on a smartphone and uploaded to a website. Participants received individual feedback from physiotherapists on their training efforts by telephone/email. Outcome measures were changes in physical capacity (peak oxygen uptake), muscle endurance, power, and strength, and health-related quality of life between baseline end of telemonitored exercise-based cardiac rehabilitation intervention, and at six and 12 months after end of telemonitored exercise-based cardiac rehabilitation. Results Thirty-four participants completed telemonitored exercise-based cardiac rehabilitation. We identified a significant increase in peak oxygen uptake of 10%, in muscle endurance of 17%, in muscle power of 7%, and in muscle strength of 10% after the telemonitored exercise-based cardiac rehabilitation programme. Health-related quality of life was significantly improved by 19% in the physical and 17% in the mental component scores. We found no significant improvement in peak oxygen uptake between baseline and 12 months follow-up, but a significant improvement in muscle endurance (0.3 watts/kg, 95% confidence interval; 0.2-0.4), muscle power (0.4 watts/kg; 0.2-0.5), muscle strength (0.5 N/m/kg; 0.1-0.9), physical health-related quality of life (five points; 2-8) and mental health-related quality of life (six points; 3-9). Discussion This study demonstrated that the self-elected type of physical exercise in cardiac rehabilitation with telemonitoring improved all outcome measures both on the short and long-term, except for peak oxygen uptake at 12 months follow-up