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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >THE DISCRIMINATE ABILITY OF THE PEDIATRIC ADOLESCENT SHOULDER SURVEY (PASS)
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THE DISCRIMINATE ABILITY OF THE PEDIATRIC ADOLESCENT SHOULDER SURVEY (PASS)

机译：小学生青少年肩膀调查（PASS）的区分能力

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Purpose: The purpose of this study was to examine whether improvements in the Pediatric and Adolescent Shoulder Survey (PASS) are seen at 3 months following surgical treatment for shoulder instability and whether the PASS can discriminate between patients with differing outcomes based on clinical exam and the single assessment numeric evaluation (SANE). Performance of the PASS was contrasted with an adult validated tool, the quickDASH. Methods: Patients who underwent surgical treatment for shoulder instability with completed PASS forms available at pre-operative and 3 months post-operative (range 2.5-4.5mos) were included in this review. The PASS consists of 13 questions that assess (in child friendly language) symptoms, limitations, need for compensatory mechanisms, and emotional distress related to shoulder dysfunction. Responses are on a 0-5 or 0-10 scale with a score calculation based on percentage of total possible points (100% indicates no/minimal impact on quality of life from shoulder dysfunction). Patients were grouped based on range of motion or strength (within 10 degrees to contralateral extremity or no discrepancy in strength score was considered no deficit) and SANE score (=80% vs &80%) at the 3-month visit. Alpha was set at p&0.05 to declare significance. Results: 50 patients with a mean age of 16 years (range 13.5-18 yrs) were identified in this review with a mean post-operative follow-up of 3.2 ± 0.5 months. Scores on the PASS improved significantly from pre-operative (57 ± 16%) to post-operative (74 ± 16%, p&0.001). The quickDASH similarly showed improvement (27 ± 16 pre vs 18 ± 16 post, p=0.003) although the magnitude of the effect for the PASS was larger (f=0.84 for PASS vs f=0.48 for quickDASH). Ceiling effect (&15% reporting the highest score) was observed at 3 months with the quickDASH (16% with top score), but not with the PASS (4%, p=0.03). While both tools were able to discriminate between patients with SANE score =80% vs &80%, the difference in quickDASH score between patients with/without diminished motion did not reach significance (p=0.07, Table). Conclusion: The PASS shows anticipated improvements in shoulder function following surgical intervention for instability without ceiling effects. The PASS is able to discriminate between patients with differing post-operative outcomes at 3 months following surgery. PASS QuickDASH Diminished Motion/Strength no 80 ± 14% 14 ± 15 yes 68 ±15% 22 ± 15 p 0.04 0.07 effect size f 0.44 0.28 SANE Score ≥80% 82 ± 16% 12 ± 17 &80% 65 ± 11% 25 ± 14 p 0.001 0.026 effect size f 0.63 0.42 *effect size f index; small=0.10, medium =0.25, large =0.40
机译：目的：本研究的目的是检查在手术治疗后3个月是否因肩部不稳而发现小儿和青少年肩部调查（PASS）有所改善，以及PASS是否可以根据临床检查和临床检查区分具有不同结局的患者单一评估数字评估（SANE）。 PASS的性能与经过成人验证的工具quickDASH进行了对比。方法：本研究纳入了因肩关节不稳而接受手术治疗的患者，术前和术后3个月可使用完整的PASS表格（范围2.5-4.5 mos）。 PASS由13个问题组成，这些问题评估（使用对儿童友好的语言）症状，局限性，对补偿机制的需求以及与肩膀功能障碍有关的情绪困扰。回应的评分范围为0-5或0-10，并根据可能的总得分的百分比进行评分计算（100％表示没有/因肩部功能障碍对生活质量的影响最小）。根据运动或强度范围（对侧肢体在10度以内或强度得分无差异被视为无缺陷）和SANE得分（= 80％比＆ 80％）进行分组，为期3个月。 Alpha设置为p <0.05以声明显着性。结果：本评价确定了50例平均年龄为16岁（范围13.5-18岁）的患者，术后平均随访时间为3.2±0.5个月。从手术前（57±16％）到手术后（74±16％，p <0.001），PASS评分显着提高。尽管对PASS的影响幅度较大（PASS的f = 0.84与quickDASH的f = 0.48），但quickDASH同样显示出改善（27±16之前vs 18±16之后，p = 0.003）。使用quickDASH在3个月时观察到了天花板效应（大于15％，其得分最高）（最高得分为16％），而通过PASS则没有（4％，p = 0.03）。虽然这两种工具都能够区分SANE评分= 80％vs <80％的患者，但有/无运动减少的患者之间quickDASH评分的差异并未达到显着性（p = 0.07，表）。结论：PASS显示了在不产生天花板效应的情况下进行手术干预后，肩部功能有望得到改善。术后3个月，PASS能够区分术后结局不同的患者。 PASS QuickDASH运动/强度降低否80±14％14±15是68±15％22±15 p 0.04 0.07效果大小f 0.44 0.28 SANE得分≥80％82±16％12±17＆ 80％65±11％ 25±14 p 0.001 0.026效应大小f 0.63 0.42 *效应大小f指数;小= 0.10，中= 0.25，大= 0.40

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