Skip to main content
Log in

Instruments to assess patients with rotator cuff pathology: a systematic review of measurement properties

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aims of this study were to obtain an overview of the methodological quality of studies on the measurement properties of rotator cuff questionnaires and to describe how well various aspects of the design and statistical analyses of studies on measurement properties are performed.

Methods

A systematic review of published studies on the measurement properties of rotator cuff questionnaires was performed. Two investigators independently rated the quality of the studies using the Consensus-based Standards for the selection of health Measurement Instruments checklist. This checklist was developed in an international Delphi consensus study.

Results

Sixteen studies were included, in which two measurement instruments were evaluated, namely the Western Ontario Rotator Cuff Index and the Rotator Cuff Quality-of-Life Measure. The methodological quality of the included studies was adequate on some properties (construct validity, reliability, responsiveness, internal consistency, and translation) but need to be improved on other aspects. The most important methodological aspects that need to be developed are as follows: measurement error, content validity, structural validity, cross-cultural validity, criterion validity, and interpretability.

Conclusion

Considering the importance of adequate measurement properties, it is concluded that, in the field of rotator cuff pathology, there is room for improvement in the methodological quality of studies measurement properties.

Level of evidence

II.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bullinger M, Alonso J, Apolone G, Leplege A, Sullivan M, Wood-Dauphinee S, Gandek B, Wagner A, Aaronson N, Bech P, Fukuhara S, Kaasa S, Ware JE Jr (1998) Translating health status questionnaires and evaluating their quality: the IQOLA project approach. International quality of life assessment. J Clin Epidemiol 51:913–923

    Article  PubMed  CAS  Google Scholar 

  2. Bunker T (2002) Rotator cuff disease. Curr Orthop 16:223–233

    Article  Google Scholar 

  3. Castricini R, Longo UG, De Benedetto M, Panfoli N, Pirani P, Zini R, Maffulli N, Denaro V (2011) Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial. Am J Sports Med 39:258–265

    Article  PubMed  Google Scholar 

  4. de Vet HC, Terwee CB, Knol DL, Bouter LM (2006) When to use agreement versus reliability measures. J Clin Epidemiol 59:1033–1039

    Article  PubMed  Google Scholar 

  5. Denaro V, Ruzzini L, Barnaba SA, Longo UG, Campi S, Maffulli N, Sgambato A (2011) Effect of pulsed electromagnetic fields on human tenocyte cultures from supraspinatus and quadriceps tendons. Am J Phys Med Rehabil 90:119–127

    Article  PubMed  Google Scholar 

  6. Denaro V, Ruzzini L, Longo UG, Franceschi F, De Paola B, Cittadini A, Maffulli N, Sgambato A (2010) Effect of dihydrotestosterone on cultured human tenocytes from intact supraspinatus tendon. Knee Surg Sports Traumatol Arthrosc 18:971–976

    Article  PubMed  Google Scholar 

  7. Ekeberg OM, Bautz-Holter E, Keller A, Tveita EK, Juel NG, Brox JI (2010) A questionnaire found disease-specific WORC index is not more responsive than SPADI and OSS in rotator cuff disease. J Clin Epidemiol 63:575–584

    Article  PubMed  Google Scholar 

  8. Ekeberg OM, Bautz-Holter E, Tveita EK, Keller A, Juel NG, Brox JI (2008) Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease. BMC Musculoskelet Disord 9:68

    Article  PubMed  Google Scholar 

  9. El O, Bircan C, Gulbahar S, Demiral Y, Sahin E, Baydar M, Kizil R, Griffin S, Akalin E (2006) The reliability and validity of the Turkish version of the Western Ontario rotator cuff index. Rheumatol Int 26:1101–1108

    Article  PubMed  Google Scholar 

  10. Franceschi F, Longo UG, Ruzzini L, Papalia R, Rizzello G, Denaro V (2007) To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques. Int Orthop 31:537–545

    Article  PubMed  Google Scholar 

  11. Franceschi F, Longo UG, Ruzzini L, Rizzello G, Denaro V (2007) Arthroscopic management of calcific tendinitis of the subscapularis tendon. Knee Surg Sports Traumatol Arthrosc 15:1482–1485

    Article  PubMed  Google Scholar 

  12. Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2008) Soft tissue tenodesis of the long head of the biceps tendon associated to the Roman Bridge repair. BMC Musculoskelet Disord 9:78

    Article  PubMed  Google Scholar 

  13. Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2007) The Roman bridge: a “double pulley—suture bridges” technique for rotator cuff repair. BMC Musculoskelet Disord 8:123

    Article  PubMed  Google Scholar 

  14. Franceschi F, Ruzzini L, Longo UG, Martina FM, Zobel BB, Maffulli N, Denaro V (2007) Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. Am J Sports Med 35:1254–1260

    Article  PubMed  Google Scholar 

  15. Getahun TY, MacDermid JC, Patterson SD (2000) Concurrent validity of patient rating scales in assessment of outcome after rotator cuff repair. J Musculoskelet Res 4:119–127

    Article  Google Scholar 

  16. Hollinshead RM, Mohtadi NG, Vande Guchte RA, Wadey VM (2000) Two 6-year follow-up studies of large and massive rotator cuff tears: comparison of outcome measures. J Should Elb Surg 9:373–381

    Article  CAS  Google Scholar 

  17. Holtby R, Razmjou H (2005) Measurement properties of the Western Ontario rotator cuff outcome measure: a preliminary report. J Should Elb Surg 14:506–510

    Article  Google Scholar 

  18. Huber W, Hofstaetter JG, Hanslik-Schnabel B, Posch M, Wurnig C (2005) Translation and psychometric testing of the rotator cuff quality-of-life measure (RC-QOL) for use in German-speaking regions. Z Rheumatol 64:188–197

    Article  PubMed  CAS  Google Scholar 

  19. Kirkley A, Alvarez C, Griffin S (2003) The development and evaluation of a disease-specific quality-of-life questionnaire for disorders of the rotator cuff: the Western Ontario rotator cuff index. Clin J Sport Med 13:84–92

    Article  PubMed  Google Scholar 

  20. Koller M, Aaronson NK, Blazeby J, Bottomley A, Dewolf L, Fayers P, Johnson C, Ramage J, Scott N, West K (2007) Translation procedures for standardised quality of life questionnaires: the European Organisation for Research and Treatment of Cancer (EORTC) approach. Eur J Cancer 43:1810–1820

    Article  PubMed  Google Scholar 

  21. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  PubMed  CAS  Google Scholar 

  22. Lippi G, Longo UG, Maffulli N (2010) Genetics and sports. Br Med Bull 93:27–47

    Article  PubMed  Google Scholar 

  23. Longo UG, Berton A, Ahrens PM, Maffulli N, Denaro V (2011) Clinical tests for the diagnosis of rotator cuff disease. Sports Med Arthrosc 19:266–278

    Article  PubMed  Google Scholar 

  24. Longo UG, Berton A, Khan WS, Maffulli N, Denaro V (2011) Histopathology of rotator cuff tears. Sports Med Arthrosc 19:227–236

    Article  PubMed  Google Scholar 

  25. Longo UG, Berton A, Papapietro N, Maffulli N, Denaro V (2012) Biomechanics of the rotator cuff: European perspective. Med Sport Sci 57:10–17

    Article  PubMed  Google Scholar 

  26. Longo UG, Berton A, Papapietro N, Maffulli N, Denaro V (2012) Epidemiology, genetics and biological factors of rotator cuff tears. Med Sport Sci 57:1–9

    Article  PubMed  Google Scholar 

  27. Longo UG, Franceschi F, Berton A, Maffulli N, Droena V (2012) Conservative treatment and rotator cuff tear progression. Med Sport Sci 57:90–99

    Article  PubMed  Google Scholar 

  28. Longo UG, Franceschi F, Loppini M, Maffulli N, Denaro V (2008) Rating systems for evaluation of the elbow. Br Med Bull 87:131–161

    Article  PubMed  Google Scholar 

  29. Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N, Denaro V (2008) Histopathology of the supraspinatus tendon in rotator cuff tears. Am J Sports Med 36:533–538

    Article  PubMed  Google Scholar 

  30. Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N, Forriol F, Denaro V (2007) Light microscopic histology of supraspinatus tendon ruptures. Knee Surg Sports Traumatol Arthrosc 15:1390–1394

    Article  PubMed  Google Scholar 

  31. Longo UG, Franceschi F, Ruzzini L, Spiezia F, Maffulli N, Denaro V (2009) Higher fasting plasma glucose levels within the normoglycaemic range and rotator cuff tears. Br J Sports Med 43:284–287

    Article  PubMed  CAS  Google Scholar 

  32. Longo UG, Franceschi F, Spiezia F, Forriol F, Maffulli N, Denaro V (2010) Triglycerides and total serum cholesterol in rotator cuff tears: do they matter? Br J Sports Med 44:948–951

    Article  PubMed  CAS  Google Scholar 

  33. Longo UG, Franceschi F, Spiezia F, Marinozzi A, Maffulli N, Denaro V (2011) The low-profile Roman bridge technique for knotless double-row repair of the rotator cuff. Arch Orthop Trauma Surg 131:357–361

    Article  PubMed  Google Scholar 

  34. Longo UG, Lamberti A, Maffulli N, Denaro V (2010) Tendon augmentation grafts: a systematic review. Br Med Bull 94:165–188

    Article  PubMed  Google Scholar 

  35. Longo UG, Lamberti A, Maffulli N, Denaro V (2011) Tissue engineered biological augmentation for tendon healing: a systematic review. Br Med Bull 98:31–59

    Article  PubMed  Google Scholar 

  36. Longo UG, Lamberti A, Rizzello G, Maffulli N, Denaro V (2012) Synthetic augmentation in massive rotator cuff tears. Med Sport Sci 57:168–177

    Article  PubMed  Google Scholar 

  37. Longo UG, Loppini M, Denaro L, Maffulli N, Denaro V (2010) Rating scales for low back pain. Br Med Bull 94:81–144

    Article  PubMed  Google Scholar 

  38. Longo UG, Vasta S, Maffulli N, Denaro V (2011) Scoring systems for the functional assessment of patients with rotator cuff pathology. Sports Med Arthrosc 19:310–320

    Article  PubMed  Google Scholar 

  39. Lopes AD, Ciconelli RM, Carrera EF, Griffin S, Faloppa F, Baldy dos Reis F (2009) Comparison of the responsiveness of the Brazilian version of the Western Ontario rotator cuff index (WORC) with DASH, UCLA and SF36 in patients with rotator cuff disorders. Clin Exp Rheumatol 27:758–764

    Google Scholar 

  40. Lopes AD, Ciconelli RM, Carrera EF, Griffin S, Faloppa F, Dos Reis FB (2008) Validity and reliability of the Western Ontario Rotator Cuff Index (WORC) for use in Brazil. Clin J Sport Med 18:266–272

    Article  PubMed  Google Scholar 

  41. Lopes AD, Vilar e Furtado R, Silva CA, Yi LC, Malfatti CA, Araujo SA (2009) Comparison of self-report and interview administration methods based on the Brazilian versions of the Western Ontario rotator cuff index and disabilities of the arm, shoulder and hand questionnaire in patients with rotator cuff disorders. Clinics (Sao Paulo, Brazil) 64:121–125

    Google Scholar 

  42. MacDermid JC, Drosdowech D, Faber K (2006) Responsiveness of self-report scales in patients recovering from rotator cuff surgery. J Should Elb Surg 15:407–414

    Article  Google Scholar 

  43. Maffulli N, Longo UG, Berton A, Loppini M, Denaro V (2011) Biological factors in the pathogenesis of rotator cuff tears. Sports Med Arthrosc 19:194–201

    Article  PubMed  Google Scholar 

  44. Maffulli N, Longo UG, Franceschi F, Rabitti C, Denaro V (2008) Movin and Bonar scores assess the same characteristics of tendon histology. Clin Orthop Relat Res 466:1605–1611

    Article  PubMed  Google Scholar 

  45. Martinelli N, Longo UG, Marinozzi A, Franceschetti E, Costa V, Denaro V (2011) Cross-cultural adaptation and validation with reliability, validity, and responsiveness of the Italian version of the Oxford Hip Score in patients with hip osteoarthritis. Qual Life Res 20:923–929

    Article  PubMed  Google Scholar 

  46. Mokkink LB, Terwee CB, Gibbons E, Stratford PW, Alonso J, Patrick DL, Knol DL, Bouter LM, de Vet HC (2010) Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) checklist. BMC Med Res Methodol 10:82

    Article  PubMed  Google Scholar 

  47. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, Bouter LM, de Vet HC (2010) The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol 10:22

    Article  PubMed  Google Scholar 

  48. Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, Bouter LM, de Vet HC (2006) Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments. BMC Med Res Methodol 6:2

    Article  PubMed  CAS  Google Scholar 

  49. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 19:539–549

    Article  PubMed  Google Scholar 

  50. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737–745

    Article  PubMed  Google Scholar 

  51. Mokkink LB, Terwee CB, Stratford PW, Alonso J, Patrick DL, Riphagen I, Knol DL, Bouter LM, de Vet HC (2009) Evaluation of the methodological quality of systematic reviews of health status measurement instruments. Qual Life Res 18:313–333

    Article  PubMed  Google Scholar 

  52. Mousavi SJ, Hadian MR, Abedi M, Montazeri A (2009) Translation and validation study of the Persian version of the Western Ontario rotator cuff index. Clin Rheumatol 28:293–299

    Article  PubMed  Google Scholar 

  53. Papalia R, Osti L, Leonardi F, Denaro V, Maffulli N (2010) RC-QOL score for rotator cuff pathology: adaptation to Italian. Knee Surg Sports Traumatol Arthrosc 18:1417–1424

    Article  PubMed  Google Scholar 

  54. Poolman RW, Swiontkowski MF, Fairbank JC, Schemitsch EH, Sprague S, de Vet HC (2009) Outcome instruments: rationale for their use. J Bone Joint Surg Am 91(Suppl 3):41–49

    Article  PubMed  Google Scholar 

  55. Razmjou H, Bean A, van Osnabrugge V, MacDermid JC, Holtby R (2006) Cross-sectional and longitudinal construct validity of two rotator cuff disease-specific outcome measures. BMC Musculoskelet Disord 7:26

    Article  PubMed  Google Scholar 

  56. Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, Imbernon E, Goldberg M (2006) Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthr Rheum 55:765–778

    Article  Google Scholar 

  57. Scholtes VA, Terwee CB, Poolman RW (2011) What makes a measurement instrument valid and reliable? Injury 42:236–240

    Article  PubMed  Google Scholar 

  58. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42

    Article  PubMed  Google Scholar 

  59. Terwee CB, Jansma EP, Riphagen II, de Vet HC (2009) Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments. Qual Life Res 18:1115–1123

    Article  PubMed  Google Scholar 

  60. Tseng TY, Dahm P, Poolman RW, Preminger GM, Canales BJ, Montori VM (2008) How to use a systematic literature review and meta-analysis. J Urol 180:1249–1256

    Article  PubMed  Google Scholar 

  61. Wamper KE, Sierevelt IN, Poolman RW, Bhandari M, Haverkamp D (2010) The Harris hip score: do ceiling effects limit its usefulness in orthopedics? Acta Orthop 81:703–707

    Article  PubMed  Google Scholar 

  62. Wessel J, Razmjou H, Mewa Y, Holtby R (2005) The factor validity of the Western Ontario rotator cuff index. BMC Musculoskelet Disord 6:22

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no financial or personal relationships with other people or organisations that could potentially and inappropriately influence (bias) their work and conclusions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Umile Giuseppe Longo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Longo, U.G., Saris, D., Poolman, R.W. et al. Instruments to assess patients with rotator cuff pathology: a systematic review of measurement properties. Knee Surg Sports Traumatol Arthrosc 20, 1961–1970 (2012). https://doi.org/10.1007/s00167-011-1827-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1827-z

Keywords

Navigation