Original Article
The Short, 5-Item Shoulder Instability–Return to Sport After Injury Score Performs as Well as the Longer Version in Predicting Psychological Readiness to Return to Sport

https://doi.org/10.1016/j.arthro.2022.10.010Get rights and content

Purpose

To reduce the length of the Shoulder Instability–Return to Sport After Injury (SIRSI) scale and determine the predictive validity of the short version compared with the original form.

Methods

This study included patients who underwent an arthroscopic Bankart repair or open Latarjet procedure between 2017 and 2019. One group was used for the SIRSI scale-reduction process, and a second group was used to test the predictive validity of the proposed short SIRSI scale. The Cronbach α value was used to evaluate internal consistency. Validity was determined by calculating the Pearson correlation coefficient with the Western Ontario Shoulder Instability Index scale. Predictive validity was assessed using receiver operating characteristic (ROC) curve statistics.

Results

A total of 158 patients participated in the scale-reduction process, and 137 patients participated in the predictive-validation process. The SIRSI scale was successfully reduced to a 5-item scale constructed by 1 underlying factor accounting for 60% of the variance. The short version showed good internal consistency (Cronbach α = 0.82) and was highly correlated with the Western Ontario Shoulder Instability Index scale and the long version. The short SIRSI scores were significantly different between patients who returned to sports and those who did not. The SIRSI scale had excellent predictive ability for return-to-sport outcomes (area under ROC curve of 0.84 for short version [95% confidence interval, 0.7-0.9] and 0.83 for long version [95% confidence interval, 0.7-0.9]).

Conclusions

A valid 5-item, short version of the SIRSI scale was successfully developed in our patient population. The short version was found to be as robust as the long scale for discriminating and predicting return-to-sport outcomes.

Level of Evidence

Level II, prospective cohort study.

Section snippets

Participants

In designing this study, we analyzed patients who had undergone shoulder instability surgery between January 2017 and January 2019 at our institution. All surgical procedures were performed by 3 different surgeons (L.A.R., I.T., and M.R.). This study was divided into 2 parts. First, one group was used for the SIRSI scale-reduction process; then, a second group was used to test the predictive validity of the proposed short SIRSI scale. A computer algorithm was used to randomly assign patients to

Participants

A total of 310 shoulder instability surgical procedures were performed during the study period; of these, 5 did not meet the inclusion criteria and 15 patients were lost to follow-up, leaving a final sample of 295 patients (95.1%). A total of 158 patients (142 male and 16 female patients; mean age, 26.5 years [SD, 10 years]) participated in the scale-reduction process. The second group, comprising 137 patients (123 male and 14 female patients; mean age, 27 years [SD, 10.5 years]) participated

Discussion

This study had 3 main findings: First, we successfully developed and validated a short version of the SIRSI scale consisting of 5 items constructed by 1 underlying factor. Second, the short SIRSI score showed a high correlation with the WOSI score and exhibited good internal consistency. Third, the short SIRSI score successfully predicted return to sports and preinjury sports level results. All around, the short scale was found to be as robust as the long scale for discriminating

Conclusions

A valid 5-item, short version of the SIRSI scale was successfully developed in our patient population. The short version was found to be as robust as the long scale for discriminating and predicting return-to-sport outcomes.

References (35)

  • J.S. Everhart et al.

    Psychological predictors of anterior cruciate ligament reconstruction outcomes: A systematic review

    Knee Surg Sports Traumatol Arthrosc

    (2015)
  • V.K. Tjong et al.

    A qualitative investigation of return to sport after arthroscopic Bankart repair: Beyond stability

    Am J Sports Med

    (2015)
  • L.A. Rossi et al.

    Reasons why athletes do not return to sports after arthroscopic Bankart repair: A comparative study of 208 athletes with minimum 2-year follow-up

    Orthop J Sports Med

    (2021)
  • A. Gerometta et al.

    The Shoulder Instability-Return to Sport after Injury (SIRSI): A valid and reproducible scale to quantify psychological readiness to return to sport after traumatic shoulder instability

    Knee Surg Sports Traumatol Arthrosc

    (2018)
  • M. Olds et al.

    Factor structure of the Shoulder Instability Return to Sport After Injury scale: Performance confidence, reinjury fear and risk, emotions, rehabilitation and surgery

    Am J Sports Med

    (2021)
  • E.T. Hurley et al.

    Arthroscopic Bankart repair versus open Latarjet for first-time dislocators in athletes

    Orthop J Sports Med

    (2021)
  • E.T. Hurley et al.

    Arthroscopic Bankart repair versus open Latarjet for recurrent shoulder instability in athletes

    Orthop J Sports Med

    (2021)
  • Cited by (6)

    See commentary on page 1139

    The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

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