Rocio Aldon-Villegas

Background/Objectives: The aim of this study was to cross-culturally adapt to Spanish and to analyze the psychometric properties of Fulkerson Knee Instability Scale in Patellofemoral Pain. Methods: A Cross-cultural adaptation and validation study has been carried out following the recommendations of COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN). The sample consisted of seventy-five Spanish subjects with Patellofemoral Pain, implying 106 affected knees. Cross-cultural adaptation involved both cultural and linguistic adaptation of the Fulkerson Knee Instability Scale. Psychometric properties evaluated were: validity (construct and external), reliability (internal consistency, test-retest and agreement), discriminant ability and feasibility. Results: Construct validity showed strong correlation between Fulkerson Scale and both Knee injury and Osteoarthritis Outcome Score for Patellofemoral pain and osteoarthritis (r=0.83) and Kujala Patellofemoral Score (r=0.79). Correlation coefficients assessing discriminant validity between Fulkerson and descriptive data were all r90% of the cases were within the limits of agreement. No floor or ceiling effects were found. Assessing feasibility, Fulkerson was understandable in general and completed by all participants. Conclusions: The Spanish version of Fulkerson Knee Instability Scale is a valid, reliable and feasible functional assessment tool for Spanish subjects with patellofemoral pain according to its psychometric properties.

Background: The important functional role the rotator cuff (RC) and biceps play in the shoulder, the close anatomical relationship between them and the high incidence of injuries require an appropriate multidisciplinary therapeutic approach after a rigorous assessment. The objective is to identify and analyze surgical interventions, whether or not followed by a postsurgical one, of associated dysfunctions on the RC and long head of the biceps (LHB) and their effectiveness in improving shoulder functionality.Methods: A systematic review based on PRISMA protocol was conducted using PubMed, Web of Science, PEDro, Scopus, CINAHL, and Dialnet until 22 April 2021. The main inclusion criteria were as follows: randomized clinical trials including subjects diagnosed with RC and LHB lesions who had surgical and/not post-surgical treatments. The methodological quality of trials was evaluated by the PEDro scale. Data were shown in 3 pre-established tables: (1)sample data, diagnostic methods, dysfunctions and injury frequency, interventions, outcome measures and results; (2)significance and effectiveness of interventions; and (3)comparison of the effectiveness of interventions.Results: Eleven studies were selected. The methodological quality of ten of them was assessed asgoodand oneexcellent(PEDro scale). All articles had surgical treatments and ten had postoperative management. All trials used arthroscopy and two open surgery too. Single-row, double-row and transosseous repair were used for RC lesions, while SLAP repair, tenotomy, and tenodesis were applied to LHB injuries. Measured parameters were functionality, pain, Popeye’s sign, strength, range of motion, satisfaction degree, biceps cramping, and quality of life. All approaches in general, surgical plus postsurgical, were always effective to the parameters measured in each study. Seven trials compared tenotomy and tenodesis: four of them obtained statistically significant differences in favor of tenodesis in Popeye’s sign, cramping, satisfaction degree, and/or forearm supination strength; and one, in favor of tenotomy in cramping. All studies measured functionality using functional assessment scales. The most widely used was the Constant Score.Conclusions: Surgical plus post-surgical interventions in associated dysfunctions on RC and LHB were effective. Tenodesis obtained better results than tenotomy in Popeye’s sign, satisfaction, and forearm supination strength. However, there was no difference regarding biceps cramping.

The objective of this review was to compile validated functional shoulder assessment tools and analyse the methodological quality of their validations. Secondarily, we aimed to provide a comparison of the tools, including parameter descriptions, indications/applications, languages and operating instructions, to choose the most suitable for future clinical and research approaches. A systematic review (PRISMA) was conducted using: PubMed, WoS Scopus, CINHAL, Dialnet and reference lists until 2020. The main criteria for inclusion were that papers were original studies of validated tools or validation studies. Pre-established tables showed tools, validations, items/components, etc. The QUADAS-2 and COSMIN-RB were used to assess the methodological quality of validations. Ultimately, 85 studies were selected, 32 tools and 111 validations. Risk of bias scored lower than applicability, and patient selection got the best scores (QUADAS-2). Internal consistency had the highest quality and PROMs development the lowest (COSMIN-RB). Responsiveness was the most analysed metric property. Modified UCLA and SST obtained the highest quality in shoulder instability surgery, and SPADI in pain. The most approached topic was activities of daily living (81%). We compiled 32 validated functional shoulder assessment tools, and conducted an analysis of the methodological quality of 111 validations associated with them. Modified UCLA and SST showed the highest methodological quality in instability surgery and SPADI in pain.