Shoulder Performance Activity Test (SPAT) for People With Shoulder Pain: Feasibility, Reliability, and Validity

Introduction Shoulder pain is a common cause of musculoskeletal complaints, (1-3) impacting daily home and work activities (4-6) and overall quality of life. (2) A broad range of patient-reported outcome [...]
Objective. The purpose of this study was to assess feasibility, reliability, and validity of a new performance-based test, the Shoulder Performance Activity Test (SPAT). Methods. People with shoulder pain (n = 93) and without shoulder pain (n = 43) were included. The SPAT consists of overhead reach, hand behind head, and hand behind back tasks, each performed with 20 repetitions and rated by time, pain, and effort. The SPAT scores were summed for time, pain, and effort, and a total score across the 3 tasks. Feasibility was assessed by the percentage of SPAT task completion, test-retest reliability by intraclass correlation coefficient (ICC), standard error measurement, minimal detectable change, and known-groups construct validity by comparing between groups (shoulder pain and no pain) and between shoulders in those with pain. Results. All participants performed the 3 SPAT tasks. The ICC was 0.74-0.91, and the minimal detectable change was 3.1-4.7 for task scores and 10.0 points for the total score. Individuals with pain presented higher tasks and total scores compared with those without pain. The moderate/severe pain group had higher scores than the low pain and no shoulder pain groups, and the low pain group had higher scores than the no pain group. Scores were higher in the involved shoulder compared with the uninvolved shoulder. Conclusion. The SPAT is a feasible and reliable performance-based test for use in patients with shoulder pain and can differentiate between individuals with and without pain, among different levels of pain, and between involved and uninvolved shoulders. Impact. The SPAT provides a standardized method for clinicians to assess shoulder functional performance tasks, which can enable a comprehensive assessment of shoulder disability and clinical decision making. The error metrics can be used to determine meaningful changes in performance. Keywords: Patient Outcome Assessment, Functional Performance, Shoulder, Outcome Measures, Validation Study