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Shah K.1, Baker T.1, Dingle A.1, Hansmeier T.1, Jimenez M.1, Lopez S.1, Marks D.1, Safford D.1, Sternberg A.1, Turner J.1, McClure P.1
1Arcadia University, Physical Therapy, Glenside, United States
Background: No standard or widely used functional performance test of arm and shoulder function currently exists and functional measures rely on patient self-report instruments.
Purpose: The purpose of this study was to describe the development of the Functional Arm and Shoulder Test (FAST), age-related values and between-session reliability in a group of asymptomatic high-school athletes, young, middle-aged and older adults, and a preliminary group of symptomatic patients with varied shoulder pathologies.
Methods: 140 asymptomatic individuals: 36 high-school athletes (14-18 years), 34 young adults (19-35 years), 37 middle-aged adults (36-65 years), 33 older adults (over 65 years); and 16 symptomatic patients (22-66 years) were included in this study. Initial development of the test was done by reviewing the functional task questions from several widely used shoulder self-report instruments. Three basic constructs emerged that described the functional tasks and were included in the FAST: range of motion (ROM), endurance, and strength. We sought to develop a functional performance test that 1) challenged these factors, 2) was feasible to perform in a clinical environment with no special equipment, and, 3) captured functional tasks common to self-report instruments. It took 5 mins to complete this test on each arm. The Hand to Head and Back (HHB) (ROM task) included alternately touching the hand to back of head and lumbar spine for 30 seconds, the Wall Wash (endurance task) included rotating hand and arm with towel on wall at shoulder height externally (ER) and internally (IR) each for 60 seconds, and the Gallon Lift (strength task) involved lifting a gallon jug of water (US liquid gallon = 3.78 kg) from counter height to a shelf height for 30 seconds. Total repetitions (reps) for each task were noted and total FAST score was calculated. Between-session reliability data was collected 2-14 days apart in asymptomatic (n=85) and symptomatic individuals (n=16).
Results: Mean (95%CI) total FAST scores were higher for young adults (107.9 (102.5-113.4) and middle-aged adults (105.2 (99.1-111.3) as compared to the high-school athletes (89.9 (81.2 98.5)) and older adults (74.5 (65.6-83.5), all groups were significantly different (p 0.05) from each other, except the young and middle-aged adults; for patients mean score for symptomatic side was 100.1 (89.6-110.5). The between-session reliability for the total FAST scores were ICC 0.93 (0.60-0.98, 95%CI), SEM 6.7 and MDC 18.5 reps. The ICC values for individual tasks ranged from 0.800.94.
Conclusion(s): The FAST was sensitive to detect differences in functional performance between age groups, demonstrated excellent between-session reliability, and demonstrated feasibility in a symptomatic patient group.
Implications: Differences often exist between functional performance scores and self-report measures. Development of a feasible and valid test of arm and shoulder function would enhance clinical evaluation and outcome measurement. Further validation of this test in symptomatic patients and comparing functional performance and self-report measures of patients with shoulder dysfunction is warranted.
Funding acknowledgements: None
Topic: Musculoskeletal: peripheral
Ethics approval: This study is approved by the Institutional Review Board (13-11-09, 14-11-13, 14-11-12) at Arcadia university, Glenside, PA.
All authors, affiliations and abstracts have been published as submitted.
