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European Spine Journal

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01-11-2016 | Original Article

Does patient perception of shoulder balance correlate with clinical balance?

Authors: Antonia Matamalas, Juan Bagó, Elisabetta D’Agata, Ferran Pellisé

Published in: European Spine Journal | Issue 11/2016

Abstract

Objective

To evaluate the relationship between radiological, clinical and perceived shoulder balance (ShB) in a sample of non-operated, moderate, idiopathic scoliosis (IS) patients.

Methods

80 patients (85 % women) with a mean age of 20.3 years (SD 8.6, 12–40 years) were included. Mean Cobb angle was 45.9° (SD 12.9, 25.1°–77.2°). All patients had full spine X-ray and a digital photography from the front. To determine clinical ShB, shoulder height angle (SHA) and axilla height angle (AHA) were measured on clinical photographs. Radiological ShB was assessed with the clavicle–rib intersection angle and T1-tilt. Patients also completed different patient-reported outcomes (PRO) instruments: SRS-22, TAPS and Spinal Appearance Questionnaire (SAQ). SAQ included two questions concerning the shoulder area (SAQ-6 = perception and SAQ-13 = expectation) which were used to assess perceived ShB. Patients were divided into two groups: balanced (SHA <3.0°), and imbalanced (SHA ≥3.0°) according to minimal detectable change of SHA. The correlations between variables and mean differences between the two groups were analyzed.

Results

No statistically significant correlations were found between clinical (SHA and AHA) and perceived ShB (SAQ-6), or with PRO scores. 62.5 % of patients were in the “Balanced” group. 46.6 % (14/30) of patients in the clinically imbalanced group (≥3.0°) perceive themselves as totally balanced (score 1 and 2 in SAQ-6), while 10 % (5/50) of patients in the balanced group (SHA <3.0°) perceive themselves as totally imbalanced (score 4 and 5 in SAQ-13). No differences were found between both groups in terms of radiological and perceived ShB, or in PRO scores.

Conclusion

We have not found a significant correlation between clinical/radiological ShB and perceived ShB in non-operated IS patients. It seems that ShB is not a key factor in patient trunk deformity perception. In addition, patient expectations regarding improvement with treatment are not directly related to actual clinical imbalance.

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Title: Does patient perception of shoulder balance correlate with clinical balance?
Authors: Antonia Matamalas
Juan Bagó
Elisabetta D’Agata
Ferran Pellisé
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 11/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3971-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Does patient perception of shoulder balance correlate with clinical balance?

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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