Avaliação da responsividade do Shoulder Performance Activity Test (SPAT) em indivíduos com tendinopatia do manguito rotador submetidos a um treinamento resistido

Abstract

Objective: To assess the responsiveness of the Shoulder Performance Activity Test (SPAT) in individuals with rotator cuff tendinopathy undergoing resisted training for shoulder complex muscles. Methods: Twenty-two individuals (42.0 ± 11.5 years, 27.8 ± 4.1 kg/m2, 17 women, and five men) with rotator cuff tendinopathy, participants in a randomized clinical trial, were included in this study. Before and after a 6-week protocol of shoulder complex muscle strengthening, individuals were evaluated for self-reported function using the Penn Shoulder Score and shoulder functional performance using the SPAT. The SPAT involves performing 20 repetitions of reaching overhead, placing the hand behind the head, and behind the back. The performance of each task is assessed for time, pain, and effort. The score for each task is the sum of time, pain, and effort, and the total score is the sum of the three scores. A comparison between the two assessments was made for the total score of the Penn Shoulder Score and pain during activities of daily living, and only individuals who showed improvements above the minimum detectable change in these measures were included in the responsiveness analysis. The responsiveness of the SPAT was assessed by comparing the assessments using paired t-tests or Wilcoxon tests, the Standardized Response Mean (SRM), and the effect size by Cohen's D. SRM and effect size values can be interpreted as high when > 0.80. The Spearman correlation coefficient (rho) was used to quantify the direction and strength of the relationship between the mean pre and post-intervention differences in SPAT and Penn total scores pre and post-intervention. All tests were performed considering significance at p<0.05. Results: There was a decrease in the total SPAT score, as well as in each of the tasks. The SRM and effect size were high (>0.8) for all variables. A moderate negative correlation (0.42), however, not significant (p=0.053), was observed regarding the magnitude of change in scores between SPAT and Penn after the intervention. Conclusion: The SPAT demonstrated high responsiveness, being able to detect changes in functional performance in individuals with rotator cuff tendinopathy who show improvement in pain and self-reported function after a resisted training protocol for shoulder complex muscles.