Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Constant score in asymptomatic shoulders varies with different demographic populations: derivation of adjusted score equation

  • Nitesh Gahlot (Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS)) ;
  • Ankit Rai (Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS)) ;
  • Jeshwanth Netaji (Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS))
  • Received : 2022.02.07
  • Accepted : 2022.06.20
  • Published : 2022.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: In the present study, the age- and sex-adjusted Constant score (CS) in a normal Indian population was calculated and any differences with other population cohorts assessed. Methods: The study participants were patients who visited the outpatient department for problems other than shoulder and healthy volunteers from the local population. Patients without shoulder pain/discomfort during activity were included in the study. Subjects with any problem that might affect shoulder function (e.g., cervical, thoracic spine, rib cage deformity, inflammatory arthritis) were excluded. Constant scoring of all participants was performed by trained senior residents under the supervision of the senior faculty. Shoulder range of movement and strength were measured following recommendations given by the research and Development Committee of the European Society for Shoulder and Elbow Surgery (2008). A fixed spring balance was used for strength measurement; one end was fixed on the floor and the other end tied with a strap to the wrist of the participant, arm in 90° abduction in scapular plane with palm facing down. Results: Among the 248 subjects (496 shoulders), the average age was 37 years (range, 18-78 years), 65.7% were males (326 shoulders) and 34.3% females (170 shoulders). The mean CS was 84.6±2.9 (males, 86.1±3.0; females, 81.8±2.9). CS decreased significantly after 50 years of age in males and 40 years of age in females (p<0.05). The mean CS was lower than in previous studies for both males and females. Heavy occupation workers had higher mean CS (p<0.05). A linear standardized equation was estimated for calculating the adjusted CS for any age. Conclusions: Mean CS and its change with age differed from previous studies among various population cohorts.

Keywords

References

  1. Kirkley A, Griffin S, Dainty K. Scoring systems for the functional assessment of the shoulder. Arthroscopy 2003;19:1109-20.
  2. Fialka C, Oberleitner G, Stampfl P, Brannath W, Hexel M, Vecsei V. Modification of the Constant-Murley shoulder score-introduction of the individual relative Constant score individual shoulder assessment. Injury 2005;36:1159-65.
  3. Constant CR, Gerber C, Emery RJ, Sojbjerg JO, Gohlke F, Boileau P. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg 2008;17:355-61.
  4. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987;(214):160-4.
  5. Brinker MR, Cuomo JS, Popham GJ, O'Connor DP, Barrack RL. An examination of bias in shoulder scoring instruments among healthy collegiate and recreational athletes. J Shoulder Elbow Surg 2002;11:463-9.
  6. Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR. Normalization of the Constant score. J Shoulder Elbow Surg 2005;14:279-85.
  7. Tavakkolizadeh A, Ghassemi A, Colegate-Stone T, Latif A, Sinha J. Gender-specific Constant score correction for age. Knee Surg Sports Traumatol Arthrosc 2009;17:529-33.
  8. Yian EH, Ramappa AJ, Arneberg O, Gerber C. The Constant score in normal shoulders. J Shoulder Elbow Surg 2005;14:128-33.
  9. McLean JM, Awwad D, Lisle R, Besanko J, Shivakkumar D, Leith J. An international, multicenter cohort study comparing 6 shoulder clinical scores in an asymptomatic population. J Shoulder Elbow Surg 2018;27:306-14.
  10. Imatani RJ, Hanlon JJ, Cady GW. Acute, complete acromioclavicular separation. J Bone Joint Surg Am 1975;57:328-32.
  11. Bahrs C, Badke A, Rolauffs B, et al. Long-term results after nonplate head-preserving fixation of proximal humeral fractures. Int Orthop 2010;34:883-9.
  12. Steeves JA, Tudor-Locke C, Murphy RA, King GA, Fitzhugh EC, Harris TB. Classification of occupational activity categories using accelerometry: NHANES 2003-2004. Int J Behav Nutr Phys Act 2015;12:89.
  13. Razmjou H, Holtby R, Christakis M, Axelrod T, Richards R. Impact of prosthetic design on clinical and radiologic outcomes of total shoulder arthroplasty: a prospective study. J Shoulder Elbow Surg 2013;22:206-14.
  14. Hirschmann MT, Wind B, Amsler F, Gross T. Reliability of shoulder abduction strength measure for the Constant-Murley score. Clin Orthop Relat Res 2010;468:1565-71.
  15. Kemp KA, Sheps DM, Beaupre LA, Styles-Tripp F, Luciak-Corea C, Balyk R. An evaluation of the responsiveness and discriminant validity of shoulder questionnaires among patients receiving surgical correction of shoulder instability. ScientificWorld-Journal 2012;2012:410125.
  16. Bankes MJ, Crossman JE, Emery RJ. A standard method of shoulder strength measurement for the Constant score with a spring balance. J Shoulder Elbow Surg 1998;7:116-21.
  17. Yun YH, Jeong BJ, Seo MJ, Shin SJ. Simple method of evaluating the range of shoulder motion using body parts. Clin Should Elbow 2015;18:13-20.
  18. Walton MJ, Walton JC, Honorez LA, Harding VF, Wallace WA. A comparison of methods for shoulder strength assessment and analysis of Constant score change in patients aged over fifty years in the United Kingdom. J Shoulder Elbow Surg 2007;16:285-9.
  19. Backman E, Johansson V, Hager B, Sjoblom P, Henriksson KG. Isometric muscle strength and muscular endurance in normal persons aged between 17 and 70 years. Scand J Rehabil Med 1995;27:109-17.
  20. Hughes RE, Johnson ME, O'Driscoll SW, An KN. Age-related changes in normal isometric shoulder strength. Am J Sports Med 1999;27:651-7.