When a dislocation occurs, the restraining structures of the joint are injured. The minimal clinically important difference mcid is the threshold value for a change that would be considered meaningful by the patient. The responsiveness and minimal important change of the. Shoulder instability shoulder at advanced orthopedic. The objective is to study the cultural adaptation, validity, and reliability of wosi in turkish population with shoulder disability. The western ontario shoulder instability index wosi is a patientreported outcome measure for patients with shoulder instability. New york shoulder injury medical treatment guidelines. If you continue browsing the site, you agree to the use of cookies on this website.
There is a wide spectrum of this, from subluxation the humerus slides off the glenoid, but not completely to dislocation the humerus completely slides off the glenoid and then gets stuck in that abnormal position. Shoulder instability is a common shoulder problem, and regularly seen by therapists, surgeons, sports doctors and emergency clinicians. Impingement instability differentiation physiopedia. Save when shoulder muscles, tendons, and ligaments no longer secure the shoulder joint, the top of the upper arm bone can. Also, household or occupational trauma such as falling down the stairs, falling from a height, or falling off a bicycle can cause shoulder instability. The most common cause of shoulder instability is trauma. Methods one hundred five consecutive patients with shoulder instability completed 5 proms at baseline and at 6month followup.
Shoulder instability can occur following a traumatic accident such as a fall or collision with another athlete or object. The development and evaluation of a diseasespecific quality of life measurement tool for shoulder instability. A comparison of primary and revision surgery in press ajsm 2018 images. The ball and socket joint of the shoulder is held together by ligaments, muscles and bones. To evaluate the responsiveness of the western ontario shoulder instability index wosi and the oxford shoulder instability score osis and estimate their minimal important change mic. When the shoulder is loose and slips out of place repeatedly, it is called chronic shoulder instability. The western ontario shoulder instability index wosi the wosi score instrument kirkley et al. The patient is asked to grade the function of a specific item on a horizontal visual analog scale from 0 to 100 mm.
The exercises may be suggested for a condition or for rehabilitation. There were 28 women and 17 men and mean age was 27 2142 years. Development of a shoulder pain and disability index. Pdf western ontario shoulder instability index wosi. Shoulder instability massachusetts general hospital. This commonly happens when the hand is raised above the head. Shoulder instability, characterized by subluxation or dislocation of the glenohumeral joint, is an increasingly recognized problem in young athletes, although its incidence is difficult to determine. A subluxation occurs when the humerus comes partly out of the socket and then slips back in. Write it into the space provided for that question. Western ontario shoulder instability index wosi is a subjective selfreport scale indicating the latest condition of the patients with shoulder instability.
Its management can be complex and multidiciplinary. Common causes of shoulder instability paramus, nj high. Once a shoulder has dislocated, it is vulnerable to repeat episodes. Westermann, md, moon shoulder instability group, brian r. One way to measure the effectiveness of a specific treatment is to utilize measurements designed specifically for the disorder. This can happen as a result of a sudden injury or from overuse. Roach ke, budimanmak e, songsiridej n, lertratanakul y. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Shoulder instability frozen shoulder cleveland clinic. When the shoulder slips, but does not dislocate, or come completely out of the socket, it is called subluxation. The western ontario shoulder instability index wosi 70. Measurement properties of the western ontario shoulder. Shoulder pain remains one of the main reasons to consult a physician or physiotherapist today, with up to onequarter of the western population reporting a shoulder problem at any one time.
Diagnosing shoulder instability involves a physical exam, followed by xrays or an mri to rule out any other possible causes for the pain and discomfort. When these structures become over stretched or injured, the shoulder becomes unstable. Athletes who engage in contact sports like football, rugby or lacrosse are at a greater risk for shoulder instability. Shoulder instability is when your shoulder is especially prone. The western ontario shoulder instability index wosi questionnaire is a diseasespecific selfevaluated measurement tool used for patients with shoulder instability. Concise description on shoulder instability to understand. Background and purpose the wosi score questionnaire is a tool designed for selfassessment of shoulder function for patients with instability problems. During the last three months, how much has the problem with your shoulder interfered with your social.
Sometimes individuals can achieve this on their own. We tested the oxford instability shoulder score oiss range 12 to 60, the western ontario shoulder instability index wosi 0 to 2100, and the euroqol. These factors were integrated in a 10point preoperative instability severity index score and tested retrospectively on the same population. Pdf outcome assessment after orthopaedic interventions is becoming more and more important.
The western ontario shoulder instability index wosi is a welldesigned, thoroughly evaluated questionnaire that has proved to be reliable, valid, and sensitive to changes that are of clinical importance to canadian patients with shoulder instability, leading to international acceptance. Shoulder instability occurs whenever the humerus the ball of the shoulder joint pops out of the glenoid the socket. Instability of the shoulder has symptoms that are often intermittent and characterized less by pain than by the anticipation of problems arising in association with certain activities 1. Measure the distance from the left side of the line and calculate the score out of 100 recorded t the nearest 0. A shoulder dislocation is an example of shoulder instability, which is when the top of the upper arm bone comes out of the shoulders socket. Pdf the western ontario shoulder instability index wosi. In this section we present some useful information to assist clinicians and scoring systems that might be of benefit. During the last six months, how many times has your shoulder slipped out of joint or dislocated. We made a translation into swedish and retested the score by analyzing the psychometric properties v.
Evaluation of oxford instability shoulder score, western ontario shoulder instability index and euroqol in patients with slap superior labral anterior posterior lesions or recurrent anterior dislocations of the shoulder. Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. Western ontario shoulder instability index rehabmeasures. The purpose of this study was to determine the mcids for the rowe score and the western ontario shoulder instability index wosi score after arthroscopic repair of anterior shoulder instability. Clinicians name or ref patients name or ref please answer the following 12 multiple choice questions. It is important that the shoulder be reduced, or put back in the socket. The western ontario shoulder instability index wosi clinicians name or ref patients name or ref the following questions concern the symptoms you have experienced due to your shoulder problem.
Shoulder instability in young athletes american family. Here are some examples of exercises for you to try. Evaluation of oxford instability shoulder score, western. The western ontario shoulder instability index wosi the following questions concern the physical symptoms you have experienced, how your shoulder has affected your work, sports or recreational activities, the amount that your shoulder has affected or changed your lifestyle, and your emotions with regards to your shoulder. A simple preoperative score to select patients for arthroscopic or open shoulder stabilisation. Western ontario rotator cuff worc index physiopedia. The shoulder is a ball and socket joint made up of the head of the humerus arm bone and the glenoid cavity of the scapula shoulder blade. New york state workers compensation board new york shoulder injury medical treatment guidelines third edition, september 15, 2014 ii red flags10 followup diagnostic imagingtesting10 specific diagnoses, testing and treatment. The wosi western ontario shoulder instability index is a selfadministered quality of life questionnaire designed to be used as a primary outcome measure in clinical trials on shoulder. Because the shoulder joint is the most mobile joint in the body, its also the joint that is the most unstable. The western ontario shoulder instability index wosi is a questionnaire designed to measure healthrelated quality of life in patients with shoulder instability. Wolf, md ms university of iowa hospitals and clinics bone loss epidemiology the incidence of glenohumeral bone and cartilage lesions at the time of shoulder instability surgery. Treatment for shoulder instability includes antiinflammatory medications and physical therapy to strengthen the.
The most common cause of shoulder instability is impact trauma. The western ontario shoulder instability index wosi the wosi score instrument kirkley et. Rehabilitation aims to enhance the dynamic muscular and proprioceptive restraints to shoulder instability. Shoulder instability usually occurs when the lining of the shoulder joint the capsule, ligaments or labrum become stretched, torn or detached, allowing the ball of the shoulder joint humeral head to move either completely or partially out of the socket. Minimal clinically important differences in rowe and. The goal of our study was to translate and test the western ontario shoulder instability index.
Shoulder instability is most commonly caused by two different problems, placing people into two different categories in. It can also occur without significant trauma or injury, and this type of shoulder instability is more common in people who are exceptionally flexible with loose joints or connective tissue problems such as ehlers danlos. The above table represents a cluster to help rule in favor of an anterior shoulder instability diagnosis. Shoulder instability occurs when the head of the upper arm bone in forced out of the shoulder socket. With positive results of any 2 tests or more, you can be fairly confident ruling. The purpose of this study was to evaluate the reliability and validity of the wosi japanese version for the japanese population. Current concepts for evaluation and this information is current as of december 2, 2010 reprints and permissions permissions link. You will be told when to start these exercises and which ones will work best for you.
Shoulder instability brisbane knee and shoulder clinic. Western ontario shoulder instability index wosi pro. The western ontario shoulder instability index wosi strument, the western ontario shoulder instability index wosi, was designed to be used as the primary outcome measure in clinical trials evaluating treatments for patients with shoulder instability. Developed in 1988, specifically for use in shoulder instability, the western ontario shoulder instability index wosi is a validated pro measure. The western ontario shoulder instability index wosi. When the capsule tears from the glenoid rim, the shoulder can become unstable and dislocate or subluxate repeatedly.