Summary

4-DOMAIN PROM TAILORED FOR ORTHOPEDIC SPORTS MEDICINE

Abstract

Background

Patient reported outcome measures (PROMs) have come to the forefront in the evaluation of outcomes of treatment for musculoskeletal ailments. Although different PROMs have been validated and used in clinical practice, it is essential to realize that there is a clear void of a PROM designed for the field of sports medicine. The adequate assessment of the outcomes requires suitable tools to collect data on the treatment received from the patient's point of view, especially in athletes and physically active individuals that have physical expectations and psychological goals that differ from general populations. Moreover, physical needs in sports may vary according to each sports dynamics and consequently the pattern and type of musculoskeletal injury may also differ. In this context, we considered that the properties of PROMs should be defined according to the target patients.

Objective

to validate a 4-domain questionnaire tailored for Orthopedic Sports Medicine considering the evaluated clinical conditions such as pre-injury and post-injury status, patient’s expectations of treatment and their evaluations of post-operative care and end-results.

Methods

The validation of a 4-domain PROM tailored for Orthopedic Sports Medicine was carried out through an item generation, item scaling, validity and reliability testing, statistical analysis, item reduction. Conbrach's alpha was used to verify item homogeneity, i.e. their accuracy or consistency. The data were obtained from four groups of 25 patients each. Group 1 consisted of patients who had undergone surgery because of pathologies of the foot and ankle; Group 2 hip pathologies; Group 3 knee pathologies and Group 4 shoulder and elbow. For the statistical analysis, descriptive statistics was calculated with mean values, standard deviation, minimum and maximum and median values. Fisher's exact test was used to analyze categorical variables and questionnaire responses. For the binary variables, Mann-Whitney and Kruskal-Wallis tests were used, in addition to Spearman correlation coefficient.

Conclusion

This PROM showed acceptable statistical accuracy, clinical applicability, and reproducibility for a variety of surgical treatments, regardless of the anatomical injury sites. Additionally, this PROM considers the athletes’ primary physical demands in the non-injured baseline condition, their motivation to continue sports practice and participation, and the influence of sports practice on their quality of life. This 4-domain PROM for Orthopedic Sports Medicine appears to be a valid tool to assess athletes and high-performing practitioners with sports injuries, recording their perception of injury, expectations of treatment; evaluation of postoperative care and treatment received, and perceived outcomes compared to their pre-injury status of physical demands in sports activity. The tool is unique, allowing direct comparisons between athletes’ perception of pre-injury baseline, injury, treatment, and outcome. This PROM tailored for Orthopedic Sports Medicine will be a welcome adjunct to the sports medicine professional’s tool box when assessing athlete’s status and outcome after injury and intervention.