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Reliability and Construct Validity of the ADAP Shoulder Scale in Individuals with Proximal Humerus Fracture

Grant number: 24/00285-0
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): April 01, 2024
Effective date (End): March 31, 2025
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Anamaria Siriani de Oliveira
Grantee:Júlia da Silva Fraga
Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil


Introduction: Proximal humerus fracture significantly impacts individuals' quality of life by compromising the functionality of the upper limb. Individuals often exhibit apprehension in returning to routine activities, fostering avoidance behavior. The Avoidance Daily Activities Photo Scale (ADAP Shoulder Scale) was developed to assess avoidance behavior in individuals with chronic shoulder pain. However, its reliability has not been evaluated in individuals with proximal humerus fracture. Objective: This study aims to (1) analyze inter-examiner reliability and (2) examine the construct validity of the ADAP Shoulder Scale in individuals with proximal humerus fracture. Methods: The project will undergo review by the local ethics committee. All individuals will sign the Informed Consent Form. Thirty three individuals with proximal humerus fracture within a maximum of 12 months of injury, of both genders, and aged over 18 years will participate. Exclusion criteria include other shoulder fractures or injuries, nerve injuries at the time of proximal humerus fracture, and individuals with systemic or neurological diseases. Examiner 1 will randomly apply the ADAP Shoulder Scale, The Shoulder Pain and Disability Index (SPADI), Tampa Scale of Kinesiophobia (TSK), Patient Health Questionnaire (PHQ-9), and The Pain Catastrophizing Scale (PCS). After 10 minutes, examiner 2 will administer the ADAP Shoulder Scale for inter-examiner analysis. Statistical Analysis: Inter-examiner reliability will be analyzed using the Intraclass Correlation Coefficient (ICC2,1) with a 95% confidence interval. The Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) will be calculated for inter-examiner analysis. Construct validity will be assessed by correlating ADAP Shoulder Scale measures with SPADI, TSK, PHQ-9, and PCS scores from the initial assessment using Pearson or Spearman correlation coefficients.

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