The Western Ontario osteoarthritis of the shoulder index WOOS [80

The purpose was to develop and validate a disease-specific quality of life measurement tool for osteoarthritis (OA) of the shoulder.

An Instrument which could be used as the primary outcome measure in clinical trials involving patients with OA of the shoulder was developed using a specific methodological protocol: (1) identification of a specific patient population; (2) item generation; (3) item reduction; (4) pretesting of the prototype questionnaire and (5) determining the validity reliability and responsiveness of the final questionnaire.

The final instrument has 19 items, representing the four domains (six questions for pain and physical symptoms, five questions for sport, recreation and work function, five questions for lifestyle function and three questions for emotional function (Fig. 86). The response time is approximately 10 min.

In the final instrument, each question has a possible score from 0100 (100 mm VAS) and is not multiplied by any factor because of the equal weighting. These scores are added to give a total score of 1900.

The highest or most symptomatic score is 1900 and the best or asymptomatic score is 0. In order to present this in a clinically more meaningful format, the score can be reported as a percentage of normal by subtracting the total from 1900, dividing by 1900 and multiplying by 100. As an example, a patient with a total score of 450 would have a percentage score of

1900

The instrument contains specific instructions to be read by the subjects prior to beginning and a supplement to the instrument may be referred to if patients are unsure of the meaning of any question. The instrument also has specific instructions to the clinician on how it should be scored. These features allow for a more consistent presentation to all subjects and evaluations can be done by mail when necessary. Thus, results using this measurement tool may be compared between centres.

The WOOS is a rigorously designed measurement tool for patients with OA of the shoulder that is valid, reliable and highly responsive. Since the patient's own perception of changes in health status is the most important indicator of the success of treatment, we suggest that this measurement tool may be used as the primary outcome in clinical trials of treatments in this patient population. Its properties also allow it to be used in the clinical setting.

SECTION A: Physical Symptoms INSTRUCTIONS TO PATIENTS

The following questions concern the physical symptoms you have experienced due to your shoulder problem. In all cases, please enter the amount of the symptom you have experienced in the last week. (Please mark your answers with a slash T)

1. How much pain do you experience in your shoulder with movement?

SECTION B:

Sports/Recreation/Work INSTRUCTIONS TO PATIENTS

The following section concerns how your shoulder problem has affected your sports or recreational activities in the past week. (Please mark your answers with a slash 7.

7. How much difficulty do you experience working or reaching above shoulder level?

no extreme pain pain

2. How much constant, nagging pain do you have in your shoulder?

no extreme pain pain

3. How much weakness do you experience in your shoulder?

extreme weakness

4. How much stiffness do you experience in your shoulder?

difficulty extreme difficulty

How much difficulty do you experience with lifting objects (e.g. grocery bags, garbage can etc.) below shoulder level?

difficulty extreme difficulty

9. How much difficulty do you experience doing repetitive motions below shoulder level such as raking, sweeping or washing floors because of your shoulder?

extreme stiffness

5. How much grinding do you experience in your shoulder?

difficulty extreme difficulty

10. How much difficulty do you experience pushing or pulling forcefully because of your shoulder?

6. How much is your shoulder affected by the weather?

not affected extreme affected difficulty extreme difficulty

11. How troubled are you by an increase in pain in your shoulder after activities?

extremely troubled

Fig. 86. The Western Ontario Osteoarthritis of the Shoulder (WOOS)

SECTION C: Lifestyle INSTRUCTIONS TO PATIENTS

The following section concerns the amount that your shoulder problem has affected or changed your lifestyle. Again, please indicate the appropriate amount for the past week with a slash "/"

12. How much difficulty do you have sleeping because of your shoulder?

SECTION D: Emotions INSTRUCTIONS TO PATIENTS

The following questions relate to how you have felt in the past week with regard to your shoulder problem. Please indicate your answer with a slash "/"

17. How much frustration or discouragement do you feel because of your shoulder?

no extreme difficulty difficulty

13. How much difficulty have you experienced with styling your hair because of your shoulder?

no extreme frustration frustration

18. How worried are you about what will happen to your shoulder in the future?

difficulty extreme difficulty

14. How much difficulty do you have maintaining your desired level of fitness because of your shoulder?

difficulty

15. How much difficulty do you experience reaching behind to tuck in a shirt, get a wallet from your back pocket or do up clothing because of your shoulder?

not worried at all extremely worried extreme difficulty

19. How much of a burden do you feel your are on others not at all extreme burden no extreme difficulty difficulty

16. How much difficulty do you have dressing or undressing?

no extreme difficulty difficulty

Osteoarthritis

Osteoarthritis

Thank you for deciding to learn more about the disorder, Osteoarthritis. Inside these pages, you will learn what it is, who is most at risk for developing it, what causes it, and some treatment plans to help those that do have it feel better. While there is no definitive “cure” for Osteoarthritis, there are ways in which individuals can improve their quality of life and change the discomfort level to one that can be tolerated on a daily basis.

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