Development and validation of a sport-specific shoulder score questionnaire for functional fitness and weightlifting athletes.

Background: So-called scores are a frequently used evaluation system in clinical examinations to assess the function or limitations of a joint such as the shoulder. However, research indicates that these general scores often have limited validity for specific patient groups, such as athletes. Known as a demanding patient population, athletes have unique needs. We address this by introducing a sport-specific shoulder score questionnaire developed specifically for functional fitness and weightlifting populations.

Methods: Utilizing MRIs (magnet resonance imaging) and clinical examinations from a group of 51 athletes in the functional fitness and weightlifting field who are experiencing shoulder pain, we initially validated a sport-specific score system. With these data and an approach via PCA (principal component analyze), the weights for the questionnaire were calculated, Later, we conducted clinical examinations and interviews with 92 athletes from the same field, comprising both athletes with no clinical issues and athletes with shoulder pain. With the help of the N.=92 individuals, we validated the questionnaire and adjusted the weighting of the questions where necessary. The principle of the PCA was to show which questions were most frequently answered with a high score by those athletes with structural damage in the MRI or positive clinical tests.

Results: A total of 143 athletes were analyzed, all having undergone clinical examinations with a primary focus on rotator cuff and long head of the biceps (LHB) pathologies, as well as glenohumeral instability. In N.=51 an additional MRI was available. The sensitivity was found to be 89%, precision was 67%, and specificity was 42%. The calculated F1 score was 0.76. The scoring threshold for the questionnaire was set at 22 out of 100.

Conclusions: This score offers a cost-effective, risk-free tool for identifying shoulder pathologies in weightlifting athletes, boasting a high sensitivity of 89%. It is intended to be an extension of existing score questionnaires that are more focused on a specific, very demanding patient population such as weightlifting and functional fitness athletes.