Assessing musculoskeletal complaints in para-athletes: A systematic review and critical appraisal of available Patient-Reported Outcome Measure

Abstract

Objective: To identify the available Patient-reported Outcome Measures (PROMs) for assessing musculoskeletal complaints in para-athletes and to evaluate their psychometric properties, ultimately providing recommenda tions for their use. Methods: PubMed, Embase, Scopus, Cochrane Library, Web of Science, ProQuest, and COSMIN Database were searched until October 2024. Full report studies evaluating psychometric properties of PROMs in para-sport participants with musculoskeletal pain were included. The methodology followed the Consensus-based Stan dards for selection of Health Measurement Instruments (COSMIN) and PRISMA-COSMIN for OMIs 2024 Guidelines. Results: Six articles reported information on Wheelchair User's Shoulder Pain Index (WUSPI); Shoulder Pain Scale for Wheelchair Basketball (SPS-WB); and, Shoulder Pain Index for Wheelchair Basketball (SPI-WB). Content validity was inconsistent for WUSPI and SPS-WB. Structural validity was indeterminate for SPS-WB. Internal consistency was sufficient for SPS-WB but indeterminate for WUSPI and SPI-WB. Reliability was sufficient for WUSPI and SPI-WB. Convergent validity was sufficient for WUSPI but indeterminate for SPS-WB and SPI-WB. Discriminative validity was insufficient for WUSPI and SPI-WB and indeterminate for SPS-WB. Conclusions: Evidence on PROMs for musculoskeletal complaints in para-sports focuses on shoulder pain in wheelchair basketball, showing low to very low-quality evidence. The WUSPI and SPS-WB can be used considering their limitations