97 CLINICAL OUTCOME AFTER OUTPATIENT REHABILITATION IN NA 5 during endo- and exorotation of the shoulder. Hand grip was measured using a Jamar® Hydraulic Hand dynamometer. Pinch and key grip were measured with a Baseline® LiTE Hydraulic Pinch Gauge. Dynamometry results were measured in Newtons. The Checklist Individual Strength - subscale fatigue (CIS-fatigue) was used to assess experienced fatigue. 49 Scores range from 8 to 56, with a score > 35 indicating severe experienced fatigue. The McGill Pain Questionnaire (MPQ) was used to assess the effect of pain on daily life. 50 It uses visual analogue scales for momentary, minimum and maximum pain. Scores range from 0-100, with higher scores indicating higher pain levels. We used the 3D-reachable workspace as an objective measure of upper extremity active range of motion. It quantifies the relative 3D-surface area representing the portion of a hemisphere that is covered by arm and hand movements during a standardized movement protocol. 56, 188 Scores range from 0 to 1, divided over 4 quadrants, with higher scores indicating greater active range of motion. Activities The Dutch version of the Disability of Arm, Shoulder and Hand (DASH-DLV) questionnaire189 was used to assess the capability of the affected upper extremity. The DASH has been used and validated in multiple disorders of the upper extremity. 190 Scores range from 0 to 100, with higher scores indicating more impairment. Participation The Utrecht Scale for Evaluation of Rehabilitation Participation (USER-P) was used to evaluate the effect of our MR on social participation in daily activities. 54 The USER-P has four subscales: 1A) time spent on work, education and household; 1B) frequencies of performed activities; 2) restrictions; and 3) satisfaction with current daily life activities. Scores per subscale range from 0 to 100, with higher scores indicating more frequent participation (subscale 1A and 1B), less restrictions (2), or greater satisfaction (3). Personal factors The Self-Efficacy for Performing Energy Conservation Strategies Assessment (SEPECSA) tool was used to assess how patients perceived their ability to apply energy conservation strategies in daily life. 51 Scores range from 1 to 10, with higher scores indicating higher confidence or higher self-efficacy in managing energy conservation. Finally, the Pain Self-Efficacy Questionnaire (PSEQ) was used to assess the confidence that people had in performing activities while being in pain. 52 Scores range from 0 to 60, with higher scores indicating higher confidence or higher self-efficacy in being active even in the presence of pain. Study procedure Outcome assessments inbothgroupsweredoneeither by self-report or by a single assessor (RL), not involved in administering the MR. Outcome assessments were completed at baseline (T0), after the initial MR or UC period (T1, 18 weeks after start MR and post baseline), and- for the UC group only- after a second period in which they received the
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