Meaningful Change on the NPRS and SPADI in Subacromial Pain Syndrome

Physical therapists and physical therapist assistants who treat shoulder pain in outpatient settings and who use the numeric pain rating scale or the shoulder pain and disability index to track progress.

Licensed physical therapists and physical therapist assistants in outpatient orthopaedic, sports, and general musculoskeletal practice. Physical therapist assistants work under the direction of a physical therapist; interpretation of outcome measures for evaluation and plan-of-care decisions rests with the supervising physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is based on a single open-access source:

Young I, Dunning J, Escaloni J, Maselli F, Prall J, Mourad F, Fernández-de-las-Peñas C. Reliability, construct validity, responsiveness and minimum clinically important difference of the numeric pain rating scale and shoulder pain and disability index in patients with subacromial pain syndrome. Musculoskeletal Science and Practice. 2025. doi:10.1016/j.msksp.2025.103372. Published under a CC BY license.

The study is a secondary analysis of a North American multicenter randomized clinical trial of two physical therapy interventions for subacromial pain syndrome. Every finding, figure and conclusion presented in this course comes from that source document.

After completing this course, you will be able to:

1. State the change scores on the numeric pain rating scale and the shoulder pain and disability index that this analysis identified as clinically meaningful for "improved" and for "much improved" patients with subacromial pain syndrome.
2. Describe the patients, the treatment setting, and the follow-up point from which these change thresholds were derived, and explain why the authors say the setting matters when a threshold is borrowed.
3. Distinguish minimal detectable change from minimum clinically important difference as the authors used the two concepts, and state which of the thresholds they reported fell outside measurement error.

1. Start Here: course overview, objectives, and how to earn credit
2. Podcast: How Much Change Counts in Subacromial Shoulder Pain (about eight minutes)
3. The Question Behind the Numbers: Why Shoulder Change Scores Vary So Widely
4. Who Was Studied and How Improvement Was Judged
5. The Change Scores Patients Called Meaningful
6. Measurement Error, Wide Estimates, and What the Authors Could Not Settle
7. Carrying These Thresholds Into Outpatient Shoulder Practice
8. Key Takeaways
9. Post-test and course evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course is based on a single open-access source:
2. Young I, Dunning J, Escaloni J, Maselli F, Prall J, Mourad F, Fernández-de-las-Peñas C. Reliability, construct validity, responsiveness and minimum clinically important difference of the numeric pain rating scale and shoulder pain and disability index in patients with subacromial pain syndrome. Musculoskeletal Science and Practice. 2025. doi:10.1016/j.msksp.2025.103372. Published under a CC BY license.
3. The study is a secondary analysis of a North American multicenter randomized clinical trial of two physical therapy interventions for subacromial pain syndrome. Every finding, figure and conclusion presented in this course comes from that source document.