Shoulder pain in primary care - Part 2: Predictors of clinical outcome to 12 months

Mark Laslett, Michael Steele, Wayne Hing, Peter McNair, Angela Cadogan

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)
58 Downloads (Pure)

Abstract

OBJECTIVE: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up.

DESIGN: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months.

PATIENTS: Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9% follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria.

METHODS: Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 and 12 months. Variables associated (p-value ≤ 0.2) were retained for potential inclusion within multiple logistic regression analyses.

RESULTS: Pain not improved by rest, intermittent pain, lower pain intensity with physical tests and absence of subacromial bursa pathology on ultrasound at the 3-week follow-up, constant pain and lower pain intensity with physical tests are predictors of excellent outcomes at the 3-month follow- up. Worse baseline pain and disability, no history of asthma, pain better with rest, better physical functioning, greater fear avoidance, male gender, no history of pain in the opposite shoulder, pain referred below the elbow, sleep disturbed by pain, smaller waist circumference, lower pain intensity with physical tests are factors predictive of excellent outcomes at the 12-month follow-up. Only higher pain intensity with physical tests was associated with a poor clinical outcome.

CONCLUSION: Predictive models for clinical outcomes in primary-care patients with shoulder pain were achieved for excellent clinical outcomes, successfully classifying 70-90% of cases.

Original languageEnglish
Pages (from-to)66-71
Number of pages6
JournalJournal of Rehabilitation Medicine
Volume47
Issue number1
DOIs
Publication statusPublished - Jan 2015

Fingerprint

Shoulder Pain
Primary Health Care
Pain
Logistic Models
Musculoskeletal Manipulations
Exercise Therapy
Waist Circumference
Elbow
Patient Selection
Fear
Adrenal Cortex Hormones
Sleep
Asthma

Cite this

Laslett, Mark ; Steele, Michael ; Hing, Wayne ; McNair, Peter ; Cadogan, Angela. / Shoulder pain in primary care - Part 2 : Predictors of clinical outcome to 12 months. In: Journal of Rehabilitation Medicine. 2015 ; Vol. 47, No. 1. pp. 66-71.
@article{5914ac8aab2a4142a903aebc26f1cfd7,
title = "Shoulder pain in primary care - Part 2: Predictors of clinical outcome to 12 months",
abstract = "OBJECTIVE: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up.DESIGN: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months.PATIENTS: Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9{\%} follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria.METHODS: Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 and 12 months. Variables associated (p-value ≤ 0.2) were retained for potential inclusion within multiple logistic regression analyses.RESULTS: Pain not improved by rest, intermittent pain, lower pain intensity with physical tests and absence of subacromial bursa pathology on ultrasound at the 3-week follow-up, constant pain and lower pain intensity with physical tests are predictors of excellent outcomes at the 3-month follow- up. Worse baseline pain and disability, no history of asthma, pain better with rest, better physical functioning, greater fear avoidance, male gender, no history of pain in the opposite shoulder, pain referred below the elbow, sleep disturbed by pain, smaller waist circumference, lower pain intensity with physical tests are factors predictive of excellent outcomes at the 12-month follow-up. Only higher pain intensity with physical tests was associated with a poor clinical outcome.CONCLUSION: Predictive models for clinical outcomes in primary-care patients with shoulder pain were achieved for excellent clinical outcomes, successfully classifying 70-90{\%} of cases.",
author = "Mark Laslett and Michael Steele and Wayne Hing and Peter McNair and Angela Cadogan",
year = "2015",
month = "1",
doi = "10.2340/16501977-1885",
language = "English",
volume = "47",
pages = "66--71",
journal = "Scandinavian Journal of Rehabilitation Medicine",
issn = "0036-5505",
publisher = "Foundation for Rehabilitation Information",
number = "1",

}

Shoulder pain in primary care - Part 2 : Predictors of clinical outcome to 12 months. / Laslett, Mark; Steele, Michael; Hing, Wayne; McNair, Peter; Cadogan, Angela.

In: Journal of Rehabilitation Medicine, Vol. 47, No. 1, 01.2015, p. 66-71.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Shoulder pain in primary care - Part 2

T2 - Predictors of clinical outcome to 12 months

AU - Laslett, Mark

AU - Steele, Michael

AU - Hing, Wayne

AU - McNair, Peter

AU - Cadogan, Angela

PY - 2015/1

Y1 - 2015/1

N2 - OBJECTIVE: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up.DESIGN: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months.PATIENTS: Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9% follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria.METHODS: Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 and 12 months. Variables associated (p-value ≤ 0.2) were retained for potential inclusion within multiple logistic regression analyses.RESULTS: Pain not improved by rest, intermittent pain, lower pain intensity with physical tests and absence of subacromial bursa pathology on ultrasound at the 3-week follow-up, constant pain and lower pain intensity with physical tests are predictors of excellent outcomes at the 3-month follow- up. Worse baseline pain and disability, no history of asthma, pain better with rest, better physical functioning, greater fear avoidance, male gender, no history of pain in the opposite shoulder, pain referred below the elbow, sleep disturbed by pain, smaller waist circumference, lower pain intensity with physical tests are factors predictive of excellent outcomes at the 12-month follow-up. Only higher pain intensity with physical tests was associated with a poor clinical outcome.CONCLUSION: Predictive models for clinical outcomes in primary-care patients with shoulder pain were achieved for excellent clinical outcomes, successfully classifying 70-90% of cases.

AB - OBJECTIVE: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up.DESIGN: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months.PATIENTS: Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9% follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria.METHODS: Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 and 12 months. Variables associated (p-value ≤ 0.2) were retained for potential inclusion within multiple logistic regression analyses.RESULTS: Pain not improved by rest, intermittent pain, lower pain intensity with physical tests and absence of subacromial bursa pathology on ultrasound at the 3-week follow-up, constant pain and lower pain intensity with physical tests are predictors of excellent outcomes at the 3-month follow- up. Worse baseline pain and disability, no history of asthma, pain better with rest, better physical functioning, greater fear avoidance, male gender, no history of pain in the opposite shoulder, pain referred below the elbow, sleep disturbed by pain, smaller waist circumference, lower pain intensity with physical tests are factors predictive of excellent outcomes at the 12-month follow-up. Only higher pain intensity with physical tests was associated with a poor clinical outcome.CONCLUSION: Predictive models for clinical outcomes in primary-care patients with shoulder pain were achieved for excellent clinical outcomes, successfully classifying 70-90% of cases.

UR - http://www.scopus.com/inward/record.url?scp=84937511040&partnerID=8YFLogxK

U2 - 10.2340/16501977-1885

DO - 10.2340/16501977-1885

M3 - Article

VL - 47

SP - 66

EP - 71

JO - Scandinavian Journal of Rehabilitation Medicine

JF - Scandinavian Journal of Rehabilitation Medicine

SN - 0036-5505

IS - 1

ER -