Cost-effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints

Geraets, Jacques; Goossens, Mariëlle E. J. B.; Bruijn, Camiel P. C. de; Groot, I. de; Köke, Albère; Pelt, Rob A. G. B.; Heijden, G. H. M. van der; Dinant, Geert-Jan; Heuvel, W.J.A. van den

doi:10.1017/s0266462306050860

Cited by 34 publications

(23 citation statements)

References 16 publications

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“…Those economic evaluations in similar populations that have reported EQ-5D data 118,120,121 have demonstrated improvements from baseline ranging from 0.06 to 0.16, which are comparable to those in the SAPPHIRE trial. These trials included a variety of interventions including an education and activation programme, manipulative therapy, which comprised specific manipulation and mobilisation techniques, and graded exercise therapy delivered by a physiotherapist.…”

Section: Quality Of Life and Utility Datamentioning

confidence: 65%

“…We did identify a limited number of economic evaluations conducted alongside clinical trials in patients with unilateral shoulder pain, chronic shoulder complaints and acute and subacute shoulder complaints. 91,[118][119][120][121] We considered these populations to be similar enough to allow some comparisons to be made, although these populations were not the focus of our research and we did not undertake a systematic review in these patient populations. The economic evaluations did not meet our inclusion criteria but we anticipated that they would provide some useful information to inform our research.…”

Section: Cost-effectiveness Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Management of frozen shoulder: a systematic review and cost-effectiveness analysis.

Maund

Craig²,

Suekarran³

et al. 2012

Health Technol Assess

202

203

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projec...

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Section: Quality Of Life and Utility Datamentioning

confidence: 65%

Section: Cost-effectiveness Reviewmentioning

confidence: 99%

Management of frozen shoulder: a systematic review and cost-effectiveness analysis.

Maund

Craig²,

Suekarran³

et al. 2012

Health Technol Assess

202

203

View full text Add to dashboard Cite

show abstract

“…One study, reported in two papers (risk-of-bias score=1046 47) with 176 participants with chronic shoulder complaints (>3 months) demonstrated that an operant behavioural and time-contingent graded exercise therapy programme designed to improve functional ability irrespective of pain provided no additional improvement in self-rated functional ability, perceived recovery, reported pain or quality of life at either 12 weeks or 1 year when compared to usual care from the patient's general practitioner (figure 4). There is, therefore, low-quality evidence that a graded exercise programme does not offer additional benefits to usual care from a general practitioner for the management of chronic shoulder pain.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis

2012

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ObjectiveTo determine the effectiveness of exercise and soft tissue massage either in isolation or in combination for the treatment of non-specific shoulder problems.MethodsDatabase searches for articles from 1966 to December 2011 were performed. Studies were eligible if they investigated ‘hands on’ soft tissue massage performed locally to the shoulder or exercises aimed at improving strength, range of motion or coordination; non-surgical painful shoulder disorders; included participants aged 18–80 years and outcomes measured included pain, disability, range of motion, quality of life, work status, global perceived effect, adverse events or recurrence.ResultsTwenty-three papers met the selection criteria representing 20 individual trials. We found low-quality evidence that soft tissue massage was effective for producing moderate improvements in active flexion and abduction range of motion, pain and functional scores compared with no treatment, immediately after the cessation of treatment. Exercise was shown by meta-analysis to produce greater improvements than placebo, minimal or no treatment in reported pain (weighted mean=9.8 of 100, 95% CI 0.6 to 19.0) but these changes were of a magnitude that was less than that considered clinically worthwhile. Exercise did not produce greater improvements in shoulder function than placebo, minimal or no treatment (weighted mean=5.7 of 100, 95% CI −3.3 to 14.7).ConclusionThere is low-quality evidence that soft tissue massage is effective for improving pain, function and range of motion in patients with shoulder pain in the short term. Exercise therapy is effective for producing small improvements in pain but not in function or range of motion.

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“…Hence, "autonomy" in Physiotherapy needs to be understood, defined and incorporated into the healthcare system and most importantly, followed at every stage of patient rehabilitation. It has also been seen that referring a patient to the physiotherapist reduced the overall health costs [8]. This is of utmost importance in a developing country like India where the health system is being overtaxed with lack of qualified medical personnel and increasing number of patients.…”

Section: Discussionmentioning

confidence: 99%

Referring doctors' perspectives about Physiotherapy management for chronic musculoskeletal pain

Rajan¹,

Bellare²

2013

IJTRR

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Background: Patients diagnosed with chronic disabling musculoskeletal pain have better health outcomes and higher levels of satisfaction with Physiotherapy management. A pilot study conducted by the authors found that doctor's referral to Physiotherapy treatment could have affected the satisfaction of the patients towards Physiotherapy management. Objectives:The aim of the current study was to look into the perspectives of referring doctors (physicians and surgeons) towards Physiotherapy as reported by the patients. Secondarily, it was of interest to see how the treatment strategies by the Physiotherapist affect patient satisfaction. Methods: The study was conducted at the orthopedic pain center in the Physiotherapy department at a tertiary care hospital in Mumbai, India. Personal interviews were conducted with 193 patients using a valid questionnaire. Results: The average age of the subjects was 47.5 years. Average duration of pain was close to 8 years, with low back pain being the most common location of pain. Majority of the patients were not referred for any particular Physiotherapy treatment (37.32%). Almost an equal percentage of subjects (33.16%) were referred for both exercise and electrotherapy treatments to the Physiotherapy department. Most of the times (around 68%), there was agreement in the treatment modes suggested by the referring doctor and the attending physiotherapist. However, in about 32% of the patients referred, there seemed to be a mismatch. Conclusion:The referring doctors (physicians/surgeons) gave considerable freedom to the physiotherapists regarding the treatment of chronic musculoskeletal pain. Some of them seemed to recommend electrotherapy as a treatment mode, due to which, there was dissatisfaction amongst patients about the treatment methodologies recommended by the physiotherapist.

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Cost-effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints

Abstract: GET proved to be more effective in the short- and long-term and reduces direct health care costs and direct non-health care costs but is associated with higher costs of the intervention itself.

Cited by 34 publications

References 16 publications

Management of frozen shoulder: a systematic review and cost-effectiveness analysis.

Management of frozen shoulder: a systematic review and cost-effectiveness analysis.

Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis

Referring doctors' perspectives about Physiotherapy management for chronic musculoskeletal pain

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