Abstract:Background
Persistent shoulder pain causes considerable disruption of the individual’s life and imposes high costs on healthcare and society. Well-informed treatment and referral pathways are crucial as unsuccessful interventions and longer duration of symptoms minimizes the likelihood of success in future interventions. Although physiotherapy is generally recommended as first line treatment, no prognostic model or clinical prediction rules exists to help guide the treatment of patients with pe… Show more
“…As defined by the framework of Kent et al ,10 this study was an exploratory prognostic study of individual patient data obtained from two cohort studies of patients referred to physiotherapy treatment in primary11 and secondary care12 in Denmark.…”
Section: Methodsmentioning
confidence: 99%
“…They were notified by email when follow-up questionnaires at 2, 4 and 6 months were available. Data collection was administered by an online clinical database (Trial Partner) 12. Only patients with a primary diagnosis of the shoulder ICD-10 classification DM750-759 or DM254-256 were included, excluding all surgically treated patients.…”
ObjectivePrevious studies have examined factors that may contribute to predicting outcomes for patients with shoulder pain. However, there is still a lack of consensus on which factors predict the results and whether there are differences based on the treatment setting. Thus, this study aimed to analyse and compare how baseline variables are associated with future outcomes in patients with shoulder pain in primary and secondary care settings.MethodsThis study conducted a secondary analysis of two observational prospective cohort studies involving patients with shoulder pain in primary care (n=150) and secondary care (n=183). Multiple regression analyses were employed, with one interaction term at a time, to examine potential differences in association with baseline characteristics and future outcomes between the two settings.ResultsChanges in pain and function were statistically significant at 6 months for patients in primary care and secondary care. However, associations for most baseline variables and outcomes did not differ significantly across these two treatment settings. The only statistically significant interactions observed were for the associations between baseline level of pain, function and fear avoidance beliefs and change in pain scores at 6 months, with lower change scores observed among patients in the secondary care.ConclusionThis study revealed that the association with outcomes did not differ across settings for most baseline characteristics. These findings suggest that it could be feasible to generalise the prognostic value of most baseline variables for patients with shoulder, irrespective of the treatment setting.
“…As defined by the framework of Kent et al ,10 this study was an exploratory prognostic study of individual patient data obtained from two cohort studies of patients referred to physiotherapy treatment in primary11 and secondary care12 in Denmark.…”
Section: Methodsmentioning
confidence: 99%
“…They were notified by email when follow-up questionnaires at 2, 4 and 6 months were available. Data collection was administered by an online clinical database (Trial Partner) 12. Only patients with a primary diagnosis of the shoulder ICD-10 classification DM750-759 or DM254-256 were included, excluding all surgically treated patients.…”
ObjectivePrevious studies have examined factors that may contribute to predicting outcomes for patients with shoulder pain. However, there is still a lack of consensus on which factors predict the results and whether there are differences based on the treatment setting. Thus, this study aimed to analyse and compare how baseline variables are associated with future outcomes in patients with shoulder pain in primary and secondary care settings.MethodsThis study conducted a secondary analysis of two observational prospective cohort studies involving patients with shoulder pain in primary care (n=150) and secondary care (n=183). Multiple regression analyses were employed, with one interaction term at a time, to examine potential differences in association with baseline characteristics and future outcomes between the two settings.ResultsChanges in pain and function were statistically significant at 6 months for patients in primary care and secondary care. However, associations for most baseline variables and outcomes did not differ significantly across these two treatment settings. The only statistically significant interactions observed were for the associations between baseline level of pain, function and fear avoidance beliefs and change in pain scores at 6 months, with lower change scores observed among patients in the secondary care.ConclusionThis study revealed that the association with outcomes did not differ across settings for most baseline characteristics. These findings suggest that it could be feasible to generalise the prognostic value of most baseline variables for patients with shoulder, irrespective of the treatment setting.
“…A range of factors have shown some prognostic value in patients presenting with shoulder pain in primary care; however, there is currently limited evidence to support the use of any proposed prognostic models (Karel et al., 2017; Kuijpers et al., 2006; Struyf et al., 2016; Vergouw et al., 2011). Notably, there is a lack of prospective research investigating the factors that may contribute to outcomes in patients with persistent symptoms and longer care trajectories (i.e., patients referred to tertiary care centres) (Rønnow et al., 2021).…”
BackgroundMusculoskeletal shoulder pain is a common problem and its symptoms often become persistent. The experience of pain is multidimensional, and therefore, a range of patient characteristics may influence treatment response. An altered sensory processing has been associated with persistent musculoskeletal pain states and may contribute to outcomes in patients with musculoskeletal shoulder pain. The presence and potential impact of altered sensory processing in this patient cohort is not currently known. The aim of this prospective longitudinal cohort study is to investigate if baseline sensory characteristics are associated with clinical outcomes in patients presenting to a tertiary hospital with persistent musculoskeletal shoulder pain. If found, a relationship between sensory characteristics and outcome may lead to the creation of more effective treatment strategies and improvements in risk adjustment and prognosis.MethodsThis is a single‐centre prospective cohort study with 6‐, 12‐ and 24‐month follow‐up. A total of 120 participants aged ≥18 years with persistent musculoskeletal shoulder pain (≥3 months) will be recruited from an Australian public tertiary hospital orthopaedic department. Baseline assessments, including quantitative sensory tests and a standardised physical examination, will be performed. In addition, information will be obtained from patient interviews, self‐report questionnaires and medical records. Follow‐up outcome measures will comprise information from the Shoulder Pain and Disability Index and a six‐point Global Rating of Change scale.AnalysisDescriptive statistics will be used to report baseline characteristics and outcome measures over time. Change in outcome measures at the primary endpoint of six months from baseline will be calculated using paired t‐tests. Associations between baseline characteristics and outcomes at a 6‐month follow‐up will be reported using multivariable linear and logistic regression models.DiscussionUnderstanding the relationship between sensory profile and the variable response to treatment in people with persistent musculoskeletal shoulder pain may enhance our understanding of the mechanisms contributing to the presentation. In addition, through better understanding of the contributing factors, the results of this study may contribute to the development of an individualised, patient‐centred approach to treatment for people with this highly prevalent and debilitating condition.
“…Following the publication of the original article [ 1 ] the authors noticed that the statement “all authors contributed equally” appeared in the published article. This statement is directly opposite of the author contribution statement in the article.…”
mentioning
confidence: 99%
“…This statement is directly opposite of the author contribution statement in the article. The original article [ 1 ] has been updated.…”
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