Article

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.

Langue : ANGLAIS