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Open Access Shoulder Pain in Primary Care – Part 2: Predictors of Clinical Outcome to 12 Months

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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.

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Keywords: FOLLOW-UP STUDIES; PRIMARY HEALTH CARE; SHORT AND MEDIUM TERM OUTCOMES; SHOULDER PAIN; STATISTICAL MODELS

Document Type: Research Article

Publication date: January 1, 2015

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  • Journal of Rehabilitation Medicine is the international peer-reviewed journal published in English, with at least 10 issues published per year.

    Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.

    The journal is read by a wide group of healthcare professionals including specialists in rehabilitation medicine, neurology, clinical neurophysiology, general medicine, psychologists, physiotherapists, occupational therapists and social workers.

    Contributions from all parts of the world and from different professions in rehabilitation are welcome.

    ISI Impact Factor 2009: 1.882.

    Owned by Foundation of Rehabilitation Information.


    Since the Journal of Rehabilitation Medicine is an Open Access journal, the contents will no longer be provided via Ingenta Connect after December 31, 2020. To continue accessing the journal free of charge please go to https://www.medicaljournals.se/jrm.
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