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Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: a multicentre longitudinal cohort study.

Abstract：

BACKGROUND/AIM:Shoulder pain is a major musculoskeletal problem. We aimed to identify which baseline patient and clinical characteristics are associated with a better outcome, 6 weeks and 6 months after starting a course of physiotherapy for shoulder pain. METHODS:1030 patients aged ≥18 years referred to physiotherapy for the management of musculoskeletal shoulder pain were recruited and provided baseline data. 840 (82%) provided outcome data at 6 weeks and 811 (79%) at 6 months. 71 putative prognostic factors were collected at baseline. Outcomes were the Shoulder Pain and Disability Index (SPADI) and Quick Disability of the Arm, Shoulder and Hand Questionnaire. Multivariable linear regression was used to analyse prognostic factors associated with outcome. RESULTS:Parameter estimates (β) are presented for the untransformed SPADI at 6 months, a negative value indicating less pain and disability. 4 factors were associated with better outcomes for both measures and time points: lower baseline disability (β=-0.32, 95% CI -0.23 to -0.40), patient expectation of 'complete recovery' compared to 'slight improvement' as 'a result of physiotherapy' (β=-12.43, 95% CI -8.20 to -16.67), higher pain self-efficacy (β=-0.36, 95% CI -0.50 to -0.22) and lower pain severity at rest (β=-1.89, 95% CI -1.26 to -2.51). CONCLUSIONS:Psychological factors were consistently associated with patient-rated outcome, whereas clinical examination findings associated with a specific structural diagnosis were not. When assessing people with musculoskeletal shoulder pain and considering referral to physiotherapy services, psychosocial and medical information should be considered. STUDY REGISTRATION:Protocol published at http://www.biomedcentral.com/1471-2474/14/192.

journal_name

Br J Sports Med

journal_title

British journal of sports medicine

authors

Chester R,Jerosch-Herold C,Lewis J,Shepstone L

doi

10.1136/bjsports-2016-096084

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

269-275

issue

eissn

0306-3674

issn

1473-0480

pii

bjsports-2016-096084

journal_volume

pub_type

杂志文章,多中心研究

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Psychological factors are associated with the outcome of physiotherapy for people with shoulder pain: a multicentre longitudinal cohort study.