Title | Factors influencing final outcomes in patients with shoulder pain: A retrospective review. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Uhl TL, Smith-Forbes EV, Nitz AJ |
Journal | J Hand Ther |
Volume | 30 |
Issue | 2 |
Pagination | 200-207 |
Date Published | 2017 Apr - Jun |
ISSN | 1545-004X |
Keywords | Adult, Age Factors, Aged, Female, Humans, Linear Models, Male, Middle Aged, Patient Reported Outcome Measures, Physical Therapy Modalities, Range of Motion, Articular, Retrospective Studies, Shoulder Pain, Treatment Outcome |
Abstract | STUDY DESIGN: Retrospective cohort. INTRODUCTION: Rehabilitation interventions are commonly prescribed for patients with shoulder pain, but it is unclear what factors may help clinicians' prognosis for final outcomes. PURPOSE OF THE STUDY: The purpose of this study is to determine what factors are the best predictors of improved patient-reported outcomes at discharge in patients with shoulder pain. METHODS: Retrospective chart review of 128 patients presenting with shoulder pain to an outpatient physical therapy clinic. Chart review captured data regarding patient demographics, treatment interventions, patient history, and patient-reported outcome scores. The primary dependent variable was the overall change score of the QuickDASH (initial to discharge). Thirty-eight predictor variables were entered into a forward stepwise multivariate linear regression model to determine which variables and to what degree contributed to the dependent variable. RESULTS: The linear regression model identified 5 predictor variables that yielded an R = 0.74 and adjusted R = 0.538 (P < .001). The 5 predictor variables identified in order of explained variance are QuickDASH change at the fifth visit, a total number of visits, initial QuickDASH score, scapular retraction exercise, and age. DISCUSSION: Early change scores, equal to minimal detectable change scores on patient-reported outcomes appear to be strong indicators that patients with shoulder pain are on a positive trajectory to benefit from rehabilitation. CONCLUSION: Using patient-reported outcomes throughout care, not just at the start and end of care, will provide therapist feedback regarding patient's progress and indicate treatment effectiveness. LEVELS OF EVIDENCE: 4. |
DOI | 10.1016/j.jht.2017.04.004 |
Alternate Journal | J Hand Ther |
PubMed ID | 28576346 |