Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2018 Feb;52(4):269-275.
doi: 10.1136/bjsports-2016-096084. Epub 2016 Jul 21.

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

Rachel Chester  1   2 , Christina Jerosch-Herold  1 , Jeremy Lewis  3 , Lee Shepstone  4
Affiliations
Multicenter Study

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

Rachel Chester et al. Br J Sports Med. 2018 Feb.

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.

Keywords: Assessment; Physiotherapy; Psychology; Shoulder.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
STROBE flow diagram. Participant recruitment and follow-up.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Linsell L, Dawson J, Zondervan K, et al. . Prevalence and incidence of adults consulting for shoulder conditions in UK primary care; patterns of diagnosis and referral. Rheumatology (Oxford) 2006;45:215–21. 10.1093/rheumatology/kei139 - DOI - PubMed
    1. van der Windt DA, Koes BW, de Jong BA, et al. . Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis 1995;54:959–64. 10.1136/ard.54.12.959 - DOI - PMC - PubMed
    1. Coghlan JA, Buchbinder R, Green S, et al. . Surgery for rotator cuff disease. Cochrane Database Syst Rev 2008;1:CD005619 doi:101002/14651858.CD005619.pub2 - PMC - PubMed
    1. Saltychev M, Ville Äärimaa V, Virolainen P, et al. . Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis. Disabil Rehabil 2015;37:1–8. 10.3109/09638288.2014.907364 - DOI - PubMed
    1. National Institute for Health Excellence (NICE) Clinical Knowledge Summaries. Shoulder Pain. 2015. http://cks.nice.org.uk/shoulder-pain#!topicsummary (accessed May 2015).

Publication types