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BMC Musculoskeletal Disorders

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Open Access 01-12-2013 | Research article

Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review

Authors: Rachel Chester, Lee Shepstone, Helena Daniell, David Sweeting, Jeremy Lewis, Christina Jerosch-Herold

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Abstract

Background

People suffering from musculoskeletal shoulder pain are frequently referred to physiotherapy. Physiotherapy generally involves a multimodal approach to management that may include; exercise, manual therapy and techniques to reduce pain. At present it is not possible to predict which patients will respond positively to physiotherapy treatment. The purpose of this systematic review was to identify which prognostic factors are associated with the outcome of physiotherapy in the management of musculoskeletal shoulder pain.

Methods

A comprehensive search was undertaken of Ovid Medline, EMBASE, CINAHL and AMED (from inception to January 2013). Prospective studies of participants with shoulder pain receiving physiotherapy which investigated the association between baseline prognostic factors and change in pain and function over time were included. Study selection, data extraction and appraisal of study quality were undertaken by two independent assessors. Quality criteria were selected from previously published guidelines to form a checklist of 24 items. The study protocol was prospectively registered onto the International Prospective Register of Systematic Reviews.

Results

A total of 5023 titles were retrieved and screened for eligibility, 154 articles were assessed as full text and 16 met the inclusion criteria: 11 cohort studies, 3 randomised controlled trials and 2 controlled trials. Results were presented for the 9 studies meeting 13 or more of the 24 quality criteria. Clinical and statistical heterogeneity resulted in qualitative synthesis rather than meta-analysis. Three studies demonstrated that high functional disability at baseline was associated with poor functional outcome (p ≤ 0.05). Four studies demonstrated a significant association (p ≤ 0.05) between longer duration of shoulder pain and poorer outcome. Three studies, demonstrated a significant association (p ≤ 0.05) between increasing age and poorer function; three studies demonstrated no association (p > 0.05).

Conclusion

Associations between prognostic factors and outcome were often inconsistent between studies. This may be due to clinical heterogeneity or type II errors. Only two baseline prognostic factors demonstrated a consistent association with outcome in two or more studies; duration of shoulder pain and baseline function. Prior to developing a predictive model for the outcome of physiotherapy treatment for shoulder pain, a large adequately powered prospective cohort study is required in which a broad range of prognostic factors are incorporated.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/14/203/prepub

Title: Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review
Authors: Rachel Chester
Lee Shepstone
Helena Daniell
David Sweeting
Jeremy Lewis
Christina Jerosch-Herold
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-14-203

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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