Age may predict recovery from shoulder disorders

In brief

  • The study results can help explain which patients with shoulder disorders are more likely to do better and which may not after physical therapy.
  • Age was the only common factor determining the outcome in both groups, with younger patients doing better and older ones worse after 12 weeks.

Why was this study done?

Shoulder disorders are the second most common condition treated by physical therapists, according to a 2002 Ontario survey. Patients often ask physical therapists questions about the extent of their recovery, how long it will take, and which factors may delay it. The purpose of this study was to determine the factors that predicted a patient's level of disability and change in disability after physical therapy.

How was the study done?

Over a 12-week period, researchers surveyed 361 consecutive patients who were receiving physical therapy for soft-tissue shoulder disorders. The patients were assessed at the start and end of treatment using the Disabilities of the Arm, Shoulder and Hand (DASH) measure. The DASH measures physical functions and symptoms. Patients were also questioned on 28 factors that might predict recovery, including demographics, medication use, pain intensity and expectations for recovery.

What did the researchers find?

After 12 weeks, patients with a higher level of disability had one or more of the following factors:

  • higher initial disability
  • coverage by a workers' compensation claim
  • a prediction by the physical therapist at the start of treatment that activities would be restricted after treatment
  • older age
  • female gender.

Those who showed an improvement after 12 weeks had one or more of the following factors:

  • higher initial pain
  • surgery in the last six months
  • a shorter duration of symptoms before starting physical therapy
  • younger age
  • poor general physical health.

What are some strengths and weaknesses of the study?

One strength is that the results can be generalized because the patients likely represent the larger population of patients receiving physical therapy for shoulder problems. Researchers also examined a broad range of clinical factors such as medication use and expectations for recovery. One weakness is that physical therapy interventions could not be controlled, and they varied.

Publication Information

Title: 

Prognosis in soft tissue disorders of the shoulder: Predicting both change in disability and level of disability after treatment

Author(s): 

Kennedy-Yee CA, Manno M, Hogg-Johnson S, Haines T, Hurley L, McKenzie D, Beaton D

Journal: 

Physical Therapy, 2006 July: vol. 86, no. 7, pp. 1013-1032