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

Journal article

2006 Jul 01

Physical Therapy

86

7

1013-1032

16813480

No

BACKGROUND AND PURPOSE: Clinicians often are faced with questions about prognosis and outcome of shoulder disorders. The purpose of this study was to identify predictors of both change in disability and level of disability following physical therapy treatment. SUBJECTS: The subjects were consecutive patients (n=361) who were receiving physical therapy for soft tissue shoulder disorders. METHODS: Clinical response to physical therapy, which was measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) measure, was assessed over 12 weeks. The 28 independent baseline predictors included demographics, disorder-related and disability measures, medication use, clinical findings, and expectations for recovery. Multiple linear regression techniques were used. RESULTS: Predictors of greater disability at discharge were: higher initial disability, therapist prediction of restricted activities at discharge, workers' compensation claim, older age, and being female. Predictors of greater improvement in disability were: shoulder surgery, higher pain intensity, shorter duration of symptoms, younger age, and poorer general physical health (measured using the 36-Item Short-Form Health Survey [SF-36]). DISCUSSION AND CONCLUSIONS: Prognostic factors differ depending on the format of the outcome. Only age was significant in both models