Outcome predictors in nonoperative management of newly diagnosed subacromial impingement syndrome: a longitudinal study.
OBJECTIVE
This prospective investigation is designed to determine the prognostic factors associated with the response to conservative therapy of subacromial impingement syndrome.


METHODS
We treated 102 patients with subacromial impingement syndrome, diagnosed by physical examination and a subacromial lidocaine injection test, with a standardized conservative protocol. We followed the patients for a period of 12 months. Outcome was evaluated with Constant score and effects of 8 variables: Age, sex, pretreatment symptom duration, dominant shoulder, initial Constant score, active range of motion, acromion morphology, and acromial spur on patient outcomes were evaluated with univariate and multivariate analyses.


RESULTS
Among 89 patients (44 men; mean age, 56.4 years) who finished the study, the mean difference between initial and final scores was 15.9 (95% confidence interval [CI]: 13.9-17.8). Three variables, the initial Constant score (b = .52, 95% CI: .28-.76), the duration of disease before treatment (b = -4.4, 95% CI: from -7.2 to -1.6), and acromial morphology (b = -5.3, 95% CI: from -9.8 to -.8) were found to be independent predictors of outcome (model R2 = .68).


CONCLUSIONS
Patients with more severe disease, a long duration of symptoms, and type II or III acromion may require more invasive therapeutic options as the first intervention.
Taheriazam
Afsin
A
Assistant Professor, Department of Orthopedic Surgery, Khatam Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
Sadatsafavi
Mohsen
M
Moayyeri
Alireza
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011379:Prognosis; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin