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


METHODS
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]).


CONCLUSIONS
Prognostic factors differ depending on the format of the outcome. Only age was significant in both models.
Kennedy
Carol A
CA
Institute for Work and Health, 481 University Avenue, Ste 800, Toronto, Ontario, Canada M5G 2E9.
Manno
Michael
M
Hogg-Johnson
Sheilah
S
Haines
Ted
T
Hurley
Laurie
L
McKenzie
Deirdre
D
Beaton
Dorcas E
DE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000145:classification / Q000503:physiopathology / Q000628:therapy*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011379:Prognosis; D012782:Shoulder; D017695:Soft Tissue Injuries / Q000145:classification / Q000503:physiopathology / Q000628:therapy*