title: Examining outcome of early physician specialist assessment in injured workers with shoulder complaints.
abstract: BACKGROUND
  There is minimal research on demographics, type of injury and diagnosis of injured workers with shoulder problems. The purposes of this study were: 1) to document the demographics of patients with shoulder complaints referred to an Early Shoulder Physician Assessment (ESPA) Program and to describe the recommended management, and 2) to examine the relationship between patient characteristics and their subjective complaints of pain and functional difficulty.
  
  
  METHODS
  This study involved a retrospective review of electronic files of injured workers mostly seen within the first 16 weeks of injury or recurrence. Measures of functional difficulty and pain were the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Numeric Pain Scale (NPS).
  
  
  RESULTS
  Files of 550 consecutive patients, 260 females (47%), 290 men (53%) were examined. The average age was 49 (SD = 11, range 22-77), with 28 (5%) patients being 65 years of age or older. Patients who were not working were the most disabled group based on Quick DASH (F = 49.93, p < 0.0001) and NPS (F = 10.24, p = 0.002). Patients who were working full time performing regular duties were the least disabled according to both measures, the QuickDASH (F = 10.24, p = 0.002) and NPS (F = 7.57, p = 0.006). Patients waiting more than 16 weeks were slightly older (53 years of age vs. 49, p = 0.045) than those who met the criteria for early assessment with similar levels of pain and functional difficulty. Biceps pathology had the highest prevalence (37%). Full thickness tear had a prevalence of 14%. Instability, labral lesions and osteoarthritis of glenohumeral joint were uncommon conditions (3, 2 and 1% respectively). Fifty-five patients (10%) were surgical candidates and had higher scores on QuickDASH (F = 7.16, p = 0.008) and NPS (F = 4.24, p = 0.04) compared to those who did not require surgery.
  
  
  CONCLUSIONS
  This study provides information on characteristics and prevalence of important variables in injured workers with shoulder problems and highlights the impact of these characteristics on pain and disability.
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. helen.razmjou@sunnybrook.ca.|Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada. helen.razmjou@sunnybrook.ca.|Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada. helen.razmjou@sunnybrook.ca.
authors.forename: Helen
authors.initials: H
authors.lastname: Razmjou
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. Dragana.Boljanovic@sunnybrook.ca.|Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada. Dragana.Boljanovic@sunnybrook.ca.
authors.forename: Dragana
authors.initials: D
authors.lastname: Boljanovic
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. Sandra.lincoln@sunnybrook.ca.|Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada. Sandra.lincoln@sunnybrook.ca.
authors.forename: Sandra
authors.initials: S
authors.lastname: Lincoln
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. crgeddes@gmail.com.|Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada. crgeddes@gmail.com.
authors.forename: Chris
authors.initials: C
authors.lastname: Geddes
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. Iona.Macritchie@sunnybrook.ca.
authors.forename: Iona
authors.initials: I
authors.lastname: Macritchie
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. Caterina.Virdo-cristello@sunnybrook.ca.
authors.forename: Caterina
authors.initials: C
authors.lastname: Virdo-Cristello
authors.affiliation: Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, ON, M1Y 1H1, Canada. Robin.Richards@sunnybrook.ca.|Division of Orthopedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Robin.Richards@sunnybrook.ca.|Department of Orthopedic Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada. Robin.Richards@sunnybrook.ca.
authors.forename: Robin R
authors.initials: RR
authors.lastname: Richards
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D042241:Early Diagnosis; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D016272:Occupational Health; D060051:Occupational Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D009864:Ontario / Q000453:epidemiology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D015397:Program Evaluation; D012017:Referral and Consultation; D012189:Retrospective Studies; D062707:Return to Work; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology*; D020069:Shoulder Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D013038:Specialization; D013997:Time Factors; D061665:Time-to-Treatment; D014850:Waiting Lists; D055815:Young Adult