title: The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome: Impact of Sex, Socio-Demographic and Clinical Factors.
abstract: BACKGROUND
  Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS).
  
  
  OBJECTIVE
  We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy.
  
  
  METHODS
  Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1-75.9, 1 July 2007 to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event.
  
  
  RESULTS
  Within 52 weeks after first contact, 43% of the patients had physiotherapy and 30% underwent surgery. Within 26 weeks after surgery, 80% had a record of physiotherapy. After first contact and after surgery, exercise was part of physiotherapy in 65% and 84% of the patients, respectively. A public hospital contact, physiotherapy before hospital contact, administrative region, female sex, a diagnosis of other or unspecified disorders (M75.8-M75.9), and surgical procedure predicted higher use of physiotherapy. Low education level predicted slightly lower use of physiotherapy after first contact, but not after surgery.
  
  
  CONCLUSIONS
  In patients with SIS in Danish hospital settings, physiotherapy was more often used after surgery than as part of initial non-surgical treatment. The use of physiotherapy was less common among men than women, whereas unequal use of physiotherapy in relation to education level was not noticeable. The use of physiotherapy with exercises in initial non-surgical treatment was relatively limited.
authors.affiliation: Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark.
authors.forename: David Høyrup
authors.initials: DH
authors.lastname: Christiansen
authors.affiliation: Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus Hospital, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Frost
authors.affiliation: Orthopedic Department, Odense University Hospital, Odense, Denmark.
authors.forename: Lars Henrik
authors.initials: LH
authors.lastname: Frich
authors.affiliation: Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany.|Institute for Neurorehabilitation Systems, Bernstein Focus Neurotechnology (BFNT) Göttingen Bernstein Center for Computational Neuroscience (BCCN), University Medical Center Göttingen Georg-August University, Göttingen, Germany.
authors.forename: Deborah
authors.initials: D
authors.lastname: Falla
authors.affiliation: Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark.
authors.forename: Susanne Wulff
authors.initials: SW
authors.lastname: Svendsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D026741:Physical Therapy Modalities; D012042:Registries; D012737:Sex Factors; D019534:Shoulder Impingement Syndrome / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors; D055815:Young Adult