Projected Prognosis as a Predictor of Short-term Outcome After Treatment of Minor Musculoskeletal Injuries in the Emergency Department

Projected Prognosis as a Predictor of Short-term Outcome After Treatment of Minor Musculoskeletal Injuries in the Emergency Department: A Prospective Cohort Study

This study describes the caseload treated by the extended scope physiotherapists(ESP) working in the emergency department at Slagelse Hospital.

Patients treated by the ESP during a 3 month period will be included in this study.

Furthermore we aim to assess if ESPs treating patients with minor musculoskeletal injuries in the ED can predict the short-term prognosis of recovery. The prediction is made at hospital discharge using a (-7/+7) numerical rating scale (-7=poor prognosis; 7=best prognosis).

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Diseases
• Intervention / Treatment: Behavioral: Standard care

• Study Type: Observational
• Enrollment (Actual): 432

Contacts and Locations

Study Locations

• Denmark
  • Region Zealand
    • Slagelse, Region Zealand, Denmark, 4200
      • The Emergency Department, Slagelse Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All patients treated by an ESP physiotherapist in the emergency room at Slagelse Hospital, Denmark, in a 3 month period +1 month follow-up will be invited to participate in this study.

Description

Inclusion Criteria:

• 1 Treated by an ESP for a minor musculoskeletal injury in the emergency room
• 2 Has an email address
• 3 Signed informed consent form

Exclusion Criteria:

• 1 A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., not having access to the internet, cognitive impairments etc.)
• 2 Under the influence of drugs or alcohol

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Caseload group	Behavioral: Standard care; Treatment by an extended scope physiotherapist following Standard Operating Procedures.
Prediction group	Behavioral: Standard care; Treatment by an extended scope physiotherapist following Standard Operating Procedures.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Transition ratings of global perceived effect	Using a transition questionnaire (TRANS-Q) the perceived effect of treatment will be measured by participants answering if their current health status is "unchanged", "worse" or "better" compared to their pre-injury status. "unchanged" equals a transition score of 0. If the participant answers "worse", he/she is asked to rate the degree of worsening on a 7 point Likert scale, with corresponding scores ranging from -1 to -7. If the participant answers "better", he/she is asked to rate the degree of improvement on a 7 point Likert scale, with corresponding scores ranging from 1 to 7. Thus the GPE score range from -7 (worsening) to 7 (improvement), with the mid-point - 0 - representing no change.	1 month after discharge

Secondary Outcome Measures

Outcome Measure	Time Frame
Patient Acceptable Symptom State	1 month after discharge
EuroQoL questionnaire	1 month after discharge

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
VAS Pain	The VAS pain is a measure of pain intensity, which has been widely used in diverse adult populations. The scale is a unidimensional continuous scale comprised of a horizontal line, anchored by 2 verbal descriptors, one for each symptom extreme (0 no pain, 10 the worst imaginable pain).	At baseline and 1 month after discharge
Analgesic use	The participants self-reported use of analgesics will be collected at the 1 month follow-up. Participants will be asked to note their use of analgesic drugs, within the week before the follow-up, only related to the treated injury in the emergency room.	1 month after discharge
Follow-up treatments	The participants self-reported use of follow-up visits with other allied health professionals will be recorded. All visits related to the treated injury during the 1-month follow-up period should be noted.	1 month after discharge
Re-injury	The participants self-reported reinjury rate during the 1-month follow-up period will be recorded.	1 month after discharge

Collaborators and Investigators

• Sponsor: Slagelse Hospital
• Collaborators: Bispebjerg Hospital
• Investigators: Principal Investigator: Christian P Olsen, PT, Phd candidate, Næstved-Slagelse-Ringsted Hospitals; Study Chair: Marius Henriksen, PT, PhD, Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospital; Study Chair: Søren T Skou, PT, PhD, Næstved-Slagelse-Ringsted Hospitals AND University of Southern Denmark

Study record dates

Study Major Dates

• Study Start (Actual): August 15, 2019
• Primary Completion (Actual): November 15, 2019
• Study Completion (Actual): November 15, 2019

Study Registration Dates

• First Submitted: July 4, 2019
• First Submitted That Met QC Criteria: July 4, 2019
• First Posted (Actual): July 9, 2019

Study Record Updates

• Last Update Posted (Actual): January 18, 2020
• Last Update Submitted That Met QC Criteria: January 15, 2020
• Last Verified: January 1, 2020

More Information

Terms related to this study

• Keywords: Emergency Department; Minor Musculoskeletal Injuries; Prediction outcome; Extended Scope Physiotherapists
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies; Musculoskeletal Diseases
• Other Study ID Numbers: REG-032-2019

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: Upon finalisation of the prespecified analyses we will share the IPD to other researchers based on an email inquiry.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No