Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review

Rachel Chester, Lee Shepstone, Helena Daniell, David Sweeting, Jeremy Lewis, Christina Jerosch-Herold, Rachel Chester, Lee Shepstone, Helena Daniell, David Sweeting, Jeremy Lewis, Christina Jerosch-Herold

Abstract

Background: People suffering from musculoskeletal shoulder pain are frequently referred to physiotherapy. Physiotherapy generally involves a multimodal approach to management that may include; exercise, manual therapy and techniques to reduce pain. At present it is not possible to predict which patients will respond positively to physiotherapy treatment. The purpose of this systematic review was to identify which prognostic factors are associated with the outcome of physiotherapy in the management of musculoskeletal shoulder pain.

Methods: A comprehensive search was undertaken of Ovid Medline, EMBASE, CINAHL and AMED (from inception to January 2013). Prospective studies of participants with shoulder pain receiving physiotherapy which investigated the association between baseline prognostic factors and change in pain and function over time were included. Study selection, data extraction and appraisal of study quality were undertaken by two independent assessors. Quality criteria were selected from previously published guidelines to form a checklist of 24 items. The study protocol was prospectively registered onto the International Prospective Register of Systematic Reviews.

Results: A total of 5023 titles were retrieved and screened for eligibility, 154 articles were assessed as full text and 16 met the inclusion criteria: 11 cohort studies, 3 randomised controlled trials and 2 controlled trials. Results were presented for the 9 studies meeting 13 or more of the 24 quality criteria. Clinical and statistical heterogeneity resulted in qualitative synthesis rather than meta-analysis. Three studies demonstrated that high functional disability at baseline was associated with poor functional outcome (p ≤ 0.05). Four studies demonstrated a significant association (p ≤ 0.05) between longer duration of shoulder pain and poorer outcome. Three studies, demonstrated a significant association (p ≤ 0.05) between increasing age and poorer function; three studies demonstrated no association (p > 0.05).

Conclusion: Associations between prognostic factors and outcome were often inconsistent between studies. This may be due to clinical heterogeneity or type II errors. Only two baseline prognostic factors demonstrated a consistent association with outcome in two or more studies; duration of shoulder pain and baseline function. Prior to developing a predictive model for the outcome of physiotherapy treatment for shoulder pain, a large adequately powered prospective cohort study is required in which a broad range of prognostic factors are incorporated.

Figures

Figure 1
Figure 1
PRISMA Flow chart outlining the literature search and study selection.

References

    1. van der Heijden GJ. Shoulder disorders: a state-of-the-art review. Baillieres Best Pract Res Clin Rheumatol. 1999;12:287–309.
    1. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, Simmons A, Williams G. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57:649–655. doi: 10.1136/ard.57.11.649.
    1. Van der Windt DAWN, Koes BW, Boeke AJ, Deville W, De Jong BA, Bouter LM. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract. 1996;46:518–523.
    1. Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, Imbernon E, Goldberg M. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthritis Rheum. 2006;55:765–778. doi: 10.1002/art.22222.
    1. Health and Safety Executive. Musculoskeletal Disorders. 2012. .
    1. May S. An outcome audit for musculoskeletal patients in primary care. Physiother Theory Pract. 2003;19:189–198.
    1. Kuijpers T, van Tulder MW, van der Heijden GJMG, Bouter LM, van der Windt DAWN. Costs of shoulder pain in primary care consulters: a prospective cohort study in The Netherlands. BMC Musculoskelet Disord. 2006;7:83–90. doi: 10.1186/1471-2474-7-83.
    1. Virta L, Jorangerm P, Brox JI, Eriksson R. Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden. BMC Musculoskelet Disord. 2012;13:17–27. doi: 10.1186/1471-2474-13-17.
    1. Kuijpers T, Van der Windt DAWN, van der Heijden GJ, Bouter LM. Systematic review of prognostic cohort studies on shoulder disorders. Pain. 2004;109:420–431. doi: 10.1016/j.pain.2004.02.017.
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explaination and elaboration. Ann Intern Med. 2009;151:w1–w30. doi: 10.7326/0003-4819-151-1-200907070-00122.
    1. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–164.
    1. Hayden JA, Côte´ P, Bombardieri C. Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med. 2006;144:427–437. doi: 10.7326/0003-4819-144-6-200603210-00010.
    1. Downs SH, Black N. The feasability of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52:377–384. doi: 10.1136/jech.52.6.377.
    1. Wells GA, Shea B, O'Connell D, Peterson P, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute; 2011. .
    1. Verhagen AP, de Vet HCW, de Bie RA, Boers M, van den Brandt PA. The Delphi list: a criteria list for quality assessment of randomised clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol. 1998;15:1235–1241.
    1. Ryall C, Coggon D, Peveler R, Poole J, Palmer KT. A prospective cohort study of arm pain in primary care and physiotherapy–prognostic determinants. Rheumatology. 2007;46:508–515. doi: 10.1093/rheumatology/kel320.
    1. Kim SH, Park JC, Park JS, Oh I. Painful jerk test: a predictor of success in nonoperative treatment of posteroinferior instability of the shoulder. Am J Sports Med. 2004;32:1849–1855. doi: 10.1177/0363546504265263.
    1. Tanaka K, Saura R, Takahashi N, Hiura Y, Hashimoto R. Joint mobilization versus self-exercises for limited glenohumeral joint mobility: randomized controlled study of management of rehabilitation. Clin Rheumatol. 2010;29:1439–1444. doi: 10.1007/s10067-010-1525-0.
    1. Yang JL, Chang CW, Chen SY, Lin JJ. Shoulder kinematic features using arm elevation and rotation tests for classifying patients with frozen shoulder syndrome who respond to physical therapy. Man Ther. 2008;13:544–551. doi: 10.1016/j.math.2007.07.006.
    1. Hung CJ, Jan MH, Lin YF, Wang TQ, Lin JJ. Scapular kinematics and impairment features for classifying patients with subacromial impingement syndrome. Man Ther. 2010;15:547–551. doi: 10.1016/j.math.2010.06.003.
    1. Mintken PE, Cleland JA, Carpenter KJ, Bieniek ML, Keirns M, Whitman JM. Some factors predict successful short-term outcomes in individuals with shoulder pain receiving cervicothoracic manipulation: a single-arm trial. Phys Ther. 2010;90:26–42. doi: 10.2522/ptj.20090095.
    1. Conroy DE, Hayes KW. The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther. 1998;28:3–14.
    1. Engebretsen K, Grotle M, Bautz-Holter E, Ekeberg OM, Brox JI. Predictors of shoulder pain and disability index (SPADI) and work status after 1 year in patients with subacromial shoulder pain. BMC Musculoskelet Disord. 2010;11:218–226. doi: 10.1186/1471-2474-11-218.
    1. Aydogan A, Karan A, Ketenci A, Salman S, Salman F. Factors affecting therapeutic response of adhesive capsulitis in type II diabetes mellitus. J Back Musculoskelet Rehabil. 2003;4:3–7.
    1. Griggs SM, Ahn A, Green A. Idiopathic adhesive capsulitis. A prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am. 2000;82-A:1398–1407.
    1. Mao CY, Jaw WC, Cheng HC. Frozen shoulder: correlation between the response to physical therapy and follow-up shoulder arthrography. Arch Phys Med Rehabil. 1997;78:857–859. doi: 10.1016/S0003-9993(97)90200-8.
    1. Virta L, Mortensen M, Eriksson R, Möller M. How many patients with subacromial impingement syndrome recover with physiotherapy? A follow-up study of a supervised exercise programme. Adv Physiother. 2009;11:166–173. doi: 10.1080/14038190802460481.
    1. Tyler TF, Nicholas SJ, Lee SJ, Mullaney M, McHugh MP. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med. 2010;38:114–119. doi: 10.1177/0363546509346050.
    1. Sindhu BS, Lehman LA, Tarima S, Bishop MD, Hart DL, Klein MR, Shivakoti M, Wang Y. Influence of fear-avoidance beliefs on functional status outcomes for people with musculosksletal conditions of the shoulder. Phys Ther. 2012;92:992–1005. doi: 10.2522/ptj.20110309.
    1. World Health organisation (WHO), Centres for Disease Control and Prevention. International Classification of Diseases. Ninth Revision. Geneve; 2001. .
    1. Deutscher D, Horn SD, Dickstein R, Hart DL, Smout RJ, Gutvirtz M, Ariel I. Associations between treatment processes, patient characteristics, and outcomes in outpatient physical therapy practice. Arch Phys Med Rehabil. 2009;90:1349–1363. doi: 10.1016/j.apmr.2009.02.005.
    1. Kennedy CA, Manno M, Hogg-Johnson S, Haines T, Hurley L, McKenzie D, Beaton DE. Prognosis of soft tissue disorders of the shoulder: Predicting both change in disability and level of disability. Phys Ther. 2006;86:1013–1032.
    1. Dunn KM, Jordan K, Lacey RJ, Shapley M, Jinks C. Patterns of consent in epidemiologic research: evidence from over 25,000 responders. Am J Epidemiol. 2004;159:1087–1094. doi: 10.1093/aje/kwh141.
    1. Gross CP, Mallory R, Heiat A, Krumholz HM. Reporting the recruitment process in clinical trials: Who Are these patients and How Did they Get there? Ann Intern Med. 2002;137:10–16. doi: 10.7326/0003-4819-137-1-200207020-00007.
    1. Petersen MK, Andersen KV, Andersen NT, Søballe K. “To whom do the results of this trial apply?” External validity of a randomized controlled trial involving 130 patients scheduled for primary total hip replacement. Acta Orthop. 2007;78:12–18. doi: 10.1080/17453670610013367.
    1. Hayden JA, van Tulder MW, Tomlinson G. Systematic review: Strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142:776–785. doi: 10.7326/0003-4819-142-9-200505030-00014.
    1. Vermeire EEIJ, Wens J, Van Royen P, Biot Y, Hearnshaw H, Lindenmeyer A. Interventions for improving adherence to treatment recommendationsin people with type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews. 2005;18:CD003638.
    1. Symmons DPM. Methodological issues in conducting and analyzing longitudinal observational studies in rheumatoid arthritis. J Rheumatol. 2004;31:30–34.
    1. MacDermid JC, Solomon P, Prkachin K. The Shoulder Pain and Disability Index demonstrates factor, construct and longitudinal validity. BMC Musculoskelet Disord. 2006;7:12–22. doi: 10.1186/1471-2474-7-12.
    1. Hart DL, Cook KF, Mioduski JE, Teal CR, Crane PK. Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function. J Clin Epidemiol. 2006;59:290–298. doi: 10.1016/j.jclinepi.2005.08.006.
    1. Blasier RB, Soslowsky LJ, Malicky DM, Palmer ML, Michigan AA. Posterior glenohumeral subluxation:active and passive stabilisation in a biomechanical model. J Bone Joint Surg Am. 1997;79:433–440. doi: 10.1302/0301-620X.79B3.7394.
    1. Rowe CR, Patel D, Southmayd WW. The Bankart procedure: a long term end-result study. J Bone Joint Surg Am. 1978;60:1–16.
    1. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff: end-result study of factors influencing reconstruction. J Bone Joint Surg Am. 1986;68:1136–1144.
    1. Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, Iannotti JP, Mow VC, Sidles JA, Zuckerman JD. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3:347–352. doi: 10.1016/S1058-2746(09)80019-0.
    1. Cook KF, Roddey TS, Gartsman GM, Olson SL. Development and psychometric evaluation of the Flexiscale of Shoulder Function. Medical Care. 2003;41:823–825. doi: 10.1097/00005650-200307000-00006.
    1. Bot SD, Terwee CB, Van der Windt DAWN, Bouter LM, Dekker J, De Vet HCW. Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature. Ann Rheum Dis. 2004;63:335–341. doi: 10.1136/ard.2003.007724.
    1. Jaeschke R, Singer J, Guyatt GH. Measurement of health status:ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10:407–415. doi: 10.1016/0197-2456(89)90005-6.
    1. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A Fear-Avoidance beliefs Questionnaire (FABQ) and the role of fear avoidance beliefs in chronic low back pain and disability. Pain. 1993;52:157–168. doi: 10.1016/0304-3959(93)90127-B.
    1. Mintken PE, Cleland JA, Carpenter KL, Bieniek ML, Kierns M, Whitman JM. Author response to Cibulka M T and Harrell F.E. on "Some factors predict successful short term outcomes in individuals with shoulder pain receiving cervicothoracic manipulation: a single arm trial". Phys Ther. 2010;90:644–645. doi: 10.2522/ptj.2010.90.4.644.
    1. Schellingerhout JM, Verhagen AP, Thomas S, Koes BW. Lack of uniformity in diagnostic labeling of shoulder pain: Time for a different approach. Man Ther. 2008;13:478–483. doi: 10.1016/j.math.2008.04.005.
    1. Green R, Shanley K, Taylor NF, Perrott M. The anatomical basis for clinical tests assessing musculoskeletal function of the shoulder. Phys Ther Rev. 2008;13:17–24.
    1. May S, Greasley A, Reeve S, Withers S. Expert therapists use specific clinical reasoning processes in the assessment and management of patients with shoulder pain: a qualitative study. Aust J Physiother. 2008;54:261–266. doi: 10.1016/S0004-9514(08)70005-9.
    1. de Winter AF, Jans MP, Scholten RJPM, Devillé W, van Schaardenburg D, Bouter LM. Diagnostic classification of shoulder disorders: interobserver agreement and determinants of disagreement. Ann Rheum Dis. 1999;58:272–277. doi: 10.1136/ard.58.5.272.
    1. Ostor AJK, Richards CA, Prevost AT, Hazleman BL, Speed CA. Interrater reproducibility of clinical tests for rotator cuff lesions. Ann Rheum Dis. 2004;63:1288–1292. doi: 10.1136/ard.2003.014712.
    1. Hegedus EJ, Goode A, Campbell S, Morin A, Tamaddoni M, Moorman CT, Cook C. Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests. Br J Sports Med. 2008;42:80–92.
    1. Lewis JS, Tennent TD. In: Evidence Based Sports Medicine. 2. MacAuley D, Best TM, editor. London: Blackwell Publishing; 2007. How effective are diagnostic tests for the assessment of rotator cuff disease of the shoulder? pp. 327–360.
    1. Worland RL, Lee D, Orozco CG, SozaRex F, Keenan J. Correlation of age, acromial morphology, and rotator cuff tear pathology diagnosed by ultrasound in asymptomatic patients. J South Orthop Assoc. 2003;12:23–26.
    1. Lewis JS. Subacromial impingement syndrome: a musculoskeletal condition or a clinical illusion? Phys Ther Rev. 2011;16:388–397. doi: 10.1179/1743288X11Y.0000000027.
    1. Milgrom C, Schaffler M, Gilbert S, van Holsbeeck M. The effect of age, hand dominance and gender. J Bone Joint Surg Br. 1995;77:296–298.
    1. Frost P, Anderssen JH, Lundorf E. Is supraspinatus pathology as defined by magnetic resonance imaging associated with clinical sign of shoulder impingement? J Shoulder Elbow Surg. 1999;8:565–568. doi: 10.1016/S1058-2746(99)90090-3.
    1. Miniaci A, Mascia AT, Salonen DC, Becker EJ. Magnetic responance imaging of the shoulder in asymptomatic professional baseball pitchers. Am J Sports Med. 2002;30:66–73.
    1. Smith C, Deans V, Drew S. The Sourcil sign: a useful finding on plain x-ray? Should Elb. 2010;2:9–12. doi: 10.1111/j.1758-5740.2009.00034.x.
    1. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance imaging associated with clinical sign of shoulder impingement? J Bone Joint Surg Am. 1995;77:10–15.
    1. Lewis JS. Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment? Br J Sports Med. 2009;43:259–264. doi: 10.1136/bjsm.2008.052183.
    1. Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, Hay EM. A primary care back pain screening tool: Identifying patient subgroups for initial treatment. Arthritis Care Res. 2008;59:632–641. doi: 10.1002/art.23563.
    1. Waddell G. The Back Pain Revolution. 2. Edinburgh: Churchill Livingstone; 2004.
    1. Morrison DS, Frogameni AD, Woodworth P. Non-operative treatment of subacromial impingement syndrome. J Bone Joint Surg Am. 1997;79:732–737.
    1. Bartolozzi Ay D, Andreychik D, Ahmad S. Determinants of outcome in the treatment of rotator cuff disease. Clin Orthop Relat Res. 1994;308:90–97.
    1. Mintken PE, Cleland JA, Whitman JM, George SZ. Psychometric properties of the fear-avoidance beliefs questionnaire and Tampa scale of kinesiophobia in patients with shoulder pain. Arch Phys Med Rehabil. 2010;91:1128–1136. doi: 10.1016/j.apmr.2010.04.009.

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