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Predicting change in symptoms and function in patients with persistent shoulder pain: a prognostic model development
Mathias Moselund Rønnow1, Thor André Brøndberg Stæhr2, David Høyrup Christiansen2
1Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark. mathro@rm.dk.
A new prognostic model for persistent shoulder pain was developed, but its clinical utility is currently limited due to imprecise predictions. Further research is needed to improve its accuracy and applicability in guiding physiotherapy treatment.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Clinical Epidemiology
Background:
- Persistent shoulder pain significantly impacts individuals and healthcare systems.
- Effective treatment and referral pathways are vital for successful outcomes.
- A prognostic model is needed to guide physiotherapy for persistent shoulder pain.
Purpose of the Study:
- To develop a prognostic model for persistent shoulder pain.
- To predict symptom and function changes in patients undergoing physiotherapy.
Main Methods:
- Prospective cohort study of 243 patients with persistent shoulder pain.
- Data collected at baseline and 6-month follow-up.
- Multivariable linear regression used to develop the prognostic model.
Main Results:
- The final model included seven predictors: baseline QuickDASH score, employment, education, movement impairment, pain coping, quality of life, and pain catastrophizing.
- The model explained 33% of the variance in QuickDASH change scores.
- The model's root mean squared error indicated imprecise individual change score predictions.
Conclusions:
- The developed prognostic model has limited clinical utility in its current form due to imprecision.
- Further refinement is required to improve model performance and precision.
- Novel predictors like movement impairment classification and health-related quality of life warrant further investigation.
