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Will my shoulder pain get better? - secondary analysis of data from a multi-arm randomised controlled trial
Marc-Olivier Dubé1, François Desmeules2, Jeremy Lewis3
1Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec G1M 2S8, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec G1R 1P5, Canada; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
Objective:
To determine whether higher level or improvements over time in pain self-efficacy (PSE) and expectations of intervention effectiveness lead to better outcomes and whether the intervention used to manage rotator cuff related shoulder pain (RCRSP) impacts PSE and expectations over time.
Design:
Secondary analysis of data from a randomised controlled trial.
Participants:
123 individuals (48 [15] years old; 51% female) with RCRSP.
Interventions:
Participants randomised into one of three 12-weeks interventions (education; education and motor control exercises; education and strengthening exercises).
Main Outcome Measures:
QuickDASH and Western Ontario Rotator Cuff Index (WORC) were administered at baseline and 12 weeks. Pain self-efficacy was assessed at 0 and 6 weeks. Patients' expectations regarding intervention effectiveness were assessed before randomisation and after the first and the last intervention sessions. NparLD were used for the analyses. A time effect indicated a significant change in patients' expectations or PSE over time, while a resolution effect indicated a significant difference in patients' expectations or PSE between those whose symptoms resolved and those whose did not.
Results:
Patients' expectations (-3 to 3) increased over time (0.33/3 [0.19 to 0.77]). Overall expectations were higher for those who experienced symptom resolution based on the WORC (0.19/3 [0.05 to 0.33]). PSE increased over time (5.5/60 [3.6 to 7.4]). Overall PSE was higher for those who experienced symptom resolution based on the WORC (7.0 [3.9 to 10.1]) and the QuickDASH (4.9 [1.7 to 8.2]).
Conclusion:
Clinicians should consider monitoring PSE and patients' expectations as they are important indicators of outcome. CONTRIBUTION OF THE PAPER.
