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Do bio-psycho-social self-reported factors distinguish rotator cuff tendinopathy from other shoulder problems and explain shoulder severity? A case–control study
Physiotherapy (United Kingdom) ; 114:e86-e87, 2022.
Article in English | EMBASE | ID: covidwho-1707356
ABSTRACT
Keywords Tendinopathy;Rotator cuff;Digital transformation

Purpose:

Similar associations between self-reported bio-psycho-social factors and the presentation of people with various shoulder disorders and rotator cuff (RC) tendinopathy have been reported;however, only limited numbers of variables have been assessed, often in small cohorts. We aimed to test whether RC tendinopathy could be distinguished from other shoulder problems using a range of bio-psycho-social self-reported factors and the degree to which they explain severity.

Methods:

Self-reported bio-psycho-social factors were collected via an online survey battery from an international sample. The dependent variables were diagnosis (having RC tendinopathy or other shoulder problems) and severity. After group comparison and univariate regression analyses, multivariable logistic and linear regression analyses were used to construct explanatory models for group differences and severity.

Results:

82 people with RC tendinopathy (42.8 ± 13.9 years, 50 female) and 54 people with other shoulder problems (40.2 ± 14.1 years, 33 female) were recruited and found not to differ in severity on four patient-reported PROMs (Shoulder Pain and Disability Index (SPADI) = 37.3 ± 24.5 vs 33.7 ± 22.5, Western Ontario Rotator Cuff Index (WORCI) = 56.2 ± 22.0 vs 60.3 ± 22.2, Single Assessment Numeric Evaluation = 56.6 ± 25.3 vs 56.5 ± 28.7 and Patient Acceptable Symptomatic State (yesno) 5131 vs 2322, respectively). Eight self-reported factors individually distinguished RC tendinopathy from other shoulder problems, with the model distinguishing tendinopathy from other shoulder problems including 4 variables;having a previous injury in the shoulder (OR (95% CI) = 0.30 (0.13–0.69)), activity effect on pain (OR (95% CI) = 2.24 (1.02–4.90)), General Self-Efficacy Score (OR (95% CI) = 1.12 (1.02–1.22)) and activity level according to Global Physical Activity Questionnaire (moderately active OR (95% CI) = 3.97 (1.29–12.18) and highly active OR (95% CI) = 3.66 (1.41–9.48)), with acceptable overall model accuracy. Univariate linear regression analysis showed that 32 variables were associated with RC tendinopathy severity with a multivariable model consisting of quality of life (β coefficient = −0.38), having night pain (β = 0.19), having unilateral morning stiffness (β = 0.25), BMI (β = 0.29), FABQ (work) score (β = 0.25);and pain catastrophising (β = 0.21) explaining 68% of the variance in severity. Conclusion(s) Well validated patient-reported outcomes to explain severity do not distinguish RC tendinopathy from other shoulder problems however self-reported bio-psycho-social factors do, so may be useful for clinical evaluation. Further, these factors were strongly associated with severity, reinforcing the potential to improve patient assessment, for example, using pre-consultation online data collection in usual care. The models warrant prospective validation and consideration alongside data from physical and imaging assessment. Impact Online survey including self-reported bio-psycho-social factors may help augment diagnosis and, more importantly, provide some of the detail needed for holistic assessment by complementing physical examination and imaging. Therefore, the online survey may be useful to minimise the clinical time commitment and optimising safety during the Covid-19 pandemic. Funding acknowledgements The review is a part of Mehmet Delen's Ph.D., which is sponsored by the Turkish Ministry of National Education. The sponsors had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study Language: English Journal: Physiotherapy (United Kingdom) Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Observational study / Prognostic study Language: English Journal: Physiotherapy (United Kingdom) Year: 2022 Document Type: Article