Evaluation of measurement properties of self-administered PROMs aimed at patients with non-specific shoulder pain and "activity limitations": a systematic review.

OBJECTIVE: To critically appraise and compare the measurement properties of self-administered patient-reported outcome measures (PROMs) focussing on the shoulder, assessing "activity limitations." STUDY DESIGN: Systematic review. The study population had to consist of patients with shoulder pain. We excluded postoperative patients or patients with generic diseases. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist. RESULTS: Out of a total of 3427 unique hits, 31 articles, evaluating 7 different questionnaires, were included. The SPADI is the most frequently evaluated PROM and its measurement properties seem adequate apart from a lack of information regarding its measurement error and content validity. CONCLUSION: For English, Norwegian and Turkish users, we recommend to use the SPADI. Dutch users could use either the SDQ or the SST. In German, we recommend the DASH. In Tamil, Slovene, Spanish and the Danish languages, the evaluated PROMs were not yet of acceptable validity. None of these PROMs showed strong positive evidence for all measurement properties. We propose to develop a new shoulder PROM focused on activity limitations, taking new knowledge and techniques into account.

Pain severity and catastrophising modify treatment success in neck pain patients in primary care.

The objective of this study was to evaluate whether clinical factors at baseline in patients with non-specific neck pain are related to recovery after treatment with manual therapy versus physiotherapy. Participating physiotherapists recruited new consulters with complaints of the neck and/or upper extremity. For this study we selected patients from this cohort with non-specific neck complaints. Participants filled in questionnaires at baseline, 3 and 6 months. The main outcome measure was recovery at 6 months follow-up. Possible predictors like complaint-specific factors, physical factors, social and psychological factors were evaluated for interaction with treatment. Of the 396 participants in this study, 97 (24.5%) received manual therapy, all others received physiotherapy, consisting of exercises, massage or physical applications. In the multivariable model four variables were significantly related to recovery: duration of complaint, catastrophising, distress and somatisation. Severity of main complaint and catastrophising appeared to show interaction with treatment. It appeared that every point increase in severity or catastrophising resulted in a lower chance to recover from physiotherapy compared to manual therapy. In conclusion, severity of main complaint and catastrophising seem to modify treatment success. Increased pain severity or catastrophising at baseline increased the chance of treatment success after manual therapy compared to physiotherapy.

[Aspecific shoulder complaints: literature review to assess the efficacy of current interventions]. / Aspecifieke schouderklachten: geen effectiviteit van de gangbare behandelingen; literatuurstudie.

OBJECTIVE: To assess the efficacy of current interventions for shoulder complaints in adults. DESIGN: Systematic literature review. METHOD: Medline and the Cochrane Library were searched for systematic reviews and randomised studies on the efficacy of interventions for shoulder complaints in adults. Studies of patients with an identifiable cause of shoulder symptoms or an underlying disease were excluded. Studies evaluating pain, function and duration of symptoms were included. RESULTS: Of the III randomised clinical trials found, only a few (19) focused on aspecific shoulder complaints; the remainder involved poorly defined subgroups. II useful studies were identified. There was little or no evidence to support or refute the efficacy of NSAIDs, exercise therapy, manipulative therapy, corticosteroid injection and acupuncture in comparison to placebo for the treatment of shoulder complaints. Moderate evidence was found to support the efficacy of NSAIDs, exercise therapy, manipulative therapy, corticosteroid injection and acupuncture in head-to-head comparisons with one another. These effects were not clinically relevant. The effect of adjuvant ultrasound therapy was comparable to that of placebo. CONCLUSION: The available evidence indicates that the efficacy of interventions commonly used in The Netherlands for shoulder complaints is low, and the positive evidence available suggests a clinically irrelevant effect.