Abstract
BackgroundShoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain.MethodsA prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery.DiscussionThe ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.
Highlights
Shoulder pain is disabling and has a considerable socio-economic impact
This paper describes the ShoCoDiP (Shoulder Complaints and the use of Diagnostic Ultrasound in Physiotherapy practice) cohort study
The proposed study will describe the current management of shoulder pain in primary care and will help to determine which factors can predict patient recovery in PT practice
Summary
Over 50% of patients presenting in primary care still have symptoms after 6 months; prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Publishing the design of a study provides insight into the objectives and procedures before publishing the results It may protect against (subconscious) selective outcome reporting. There is strong evidence that prognostic factors for shoulder pain such as age, high disability scores, duration of shoulder pain and pain intensity are associated with poor outcome [4,8,9]. Having a specific diagnosis like bursitis, rotator cuff tear and frozen shoulder is reported to be a predictor for increased recovery in patients with upper extremity disorders compared to patients with a non-specific diagnosis in general practice [8]
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