Scientific/Clinical Article| Volume 30, ISSUE 2, P200-207, April 2017

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Factors influencing final outcomes in patients with shoulder pain: A retrospective review


      Study Design

      Retrospective cohort.


      Rehabilitation interventions are commonly prescribed for patients with shoulder pain, but it is unclear what factors may help clinicians' prognosis for final outcomes.

      Purpose of the Study

      The purpose of this study is to determine what factors are the best predictors of improved patient-reported outcomes at discharge in patients with shoulder pain.


      Retrospective chart review of 128 patients presenting with shoulder pain to an outpatient physical therapy clinic. Chart review captured data regarding patient demographics, treatment interventions, patient history, and patient-reported outcome scores. The primary dependent variable was the overall change score of the QuickDASH (initial to discharge). Thirty-eight predictor variables were entered into a forward stepwise multivariate linear regression model to determine which variables and to what degree contributed to the dependent variable.


      The linear regression model identified 5 predictor variables that yielded an R = 0.74 and adjusted R2 = 0.538 (P < .001). The 5 predictor variables identified in order of explained variance are QuickDASH change at the fifth visit, a total number of visits, initial QuickDASH score, scapular retraction exercise, and age.


      Early change scores, equal to minimal detectable change scores on patient-reported outcomes appear to be strong indicators that patients with shoulder pain are on a positive trajectory to benefit from rehabilitation.


      Using patient-reported outcomes throughout care, not just at the start and end of care, will provide therapist feedback regarding patient's progress and indicate treatment effectiveness.

      Levels of Evidence



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      JHT Read for Credit

      Quiz: #488

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        The study design is
        • a.
        • b.
          prospective cohort
        • c.
          retrospective cohort
        • d.
          case series
      • #2.
        The primary purpose of the study was to identify the best__________________ for patients with shoulder pain
        • a.
          predictors of outcomes
        • b.
        • c.
          evaluation techniques
        • d.
      • #3.
        The primary dependent variable was the
        • a.
          McClure graded outcome measure (MGOM)
        • b.
          Mayo Clinic outcome scale (MCOS)
        • c.
          Rockwood and Matsen method (RAMM)
        • d.
          Quick-DASH change score
      • #4.
        In reviewing published studies, the authors found ________ which they characterized as “high quality”
        • a.
        • b.
        • c.
        • d.
      • #5.
        The authors recommend doing patient rated outcome measures initially and at the conclusion of therapy, but not midway through the course of treatment
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.