Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice

Yasmaine H J M Karel, Arianne P Verhagen, Marloes Thoomes-de Graaf, Edwin Duijn, Maaike P J van den Borne, Annechien Beumer, Ramon P G Ottenheijm, Geert-Jan J Dinant, Bart W Koes, Gwendolijne G M Scholten-Peeters

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: Health care providers need prognostic factors to distinguish between patients who are likely to recover and those who are not likely to recover.

OBJECTIVE: The aim of this study was to: (1) describe the clinical course of recovery and (2) identify prognostic factors of recovery in patients with shoulder pain at the 26-week follow-up.

DESIGN: A prospective cohort study was carried out in the Netherlands and included 389 patients who consulted a physical therapist for a new episode of shoulder pain.

METHOD: Participants were followed for 26 weeks. Potential predictors of recovery were selected from the literature and, with the addition of 2 new variables (ie, use of diagnostic ultrasound and working alliance), evaluated in the multivariable regression analysis. Multiple imputation was used to handle missing data, and bootstrap methods were used for internal validation.

RESULTS: The recovery rate was 60% for the total population and 65% for the working population after 26 weeks. Short duration of complaints, lower disability scores, having a paid job, better working alliance, and no feelings of anxiety or depression were associated with recovery. In the working population, only duration of complaints and disability remained in the final model. The area under the receiver operating characteristic curve (AUC) for the final model was 0.67 for the total population and 0.63 for the working population. After internal validation, the AUC was corrected to 0.66 and 0.63, respectively.

LIMITATIONS: External validation of the prognostic model should be done prior to its use in clinical practice.

CONCLUSION: The results of this study indicate that several factors can predict recovery.

Original languageEnglish
Pages (from-to)72-80
JournalPhysical Therapy
Volume97
Issue number1
Early online date18 Aug 2016
DOIs
Publication statusPublished - 1 Jan 2017

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Physical Therapists
Shoulder Pain
Population
Area Under Curve
ROC Curve
Health Personnel
Netherlands
Ultrasonography
Emotions
Cohort Studies
Anxiety
Regression Analysis
Prospective Studies
Depression

Keywords

  • Journal Article

Cite this

Karel, Y. H. J. M., Verhagen, A. P., Thoomes-de Graaf, M., Duijn, E., van den Borne, M. P. J., Beumer, A., ... Scholten-Peeters, G. G. M. (2017). Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice. Physical Therapy, 97(1), 72-80. https://doi.org/10.2522/ptj.20150649
Karel, Yasmaine H J M ; Verhagen, Arianne P ; Thoomes-de Graaf, Marloes ; Duijn, Edwin ; van den Borne, Maaike P J ; Beumer, Annechien ; Ottenheijm, Ramon P G ; Dinant, Geert-Jan J ; Koes, Bart W ; Scholten-Peeters, Gwendolijne G M. / Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice. In: Physical Therapy. 2017 ; Vol. 97, No. 1. pp. 72-80.
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Karel, YHJM, Verhagen, AP, Thoomes-de Graaf, M, Duijn, E, van den Borne, MPJ, Beumer, A, Ottenheijm, RPG, Dinant, G-JJ, Koes, BW & Scholten-Peeters, GGM 2017, 'Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice' Physical Therapy, vol. 97, no. 1, pp. 72-80. https://doi.org/10.2522/ptj.20150649

Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice. / Karel, Yasmaine H J M; Verhagen, Arianne P; Thoomes-de Graaf, Marloes; Duijn, Edwin; van den Borne, Maaike P J; Beumer, Annechien; Ottenheijm, Ramon P G; Dinant, Geert-Jan J; Koes, Bart W; Scholten-Peeters, Gwendolijne G M.

In: Physical Therapy, Vol. 97, No. 1, 01.01.2017, p. 72-80.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice

AU - Karel, Yasmaine H J M

AU - Verhagen, Arianne P

AU - Thoomes-de Graaf, Marloes

AU - Duijn, Edwin

AU - van den Borne, Maaike P J

AU - Beumer, Annechien

AU - Ottenheijm, Ramon P G

AU - Dinant, Geert-Jan J

AU - Koes, Bart W

AU - Scholten-Peeters, Gwendolijne G M

N1 - © 2016 American Physical Therapy Association.

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N2 - BACKGROUND: Health care providers need prognostic factors to distinguish between patients who are likely to recover and those who are not likely to recover.OBJECTIVE: The aim of this study was to: (1) describe the clinical course of recovery and (2) identify prognostic factors of recovery in patients with shoulder pain at the 26-week follow-up.DESIGN: A prospective cohort study was carried out in the Netherlands and included 389 patients who consulted a physical therapist for a new episode of shoulder pain.METHOD: Participants were followed for 26 weeks. Potential predictors of recovery were selected from the literature and, with the addition of 2 new variables (ie, use of diagnostic ultrasound and working alliance), evaluated in the multivariable regression analysis. Multiple imputation was used to handle missing data, and bootstrap methods were used for internal validation.RESULTS: The recovery rate was 60% for the total population and 65% for the working population after 26 weeks. Short duration of complaints, lower disability scores, having a paid job, better working alliance, and no feelings of anxiety or depression were associated with recovery. In the working population, only duration of complaints and disability remained in the final model. The area under the receiver operating characteristic curve (AUC) for the final model was 0.67 for the total population and 0.63 for the working population. After internal validation, the AUC was corrected to 0.66 and 0.63, respectively.LIMITATIONS: External validation of the prognostic model should be done prior to its use in clinical practice.CONCLUSION: The results of this study indicate that several factors can predict recovery.

AB - BACKGROUND: Health care providers need prognostic factors to distinguish between patients who are likely to recover and those who are not likely to recover.OBJECTIVE: The aim of this study was to: (1) describe the clinical course of recovery and (2) identify prognostic factors of recovery in patients with shoulder pain at the 26-week follow-up.DESIGN: A prospective cohort study was carried out in the Netherlands and included 389 patients who consulted a physical therapist for a new episode of shoulder pain.METHOD: Participants were followed for 26 weeks. Potential predictors of recovery were selected from the literature and, with the addition of 2 new variables (ie, use of diagnostic ultrasound and working alliance), evaluated in the multivariable regression analysis. Multiple imputation was used to handle missing data, and bootstrap methods were used for internal validation.RESULTS: The recovery rate was 60% for the total population and 65% for the working population after 26 weeks. Short duration of complaints, lower disability scores, having a paid job, better working alliance, and no feelings of anxiety or depression were associated with recovery. In the working population, only duration of complaints and disability remained in the final model. The area under the receiver operating characteristic curve (AUC) for the final model was 0.67 for the total population and 0.63 for the working population. After internal validation, the AUC was corrected to 0.66 and 0.63, respectively.LIMITATIONS: External validation of the prognostic model should be done prior to its use in clinical practice.CONCLUSION: The results of this study indicate that several factors can predict recovery.

KW - Journal Article

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JO - Physical Therapy

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Karel YHJM, Verhagen AP, Thoomes-de Graaf M, Duijn E, van den Borne MPJ, Beumer A et al. Development of a Prognostic Model for Patients With Shoulder Complaints in Physical Therapist Practice. Physical Therapy. 2017 Jan 1;97(1):72-80. https://doi.org/10.2522/ptj.20150649